[1]滕 婧,杨 柳.祛湿化痰方联合针刺治疗脾虚痰湿型多囊卵巢综合征疗效研究[J].陕西中医,2023,(12):1813-1818.[doi:DOI:10.3969/j.issn.1000-7369.2023.12.033]
 TENG Jing,YANG Liu.Effect of Qushi Huatan recipe combined with acupuncture on spleen deficiency phlegm-dampness polycystic ovary syndrome[J].,2023,(12):1813-1818.[doi:DOI:10.3969/j.issn.1000-7369.2023.12.033]
点击复制

祛湿化痰方联合针刺治疗脾虚痰湿型多囊卵巢综合征疗效研究
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年12期
页码:
1813-1818
栏目:
针灸经络
出版日期:
2023-12-05

文章信息/Info

Title:
Effect of Qushi Huatan recipe combined with acupuncture on spleen deficiency phlegm-dampness polycystic ovary syndrome
作者:
滕 婧123杨 柳123
(1.湖北省中医院,湖北 武汉 430061; 2.湖北中医药大学附属医院,湖北 武汉 430061; 3.湖北省中医药研究院,湖北 武汉 430074)
Author(s):
TENG JingYANG Liu
(Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China)
关键词:
多囊卵巢综合征 针刺 脾虚痰湿型 祛湿化痰方 miR-223 miR-181a
Keywords:
Polycystic ovary syndrome Acupuncture Spleen deficiency phlegm-dampness type Qushi Huatan recipe miR-223 miR-181a
分类号:
R 711.75
DOI:
DOI:10.3969/j.issn.1000-7369.2023.12.033
文献标志码:
A
摘要:
目的:探讨祛湿化痰方联合针刺治疗脾虚痰湿型多囊卵巢综合征(PCOS)的疗效及对血清miR-223、miR-181a的影响。方法:选取90例PCOS患者,随机分为对照组和观察组,每组45例。对比两组性激素、卵巢体积、中医症候积分、炎症因子、miR-223、miR-181a水平,分析miR-223、miR-181a与炎症因子的相关性,以及miR-223、miR-181a对PCOS治疗后1年内未妊娠的预测价值。结果:观察组治疗后FSH、LH、T水平低于对照组(均P<0.01)。观察组治疗后卵巢体积小于对照组(P<0.01)。观察组治疗后食欲不振、腹胀、便溏、神疲乏力积分低于对照组(均P<0.01)。观察组治疗后IL-1β、IL-6、TNF-α水平低于对照组(均P<0.01)。观察组治疗后血清miR-223水平低于对照组,miR-181a水平高于对照组(均P<0.01)。血清miR-223水平与IL-1β、IL-6、TNF-α呈正相关,miR-181a水平与IL-1β、IL-6、TNF-α呈负相关(均P<0.01)。观察组妊娠率高于对照组(P<0.01)。miR-223、IL-6为治疗后1年内未妊娠的独立危险因素(OR=2.184,3.180,P<0.01),miR-181a为独立保护因素(OR=0.268,P<0.01)。miR-223、miR-181a及二者联合预测的AUC分别为0.837、0.811、0.934,二者联合预测优于各自单独预测效能(Z=7.168、9.376,P<0.01)。结论:祛湿化痰方联合针刺能调节PCOS患者性激素水平,缩小卵巢体积,降低中医症候积分,抑制炎症反应,降低血清miR-223水平,升高miR-181a水平,miR-223、miR-181a均是PCOS治疗后1年内未妊娠的独立影响因素,二者对治疗后未妊娠有较好的预测价值。
Abstract:
Objective:To investigate the curative effect of Qushi Huatan recipe combined with acupuncture on spleen deficiency phlegm-dampness polycystic ovary syndrome(PCOS)and its influence on serum miR-223 and miR-181a.Methods:A total of 90 patients with PCOS were selected as the research objects.They were divided into observation group and control group randomly,with 45 cases in both groups.Sex hormone,ovarian volume,TCM syndrome score,inflammatory factors,miR-223 and miR-181a levels were compared between the two groups.The correlation between miR-223 and miR-181a and inflammatory factors was analyzed.To analyze the predictive value of miR-223 and miR-181a for non-pregnancy within one year after PCOS treatment.Results:After treatment,the levels of FSH,LH and T in the observation group were dramatically lower than those in the control group(all P<0.01).The ovarian volume in the observation group was smaller compared to the control group(all P<0.01).After treatment,the scores of anorexia,abdominal distension,loose stool and fatigue in the observation group were lower than those in the control group(all P<0.01).After treatment,the levels of IL-1β,IL-6 and TNF-α in observation group were lower than those in control group(all P<0.01).After treatment,the serum miR-223 level in the observation group was lower than that in the control group,and the serum miR-181a level was higher than that in the control group(all P<0.01).Serum miR-223 level was positively correlated with IL-1β,IL-6 and TNF-α,while miR-181a level was negatively correlated with IL-1β,IL-6 and TNF-α(all P<0.01).The pregnancy rate of observation group was higher than that of control group(P<0.01).miR-223 and IL-6 were independent risk factors for non-pregnancy within one year after treatment(OR=2.184,3.180,P<0.01),and miR-181a was independent protective factor(OR=0.268,P<0.01).The AUC of miR-223,miR-181a and the combined prediction was 0.837,0.811 and 0.934,respectively,and the combined prediction was superior to the single prediction(Z=7.168,9.376,P<0.01).Conclusion:Qushi Huatan recipe combined with acupuncture can regulate sex hormone levels in PCOS patients,reduce ovarian volume,reduce TCM syndrome score,inhibit inflammation,reduce serum miR-223 level and increase miR-181a level.Both miR-223 and miR-181a are independent influencing factors for non-pregnancy within one year after treatment.Both of them have good predictive value for non-pregnancy after treatment.

参考文献/References:

[1] 陈艳丹,莫 政,许浪萍,等.补肾助孕汤对肾阳虚型多囊卵巢综合征不孕症患者中医症候评分、血清性激素水平和卵细胞质量的影响[J].陕西中医,2023,44(5):575-578.
[2] Haddad-filho H,Tosatti J,Vale FM,et al.Updates in diagnosing polycystic ovary syndrome-related infertility[J].Expert Rev Mol Diagn,2023,23(2):123-132.
[3] Singh S,Pal N,Shubham S,et al.Polycystic ovary syndrome:Etiology,current management,and future therapeutics[J].J Clin Med,2023,12(4):1454.
[4] 马志宾,陈 燕,苏 永.促排卵汤对多囊卵巢综合征患者血清淀粉样蛋白P、脂肪因子与白介素-18的影响研究[J].陕西中医,2019,40(5):651-654.
[5] Ctar DM,Acar TN.The effect on inflammation of adherence to the mediterranean diet in polycystic ovary syndrome[J].Curr Nutr Rep,2023,12(1):191-202.
[6] Zhou J,Zuo W,Tan Y,et al.Effects of n-3 polyunsaturated fatty acid on metabolic status in women with polycystic ovary syndrome:A meta-analysis of randomized controlled trials[J].J Ovarian Res,2023,16(1):54.
[7] Greff D,Juhasz AE,Vancsa S,et al.Inositol is an effective and safe treatment in polycystic ovary syndrome:A systematic review and meta-analysis of randomized controlled trials[J].Reprod Biol Endocrinol,2023,21(1):10.
[8] 多囊卵巢综合征相关不孕治疗及生育保护共识专家组,中华预防医学会生育力保护分会生殖内分泌生育保护学组.多囊卵巢综合征相关不孕治疗及生育保护共识[J].生殖医学杂志,2020,29(7):843-851.
[9] 刘思祎,俞 洁.多囊卵巢综合征痰湿证的基础及临床研究进展[J].中医药通报,2022,21(5):58-60.
[10] Aziz F,Chakraborty A,Khan I,et al.Relevance of miR-223 as potential diagnostic and prognostic markers in cancer[J].Biology(Basel),2022,11(2):249.
[11] Mortazavi-jahromi SS,Aslani M,Mirshafiey A.A comprehensive review on miR-146a molecular mechanisms in a wide spectrum of immune and non-immune inflammatory diseases[J].Immunol Lett,2020,11(7):8-27.
[12] 中华医学会妇产科学分会内分泌学组及指南专家组.多囊卵巢综合征中国诊疗指南[J].中华妇产科杂志,2018,53(1):2-6.
[13] 国家食品药品监督管理总局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:119.
[14] 钟社兰,陈 星.多囊卵巢综合征与失眠症共病患者临床特征及相关因素分析[J].陕西医学杂志,2023,52(4):437-440.
[15] Mukherjee AG,Wanjari UR,Kannampuzha S,et al.The implication of mechanistic approaches and the role of the microbiome in polycystic ovary syndrome(PCOS):A review[J].Metabolites,2023,13(1):129.
[16] 石 城,李泽武,杨爱军,等.免疫相关细胞因子在多囊卵巢综合征发病机制中的作用[J].中国医药科学,2023,13(1):41-44.
[17] 梁新新,林 睿.二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征所致不孕症对患者胰岛素、胰岛素抵抗指数水平及卵巢排卵功能的影响[J].陕西医学杂志,2023,52(4):460-463.
[18] 张 杏,连 方.炎症细胞因子白介素-6、肿瘤坏死因子-α、转化生长因子-β1在多囊卵巢综合征中作用机制及临床意义的研究进展[J].中国性科学,2022,31(1):47-50.
[19] 庄小平,刘菊莲,李金姑.多囊卵巢综合征不孕症患者血清白介素-1β、神经生长因子的表达及其与体外受精-胚胎移植妊娠结局的相关性[J].中国性科学,2023,32(2):97-100.
[20] Ionescu OM,Frincu F,Mehedintu A,et al.Berberine-A promising therapeutic approach to polycystic ovary syndrome in infertile/pregnant women[J].Life(Basel),2023,13(1):125.
[21] 陶 静.中医药治疗肥胖型多囊卵巢综合征研究进展[J].内蒙古中医药,2022,41(12):161-163.
[22] 李永红,刘玉洁,赵燕燕,等.苍附导痰汤联合通元针法对脾虚痰湿型多囊卵巢综合征患者脂代谢、性激素和子宫内膜容受性的影响[J].现代生物医学进展,2023,23(3):519-523.
[23] 李庆胜,曾静静,丛培玮.从痰论治多囊卵巢综合征的临床研究进展[J].内蒙古中医药,2023,42(2):131-133.
[24] 苟雅姣,赵粉琴,胡芝霞.多囊卵巢综合征病因病机及治疗的研究进展[J].实用中医内科杂志,2022,36(4):11-13.
[25] 李承功,徐莲薇.肥胖型多囊卵巢综合征的辨证论治[J].中国民间疗法,2020,28(2):5-7.
[26] 朱新玉,何鹏庆,武婷婷,等.针刺治疗多囊卵巢综合征机制研究进展[J].实用中医药杂志,2023,39(3):625-628.
[27] 于 泽,孟然然,周慧慧,等.针刺治疗多囊卵巢综合征排卵障碍性不孕作用机制研究[J].环球中医药,2022,15(9):1716-1721.
[28] 吴 笑,董浩旭,张明敏,等.从抗炎角度探讨针刺治疗多囊卵巢综合征机制[J].中西医结合研究,2022,14(1):52-55.
[29] 钟毅征,林 静,谢蓬蓬,等.针刺通过lncRNA MEG3调控AKT/mTOR自噬途径治疗大鼠多囊卵巢综合征的作用机制[J].山西医科大学学报,2022,53(4):448-454.
[30] Samelak-czajka A,Wojciechowski P,Marszalek-zenczak M,et al.Differences in the intraspecies copy number variation of arabidopsis thaliana conserved and nonconserved miRNA genes[J].Funct Integr Genomics,2023,23(2):120.
[31] Tian Y,Wang TS,Bu H,et al.Role of exosomal miR-223 in chronic skeletal muscle inflammation[J].Orthop Surg,2022,14(4):644-651.
[32] 韩 超,封启明,师灵灵,等.微小RNA-223(miR-223)在脓毒症早期诊断、炎症程度评估中的价值研究[J].现代生物医学进展,2023,23(3):452-456.
[33] 郭云波,张晓萍,高崴崴,等.老年重症肺炎病人血清微小RNA-146a、微小RNA-223、微小RNA-21、微小RNA-124水平及其与预后的关系[J].安徽医药,2022,26(12):2443-2447.
[34] Kim C,Ye Z,Weyand CM,et al.miR-181a-regulated pathways in T-cell differentiation and aging[J].Immun Ageing,2021,18(1):28.
[35] 潘春风,陶丽菊,覃宗帅,等.miR-181a-5p靶向HMGB1调节急性胰腺炎腺泡细胞凋亡的实验研究[J].右江民族医学院学报,2023,45(1):1-8.
[36] 张 瑜,辛前有,冯亚飞,等.急性胰腺炎患者血清miR-181a-5p表达及与Th17/Treg免疫平衡的关系[J].河北医学,2023,29(1):115-120.

相似文献/References:

[1]欧丽芬,张莹轩,周英.葛根汤合四逆散在多囊卵巢综合征型痤疮中的应用[J].陕西中医,2017,(06):791.
[2]王改梅,李 晶,张 励,等.苍附导痰方联合法地兰对PCOS合并不孕症患者性激素水平 及子宫内膜容受性的影响*[J].陕西中医,2019,(2):201.
 WANG Gaimei,LI Jing,ZHANG Li,et al.Effect of Cangfu Daotan prescription combined with Fadiland on sex hormone level and endometrial receptivity in PCOS patients with infertility[J].,2019,(12):201.
[3]袁社霞.补肾促排方治疗多囊卵巢综合征排卵障碍性不孕临床研究*[J].陕西中医,2019,(1):12.
 YUAN Shexia..Clinical observation on the therapeutic effect of Bushen Cupai recipe on ovulation disorder infertility in polycystic ovary syndrome[J].,2019,(12):12.
[4]高翠霞,宋红湘.补肾调经汤联合温针灸督脉治疗多囊卵巢综合征疗效及对患者内分泌系统和排卵的影响*[J].陕西中医,2019,(1):21.
[5]石小哲,张大伟.温肾健脾汤治疗多囊卵巢综合征及对患者胰岛素抵抗、 激素水平的影响*[J].陕西中医,2019,(5):637.
 SHI Xiaozhe,ZHANG Dawei..Curative effect of Wenshen Jianpi decoction in the treatment of polycystic ovary syndrome and the influence on insulin resistance and hormone levels[J].,2019,(12):637.
[6]马志宾,陈 燕,苏 永.促排卵汤对多囊卵巢综合征患者血清淀粉样蛋白P、脂肪因子 与白介素-18的影响研究*[J].陕西中医,2019,(5):651.
 MA Zhibin,HU Xiaohua,SU Yong ..Effect of Cupailuan decoction combined with life style on serum SAP, Apelin and IL-18 in women with polycystic ovary syndrome[J].,2019,(12):651.
[7]刘彩娜,李佳佳,李林林,等.温针灸督脉联合克罗米芬治疗肾虚血瘀型多囊卵巢综合征不孕临床研究*[J].陕西中医,2019,(6):803.
[8]李海霞,史秀英,王璀瑛,等.益肾化痰方治疗肥胖型多囊卵巢综合征不孕临床研究[J].陕西中医,2019,(7):839.
 LI Haixia,SHI Xiuying,WANG Cuiying,et al.Clinical study of Yishen Huatan decoction in the treatment of obese polycystic ovarian syndrome infertility[J].,2019,(12):839.
[9]赵卫锋,陆 鹤△,任媛媛,等.周志杰主任医师从经筋论治膝骨关节病及运用膝四针临证经验*[J].陕西中医,2020,(2):230.
 ZHAO Weifeng,LU He,REN Yuanyuan,et al.Academic thoughts of chief physician ZHOU Zhijie in treating knee osteoarthriosis based on muscle region theory and the corsesponing clinical experience of knee four needls[J].,2020,(12):230.
[10]冯亚宏,许 昕△.许昕教授治疗多囊卵巢综合征经验探析*[J].陕西中医,2020,(3):374.

备注/Memo

备注/Memo:
基金项目:湖北省卫生健康委员会科研项目(WJ2019F164)
更新日期/Last Update: 2023-12-08