【目的】观察针刺联合紫萸补肾益气调经汤治疗多囊卵巢综合征 （PCOS） 的临床疗效及对卵巢储备功能和性激素水平的影响。 【方法】将60例肾虚痰湿型PCOS患者随机分为观察组和对照组，每组各30例，对照组给予常规西药治疗，观察组在对照组治疗的基础上，给予针刺联合紫萸补肾益气调经汤治疗。2组均治疗6个月。治疗6个月后，评价2组临床疗效，观察2组患者治疗前后中医证候积分的变化情况，以及患者睾酮 （T） 、黄体生成素 （LH） 、卵泡刺激素 （FSH） 水平的情况。比较2组患者治疗前后抗苗勒管激素 （AMH） 、窦状卵泡数目 （AFC） 的变化情况，以及子宫内膜厚度、卵巢体积与宫颈评分的情况。并评价2组的安全性及1年后自然妊娠率。 【结果】（1） 治疗后，2组患者的中医证候积分均明显改善 （P＜0.05） ，且观察组在改善中医证候积分方面明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （2） 治疗后，2组患者的AFC、AMH水平明显改善 （P＜0.05） ，且观察组在改善AFC、AMH水平方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （3） 治疗后，2组患者的T、LH、FSH水平明显改善 （P＜0.05） ，且观察组在改善T、LH、FSH水平方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （4） 治疗后，2组患者的子宫内膜厚度、卵巢体积、宫颈评分水平均明显改善 （P＜0.05） ，且观察组在改善子宫内膜厚度、卵巢体积、宫颈评分水平方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （5） 观察组总有效率为96.67% （29/30） ，对照组为73.33% （22/30） 。观察组疗效优于对照组，差异有统计学意义 （P＜0.05） 。 （6） 观察组与对照组在治疗期间不良反应发生率分别为6.67% （2/30） 与33.33% （10/30） ，差异无统计学意义 （P＞0.05） 。1年后，观察组与对照组自然妊娠率分别为60.00%（18/30） 与33.33% （10/30） ，观察组自然妊娠率明显高于对照组，差异有统计学意义 （P＜0.05） 。 【结论】针刺联合紫萸补肾益气调经汤治疗PCOS，能明显改善患者的临床症状，提高患者卵巢的储备功能，促进性激素水平与子宫的恢复，提高妊娠几率，临床疗效显著。

Objective To observe the clinical efficacy of acupuncture combined with Zi Yu Bushen Yiqi Tiaojing Decoction in the treatment of polycystic ovary syndrome （PCOS） and its effect on ovarian reserve function and sex hormone level. Methods Sixty patients with PCOS of phlegm-damp due to kidney deficiency type were randomly divided into observation group and control group，30 patients in each group，the control group was treated with conventional western medicines，and the observation group was treated with acupuncture combined with Zi Yu Bushen Yiqi Tiaojing Decoction on the basis of treatment of the control group. Both groups were treated for six months. After six months of treatment，the clinical efficacy of the two groups was evaluated，and the changes of traditional Chinese medicine （TCM） syndrome scores and the levels of testosterone （T） ，luteinizing hormone （LH） and follicle stimulating hormone （FSH） of the two groups of patients were observed before and after treatment. The changes of anti-Mullerian hormone （AMH），antral follicle count（AFC），as well as endometrial thickness，ovarian volume and cervical score before and after treatment between the two groups of patients were compared.The safety of the two groups and the natural pregnancy rate after one year follow-up were evaluated. Results （1） After treatment，the TCM syndrome scores of patients in the two groups were significantly improved （P＜0.05） ，and the improvement in the observation group was significantly superior to that in the control group，and the differences were all statistically significant （P＜0.05） . （2） After treatment，the AFC and AMH levels of patients in the two groups were improved significantly（P＜0.05），and the improvement in the observation group was significantly superior to that in the control group，and the difference was statistically significant （P＜0.05） . （3） After treatment，the levels of T，LH and FSH of patients in the two groups were improved significantly （P＜0.05），and the improvement in the observation group was significantly superior to that in the control group，with statistically significant differences （P＜0.05） . （4） After treatment，the endometrial thickness，ovarian volume，and cervical score of patients in the two groups were significantly improved （P＜0.05） ，and the improvement in the observation group was significantly superior to that in the control group，with statistically significant differences （P＜0.05） . （5） The total effective rate was 96.67% （29/30） in the observation group and 73.33% （22/30） in the control group. The efficacy of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05） . （6） The incidence of adverse reactions during the treatment period in the observation group and the control group was 6.67%（2/30） and 33.33%（10/30） respectively，the difference was not statistically significant（P＞0.05） . After one year follow-up，the natural pregnancy rate in the observation group and the control group was 60.00%（18/30） and 33.33%（10/30） respectively， and the natural pregnancy rate in the observation group was significantly higher than that in the control group，the difference was statistically significant （P＜0.05） . Conclusion Acupuncture combined with Zi Yu Bushen Yiqi Tiaojing Decoction in treating PCOS can significantly improve the clinical symptoms of patients，enhance the reserve function of the ovaries，promote the recovery of sex hormone levels and recovery of uterus，and increase the pregnancy rate，with remarkable clinical efficacy.

R246.9

山东省中医药科技项目 （编号：2020M178）