培元开郁针刺疗法对多囊卵巢综合征伴焦虑抑郁样行为患者的临床疗效观察

Clinical Efficacy Observation of Peiyuan Kaiyu Acupuncture Therapy in Patients with Polycystic Ovary Syndrome Accompanied by Anxiety and Depression-Like Behaviors

摘要: 目的：观察培元开郁针刺疗法对多囊卵巢综合征(PCOS)伴焦虑抑郁样行为患者的临床疗效及对血清总睾酮(T)、促黄体生成素/促卵泡刺激素(LH/FSH)比值及焦虑、抑郁评分的影响。方法：选取64例符合PCOS诊断标准的患者，其中34例单纯PCOS患者(PCOS组)、34例PCOS伴焦虑抑郁患者(PCOS + 焦虑抑郁组)，另选取同期34例健康女性作为健康对照组。PCOS + 焦虑抑郁组予电针刺激足三里、三阴交、关元、照海穴(培元开郁针刺法)，PCOS组予单纯针刺足三里、三阴交、关元、照海穴(平补平泻法)，健康对照组仅予穴位局部消毒处理，隔日1次，连续治疗30 d。治疗前后比较三组血清T、LH/FSH比值、焦虑自评量表(SAS)及抑郁自评量表(SDS)评分，并评价PCOS + 焦虑抑郁组(研究组)与PCOS组(对照组)的临床综合疗效。结果：1) 治疗后，PCOS组与PCOS + 焦虑抑郁组血清T水平均较治疗前显著降低(P < 0.01)，且PCOS + 焦虑抑郁组降低幅度大于PCOS组(P < 0.01)，但两组仍高于健康对照组(P < 0.01)。2) 治疗后，两组LH/FSH比值均较治疗前显著降低(P < 0.01)，但两组间差异无统计学意义(P > 0.05)，且均高于健康对照组(P < 0.01)。3) 治疗后，两组SAS、SDS评分均较治疗前显著降低(P < 0.01)，但PCOS + 焦虑抑郁组仍高于PCOS组(P < 0.01)，两组均高于健康对照组(P < 0.01)。4) 研究组临床综合疗效总有效率为85.29%，对照组为70.59%，研究组疗效优于对照组(P = 0.021)。结论：培元开郁针刺疗法能显著降低PCOS伴焦虑抑郁样行为患者的血清T水平，改善LH/FSH比值，减轻焦虑、抑郁症状，提高临床综合疗效，但在LH/FSH及情绪评分方面仍较健康人群有一定差距，可进一步优化治疗策略。

Abstract: Objective: To observe the clinical efficacy of Peiyuan Kaiyu acupuncture therapy in patients with polycystic ovary syndrome (PCOS) accompanied by anxiety-depressive behaviors, as well as its effects on serum total testosterone (T), luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratios, and anxiety and depression scores. Methods: Sixty-four patients meeting PCOS diagnostic criteria were selected, including 34 patients with PCOS alone (PCOS group), 34 patients with PCOS with anxiety and depression (PCOS + anxiety-depressive group), and 34 healthy women during the same period as the health control group. The PCOS + anxiety and depression group received electroacupuncture stimulation of Zusanli, Sanyinjiao, Guanyuan, and Zhaohai points (Peiyuan Kaiyu acupuncture method); the PCOS group received simple acupuncture at Zusanli, Sanyinjiao, Guanyuan, and Zhaohai points (Pingbu Pingxue method); the healthy control group only underwent local disinfection of acupoints, treated every other day for 30 consecutive days. Before and after treatment, serum T, LH/FSH ratios, Anxiety Self-Rating Scale (SAS), and Depression Self-Rating Scale (SDS) scores were compared among the three groups, and the clinical efficacy of PCOS + anxiety-depressive group (study group) and PCOS group (control group) was evaluated. Results: 1) After treatment, serum T-levels in the PCOS group and PCOS + anxiety-depressed group were significantly lower than before treatment (P < 0.01), and the reduction in PCOS + anxiety-depressed was greater than in the PCOS group (P < 0.01), but both groups were still higher than the healthy control group (P < 0.01). 2) After treatment, the LH/FSH ratio in both groups was significantly lower than before treatment (P < 0.01), but the difference between the two groups was not statistically significant (P > 0.05), and both were higher than the healthy control group (P < 0.01). 3) After treatment, SAS and SDS scores in both groups were significantly lower than before treatment (P < 0.01), but the PCOS + anxiety-depressive group was still higher than the PCOS group (P < 0.01), and both groups were higher than the healthy control group (P < 0.01). 4) The total effective rate of comprehensive clinical efficacy in the study group was 85.29%, compared to 70.59% in the control group, with the study group showing better efficacy than the control group (P = 0.021). Conclusion: Peiyuan Kaiyu acupuncture therapy can significantly lower serum T levels in patients with PCOS accompanied by anxiety-like depressive behaviors, improve the LH/FSH ratio, alleviate anxiety and depression symptoms, and enhance overall clinical efficacy. However, there is still a certain gap compared to healthy populations in LH/FSH and mood scores, which can be further optimized for treatment strategies.