| ObjectiveThis study is an observation of clinical effect treated by warm acupuncture combined with lifestyle intervention comparing with only lifestyle intervention for kidney deficiency type of PCOS.We evaluate menstrual cycle,sex hormone levels and Traditional Chinese Medicine symptoms as clinical evidence.MethodsThis study is a prospective randomized controlled study.We admitted patients from gynecological clinic and acupuncture clinic of Shenzhen Baoan Traditional Chinese Medicine Hospital Group from November 2017 to December 2018.On the basis of simple randomization,the participants were divided into experimental group and control group with 30 cases in every group.Patients in control group were treated with only lifestyle intervention,including diet intervention and exercise intervention.Apart from the same lifestyle intervention as control group,participants in treatment group were treated with warm acupuncture on Sanyinjiao(SP6),Guanyuan(RN4),Zhongji(RN3),Zigong(EX-CA1)and Rangu(KI2).Moxibustion was performed on one column,and acupuncture was kept for half an hour.Patients in treatment group were treated once every two days in two weeks before menstruation,the period of treatment was conducted for three months.Sexual hormone,menstrual status and Traditional Chinese Medicine syndrome scores of the patients before and after intervention were recorded as clinical evidence.SPSS 23 was used for statistically analyse data.ResultsBefore intervention,there is no differences(p>0.05)in age,period of disease,sex hormone levels or TCM syndrome score in two groups,with no statistical significance or comparability.After intervention,the efficiency of improvement of menstruation in experimental group is 86.67%,while the efficiency in control group is 80.00%,p>0.05,with no statistical significance.It indicates that two groups have comparable menstrual conditions after treatment.Before and after intervention,the difference in sex hormone levels of two groups is respectively significant on T,LH and the rate of LH/FSH.The difference of two groups on T(p<0.05)and LH(p<0.01)are significant in statistics,which indicates that the warm acupuncture combined with lifestyle intervention have obvious advantages in adjusting T and LH comparing with only intervention of lifestyle.After treatment,the efficiency of TCM syndrome score in treatment group is 86.67%,while the efficiency in control group is 83.33%(p>0.05).The difference is no significant in statistics.It indicates that the efficacy index of TCM syndrome after treatment of the two groups is comparable.ConclusionIn general,according to the results of this clinical trial,it can be concluded that warm acupuncture combined with lifestyle intervention can significantly improve the levels of LH and T,as well as the efficacy score of Traditional Chinese Medicine symptoms,which has obvious advantages over lifestyle intervention alone.Although there was no significant difference between two groups in LH/FSH,the data before and after treatment were significantly improved.Warm acupuncture combined with lifestyle intervention has obvious advantages in improving the patients suffering from kidney deficiency type of PCOS.Obvious advantages are shown in aspects of LH,T and Traditional Chinese Medicine symptoms.Its mechanism may be related to warm acupuncture can remove cold,invigorate the circulation of Qi and blood,adjust the function of the hypothalamus-pituitary gonadal axis,improve endocrine,promote metabolism,and so on.Combined with selected acupoints can warming and invigorating kidney yang,enhance the role of reproductive function.In terms of menstrual adjustment,the results of this study showed that there was no significant difference in the curative effect of the two interventions on patients' menstrual conditions.Before the intervention,only the number of menstruation in the 3 months prior to the treatment was investigated.And the patient' s menstruation was not completely or comprehensively recorded,including the menstrual cycle,the time of irregular menstruation,such as the period of amenorrhea recorded.I communicated with patients in the process of intervene and have a understanding that there is obvious difference in irregular menstruation of PCOS patients.Some patients'menstruation delayed only 10 to 15 days,while some patients' amenorrhea lasted for 1-1.5 years,and some patients' menstrual cycle is not stable.This situation leads to differences in menstrual status basic data.However,there is no detailed menstrual status before intervention.No evidence can illustrate whether the differences would have an effect on the results of the study.Warm acupuncture used in kidney deficiency type of PCOS have function of warming kidney Yang,invigorating the circulation of cold,adjusting the hypothalamus-pituitary gonad axis function,improving endocrine and reproductive function and promoting human metabolism.As a result,it can adjust the menstrual cycle and menstrual quantity,adjust the sex hormone levels,lose weight,improve insulin resistance,relieve acne,and improve the quality of life.The influence of wrong lifestyle on PCOS is mainly to cause metabolic disorders,which are manifested as obesity,insulin resistance,type 2 diabetes,dyslipidemia and so on.Life intervention mainly includes diet adjustment,strengthening exercise and weight loss.The low-nutrition and high-calorie diet of PCOS patients is believed to be the cause of ovulation disorders and metabolic abnormalities.This dietary pattern is likely to cause disorders of glucose metabolism,abnormal glucose tolerance,insulin resistance,type 2 diabetes and so on.Long-term bad eating habits easily cause excess calorie and fat accumulation,which lead to obesity and dyslipidemia.Most PCOS patients lack of exercise.By doing scientific and reasonable exercise,patients can promote the metabolism of sugar and fat in the body,reduce the level of insulin,abnormal blood lipid and other conditions.At the same time,scientific diet and reasonable exercise is the key to weight control.The results of this study showed that the therapeutic effect of lifestyle intervention on PCOS patients was significant.We can be inspired to study the influence of lifestyle intervention on PCOS in terms of food type,quantity,exercise mode,time,intensity,proportion in various aspects and its main change factors,and monitor the patient' s implementation.The curative effect of warm acupuncture on PCOS patients in adjusting menstruation has not been fully demonstrated,and further study should be carried out under the conditions of changing the control group,modifying the inclusion criteria,and increasing the observation indicators to observe the therapeutic effect of warm acupuncture on PCOS. |
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