Clinical Observation Of Acupuncture Combined With Metformin In The Treatment Of Polycystic Ovary Syndrome With Insulin Resistance

Background Polycystic ovary syndrome(PCOS)is a common gynecological condition caused by endocrine disorders and multiple metabolic abnormalities,and is the most common endocrine disorder in women of reproductive age.Studies have confirmed that insulin resistance(IR)is a key factor in the development of PCOS,and the presence of insulin resistance in PCOS patients has long-term effects on overall health,such as an increased risk of endometrial cancer,type 2 diabetes and cardiovascular events.Therefore,it is particularly important to treat PCOS by improving insulin resistance in terms of the key factors that contribute to the development and progression of PCOS.Objective The clinical efficacy of acupuncture combined with metformin on phlegm-damp PCOS-IR was observed based on the theory of "Shuang Gu Yi Tong" acupuncture,providing a safe and effective treatment method for PCOS-IR.Methods From January 2021 to September 2022,64 cases meeting the inclusion criteria from the Department of Gynecology of the Second People’s Hospital of Yichang were selected according to the randomized control method and randomly divided into 32 cases in the experimental group(needle and medicine group)and 32 cases in the control group(western medicine group).The western medicine group was treated with oral metformin,and the needle medicine group was treated with "Shuanggu Yitong" acupuncture on top of oral metformin.The combination of acupuncture and medicine was comprehensively evaluated by observing menstrual status,fasting glucose,fasting insulin,HOMA-IR,waist-hip ratio,BMI,TCM symptoms,sex hormone level and safety indexes on phlegm The clinical efficacy of the combination of acupuncture and medicine on phlegmatic PCOS-IR was evaluated by observing menstrual status,fasting insulin,HOMA-IR,waist-to-hip ratio,BMI,TCM symptoms,sex hormone level and safety indexes.Results 1.Within-group comparison: using spss26.0 software,the symptoms,signs and clinical examination indexes before and after treatment in the needle medicine group and the western medicine group were compared.The Chinese medicine evidence points,menstrual status,weight,BMI,waist circumference,hip circumference,waist-hip ratio,serum sex hormone levels(LH,T,LH/FSH)and glucose metabolism indexes(fasting glucose,fasting insulin,HOMA-IR)in the two groups were all improved compared with The difference was statistically significant(P<0.05);there was no significant improvement in FSH in both groups after treatment,suggesting that the difference was not statistically significant(P> 0.05).2.Comparison between groups: compare the symptoms,signs and clinical examination indexes before and after treatment between the needle medicine group and the western medicine group.There were no statistical differences in age,disease duration,menstrual score,weight,BMI,waist circumference,hip circumference,waist-to-hip ratio,TCM syndrome score,sex hormone level and glucose metabolism indexes between the two groups before treatment,which were comparable(P>0.05).After treatment in both groups,the decrease in menstrual scores and TCM syndrome points was more significant in the needle and medicine group(P<0.05),and the difference was statistically significant.The waist circumference,waist-hip ratio,sex hormone levels(LH,T,LH/FSH),fasting blood glucose,fasting insulin,and HOMA-IR improved better in the needle and medicine group than in the western medicine group,and the difference was statistically significant(P<0.05);there was no significant difference in weight,BMI,hip circumference,and FSH,and the difference was not statistically significant(P>0.05).After three months of treatment in the two groups,the cure rate,apparent efficiency and effective rate of the needle and medicine group(22.6%,58.1% and 93.5%,respectively)and the cure rate,apparent efficiency and effective rate of the western medicine group(6.3%,21.9% and 65.7%,respectively)were compared,and the results were statistically significantly different(P < 0.05);the total clinical efficacy was compared,the cure rate of the needle and medicine group was 9.67% and The total clinical efficacy was 9.67% and 83.87% in the acupuncture group,and 3.12% and 46.88% in the western medicine group,with significant differences(P<0.05).Conclusion 1."Shuang Gu Yi Tong" acupuncture and circumference adjustment method with metformin can further improve the menstrual condition and improve the TCM symptoms of phlegm-damp PCOS-IR patients.2.The combination of "Shuang Gu Yi Tong" acupuncture circumference adjustment method with metformin is better than metformin alone in improving waist circumference,waist-to-hip ratio,serum sex hormone levels(LH,T,LH/FSH)and glucose metabolism indexes(fasting glucose,fasting insulin,HOMA-IR)are superior to metformin alone.