观察针药结合治疗痰湿型多囊卵巢综合征肥胖患者的临床疗效。

选取2022年1月至2023年6月于东莞市寮步医院妇科门诊及中医科门诊就诊的痰湿型多囊卵巢综合征肥胖患者60例，按照随机数字表法随机分为对照组（30例）和观察组（30例）。对照组给予二甲双胍口服治疗，每次0.5 g，每日3次，连续治疗3个月。观察组在对照组的基础上予针刺配合中药汤剂治疗，其中针刺治疗为隔日1次，取穴为处方一（中脘、天枢、子宫、归来、气海、足三里、丰隆、阴陵泉）和处方二（脾俞、肝俞、肾俞、委中、次髎、三阴交），两方轮流交替使用，留针30 min，中药汤剂为自拟补肾健脾化痰方，每日1剂，连续治疗3个月。观察2组治疗前后中医证候评分、人体成分、糖脂代谢变化，并进行安全性评定。

治疗后，2组患者中医证候评分包括月经周期、经量、色、质、脘腹痞满、口淡黏腻痰多、带下量色、大便、总分均较治疗前降低（观察组：Z=-3.923、-4.193、-5.012、-4.778、-4.961、-4.960、-4.810，对照组：Z=-2.113、-2.424、-2.565、-3.611、-2.558、-2.842、-4.472，P 均<0.05），且观察组低于对照组（Z =3.800、3.083、2.553、2.206、2.249、2.500、5.234，P 均<0.05）。治疗后，2组患者人体成分包括身体质量指数、脂肪含量、体脂率、内脏脂肪指数均较治疗前降低（观察组：t =11.629、3.562、9.750、8.954，对照组：t=9.204、3.278、12.618、6.740，P 均<0.05），且观察组低于对照组（t=-3.091、-2.995、-3.826、-4.277，P 均<0.05）。治疗后，2组患者糖脂代谢水平包括空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油均较治疗前降低（观察组：t=6.841、9.740、12.308、4.842、5.817，对照组：t =2.377、6.251、5.182、2.431、2.695，P 均<0.05），且观察组低于对照组（t=-2.568、-2.557、-3.259、-2.395、-2.280，P 均<0.05）。

针药结合治疗痰湿型多囊卵巢综合征肥胖疗效显著，值得临床推广。

To observe the clinical efficacy of combined acupuncture and medication in the treatment of obesity in patients with polycystic ovary syndrome (PCOS) of phlegm-dampness syndrome.

A total of 60 obese patients with PCOS of phlegm-dampness syndrome, who visited the Gynecology Outpatient Department and TCM Department of Liaobu Hospital in Dongguan City from January 2022 to June 2023, were selected. According to the random number table method, the patients were randomly divided into a control group (30 cases) and an observation group (30 cases). The control group was given oral metformin treatment, three times a day, 0.5 g each time, for three consecutive months. On the basis of the control group, the observation group was additionally treated with acupuncture combined with TCM decoction: acupuncture treatment was given once every other day. Two acupoint prescriptions were used alternately: prescription 1 included Zhongwan (CV 12), Tianshu (ST 25), Zigong (EX-CA1), Guilai (ST 29), Qihai (CV 6), Zusanli (ST 36), Fenglong (ST 40), and Yinlingquan (SP 9); prescription 2 included Pishu (BL 20), Ganshu (BL 18), Shenshu (BL 23), Weizhong (BL 40), Ciliao (BL 32), and Sanyinjiao (SP 6). The needles were retained for 30 minutes.The TCM decoction was a self-formulated "Bushen Jianpi Huatan Decoction" (Kidney-Nourishing, Spleen-Strengthening, and Phlegm-Resolving Decoction), 1 dose per day, for 3 consecutive months. Changes in TCM syndrome scores, body composition, and glucose-lipid metabolism were observed in both groups before and after treatment, and safety assessment was conducted.

After treatment, the TCM syndrome scores of both groups in terms of menstrual cycle, menstrual flow, menstrual color, menstrual texture, epigastric and abdominal fullness, tasteless mouth with sticky feeling and excessive phlegm, amount and color of leukorrhea, stool condition, and total score were all lower than those before treatment (observation group: Z=-3.923, -4.193, -5.012, -4.778, -4.961, -4.960, -4.810; control group: Z=-2.113, -2.424, -2.565, -3.611, -2.558, -2.842, -4.472; all P<0.05), and the scores of the observation group were lower than those of the control group (Z=3.800, 3.083, 2.553, 2.206, 2.249, 2.500, 5.234; all P<0.05). In regard of the body composition indicators, after treatment, indicators of both groups including body mass index (BMI), fat mass, body fat percentage, and visceral fat index were all lower than those before treatment (observation group: t=11.629, 3.562, 9.750, 8.954; control group: t=9.204, 3.278, 12.618, 6.740; all P<0.05), and the indicators of the observation group were lower than those of the control group (t=-3.091, -2.995, -3.826, -4.277; all P<0.05). Indicators of both groups including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and triglycerides (TG) were all lower than those before treatment (observation group: t=6.841, 9.740, 12.308, 4.842, 5.817; control group: t=2.377, 6.251, 5.182, 2.431, 2.695; all P<0.05), and the indicators of the observation group were lower than those of the control group (t=-2.568, -2.557, -3.259, -2.395, -2.280; all P<0.05).

Combined acupuncture and medication has a significant efficacy in the treatment of obesity in PCOS patients with phlegm-dampness syndrome, and it is worthy of clinical promotion.