【目的】观察罗氏苍附佛手散联合针刺疗法治疗脾虚痰湿型多囊卵巢综合征（PCOS）的临床疗效。【方法】选取2023 年 3 月至2024 年3 月广州荔湾区中医医院妇科病房及门诊收治的60 例明确诊断为脾虚痰湿型PCOS 的患者为研究对象。按随机 数字表将患者随机分为观察组和对照组，每组各30 例。对照组给予罗氏苍附佛手散治疗，观察组在对照组治疗的基础上， 给予针刺治疗。治疗3 个月为1 个疗程，2 组患者均治疗2 个疗程。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，以及血清雌二醇（E2）、睾酮（T）、黄体生成素（LH）、卵泡刺激素（FSH）及催乳素（PRL）水平的 情况。比较2 组患者的排卵率与妊娠率，分析2 组患者治疗前后空腹血糖（FPG）、空腹胰岛素（FINS）及稳态模型胰岛素抵抗 指数（HOMA-IR）水平的变化情况。【结果】（1）治疗后，2 组患者的中医证候积分明显改善（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，差异有统计学意义（P＜0.05）。（2）治疗后，2 组患者的血清E2、T、LH、FSH、PRL 水平明显改 善（P＜0.05），且观察组在改善血清E2、T、LH、FSH、PRL 水平方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）观 察组排卵率为80.00%（24/30），对照组为66.67%（20/30）。观察组妊娠率为40.00%（12/30），对照组为23.33%（7/30）。观察组 排卵率与妊娠率均明显高于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2 组患者的HOMA-IR、FINS、FPG 水平明显 改善（P＜0.05），且观察组在改善HOMA-IR、FINS、FPG 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90.00%（27/30），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）。【结论】罗 氏苍附佛手散联合针刺治疗脾虚痰湿型多囊卵巢综合征，能够有效地改善患者的生殖内分泌功能及代谢紊乱，提高患者的 生殖功能，临床疗效显著。

Objective To observe the clinical efficacy of Luo’s Cangfu Foshou San combined with acupuncture in the treatment of polycystic ovary syndrome（PCOS）of spleen deficiency and phlegm-damp type. Methods A total of 60 patients diagnosed with PCOS of spleen deficiency and phlegm-damp type，who were admitted to the gynecology ward and outpatient clinic of Guangzhou Liwan Hospital of Traditional Chinese Medicine from March 2023 to March 2024，were selected as the study subjects. The patients were randomly divided into an observation group and a control group using a random number table，with 30 cases in each group. The control group was treated with Luo’s Cangfu Foshou San，while the observation group received acupuncture in addition to the treatment given to the control group. A treatment course consisted of three months，and both groups were treated for two courses. After six months of treatment，the clinical efficacy was evaluated for both groups. The changes in traditional Chinese medicine（TCM）syndrome scores，as well as the levels of serum estradiol（E2），testosterone （T），luteinizing hormone（LH），follicle-stimulating hormone（FSH），and prolactin（PRL），were observed before and after treatment in both groups. The ovulation rate and pregnancy rate were compared between the two groups. The changes in fasting plasma glucose（FPG），fasting insulin（FINS），and homeostatic model assessment for insulin resistance（HOMA-IR）levels were analyzed before and after treatment. Results（1）After treatment， the TCM syndrome scores of patients in both groups were significantly improved（P＜0.05），and the improvement in the observation group was significantly superior to that in the control group，with a statistically significant difference（P＜0.05）.（2）After treatment，the serum levels of E2，T，LH，FSH，and PRL were significantly improved in both groups（P＜0.05），and the improvements in the observation group were significantly superior to those in the control group，with statistically significant differences（P＜0.05）.（3）The ovulation rate was 80.00% （24/30）in the observation group and 66.67%（20/30）in the control group. The pregnancy rate was 40.00%（12/30） in the observation group and 23.33%（7/30）in the control group. Both the ovulation rate and pregnancy rate in the observation group were significantly higher than those in the control group，with statistically significant differences （P＜0.05）.（4）After treatment，the levels of HOMA-IR，FINS，and FPG were significantly improved in both groups（P＜0.05），and the improvements in the observation group were significantly superior to those in the control group，with statistically significant differences（P＜0.05）.（5）The total effective rate was 90.00%（27/30） in the observation group and 73.33%（22/30）in the control group. The therapeutic effect of the observation group was superior to that of the control group，and the difference was statistically significant（P＜0.05）. Conclusion Luoshi Cangfu Foshou San combined with acupuncture can effectively improve reproductive endocrine function and metabolic disorders，and enhance reproductive function in patients with polycystic ovary syndrome of spleen deficiency and phlegm-damp type，demonstrating significant clinical efficacy.

R246.9

广东省中医药局科研资助项目（编号：20231267）