补肾调经汤多方分段给药对多囊卵巢综合征患者促排卵结局、症状及性激素水平的影响
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摘要
目的:观察补肾调经汤多方分段给药对多囊卵巢综合征(PCOS)患者促排卵结局、症状及性激素水平的影响。方法:选取2014年1月至2016年1月青岛市中心医院收治的PCOS患者80例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组40例。对照组采用枸橼酸氯米芬片以及炔雌醇环丙孕酮片等常规西医治疗,观察组在此基础上加用补肾调经汤治疗。2组均连续治疗3个月后进行疗效判定,比较2组治疗前后性激素水平、胰岛素抵抗指数(HOMAIR)、血清瘦素(LP)水平、中医证候积分,随访24个月比较2组月经恢复、排卵以及妊娠情况。结果:观察组治疗总有效率为82. 50%,显著高于对照组的65. 00%,差异有统计学意义(P <0. 05);治疗后,2组中医各项中医证候积分均显著降低,且治疗后观察组显著低于对照组,差异有统计学意义(P <0. 05);治疗前后2组后黄体生成素(LH)、雌二醇(E2)、血清睾酮(T)、卵泡刺激素(FSH)水平差异有统计学意义(P <0. 05),且治疗后观察组与对照组比较,差异有统计学意义(P <0. 05); 2组术后HOMA-IR、血清LP水平均显著降低,且治疗后观察组显著低于对照组,差异有统计学意义(P <0. 05);治疗后观察组月经恢复、排卵、妊娠人数显著高于对照组,差异有统计学意义(P <0. 05)。结论:补肾调经汤联合西医治疗能够显著改善PCOS患者性激素水平以及临床症状,促进排卵与月经恢复,提高成功妊娠。
Objective: To investigate the effects of multi-phase administration of Bushen Tiaojing Decoction on ovulation outcomes,symptoms and sex hormone levels in patients with polycystic ovary syndrome( PCOS). Methods: A total of 80 patients with PCOS treated in Qingdao Central Hospital from January 2014 to January 2016 were selected and randomly divided into observation group and control group,with 40 cases in each group. Patients in control group received conventional western medicine treatment of clomiphene citrate tablets and ethinylestradiol cyproterone tablets,and the observation group additionally received the Bushen Tiaojing Decoction on the basis of the same western medicine treatment,both were treated for 3 months. The levels of sex hormones,insulin resistance index( HOMA-IR),serum leptin( LP) level and traditional Chinese medicine( TCM) syndrome score in two groups before and after treatment were compared. The menstrual recovery,ovulation and pregnancy in two groups were compared during the 24 months follow-up. Results: The total effective rate of treatment in the observation group was 82. 50%,which was significantly higher than that of the control group( 65%),and the difference was statistically significant( P < 0. 05). After treatment,the TCM symptom scores were significantly reduced,and the observation group was significantly lower than the control group,the difference was statistically significant( P < 0. 05). There was a statistically significant difference in luteinizing hormone( LH),estradiol( E2),serum testosterone( T) and follicle stimulating hormone( FSH) between the two groups before and after treatment( P < 0. 05),and the difference after treatment between two groups was statistically significant( P < 0. 05). After treatment,the levels of HOMA-IR and serum LP in the two groups were significantly decreased,and the observation group was significantly lower than the control group,and the difference was statistically significant( P < 0. 05). The number of menstrual recovery,ovulation and pregnancy in the observation group was significantly higher than that of the control group,and the difference was statistically significant( P < 0. 05). Conclusion: Bushen Tiaojing Decoction combined with western medicine can significantly ameliorate the level of sex hormones and clinical symptoms,as well as promote ovulation,menstrual recovery and pregnancy in PCOS patients.
Objective: To investigate the effects of multi-phase administration of Bushen Tiaojing Decoction on ovulation outcomes,symptoms and sex hormone levels in patients with polycystic ovary syndrome( PCOS). Methods: A total of 80 patients with PCOS treated in Qingdao Central Hospital from January 2014 to January 2016 were selected and randomly divided into observation group and control group,with 40 cases in each group. Patients in control group received conventional western medicine treatment of clomiphene citrate tablets and ethinylestradiol cyproterone tablets,and the observation group additionally received the Bushen Tiaojing Decoction on the basis of the same western medicine treatment,both were treated for 3 months. The levels of sex hormones,insulin resistance index( HOMA-IR),serum leptin( LP) level and traditional Chinese medicine( TCM) syndrome score in two groups before and after treatment were compared. The menstrual recovery,ovulation and pregnancy in two groups were compared during the 24 months follow-up. Results: The total effective rate of treatment in the observation group was 82. 50%,which was significantly higher than that of the control group( 65%),and the difference was statistically significant( P < 0. 05). After treatment,the TCM symptom scores were significantly reduced,and the observation group was significantly lower than the control group,the difference was statistically significant( P < 0. 05). There was a statistically significant difference in luteinizing hormone( LH),estradiol( E2),serum testosterone( T) and follicle stimulating hormone( FSH) between the two groups before and after treatment( P < 0. 05),and the difference after treatment between two groups was statistically significant( P < 0. 05). After treatment,the levels of HOMA-IR and serum LP in the two groups were significantly decreased,and the observation group was significantly lower than the control group,and the difference was statistically significant( P < 0. 05). The number of menstrual recovery,ovulation and pregnancy in the observation group was significantly higher than that of the control group,and the difference was statistically significant( P < 0. 05). Conclusion: Bushen Tiaojing Decoction combined with western medicine can significantly ameliorate the level of sex hormones and clinical symptoms,as well as promote ovulation,menstrual recovery and pregnancy in PCOS patients.
引文
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[11]徐丁洁,洪丽文,徐洪,等.补肾调经方、逍遥丸对雄激素致排卵障碍模型大鼠腺垂体、卵巢影响的比较研究[J].中国中西医结合杂志,2014,34(1):87-90.
[12]田野.补肾调经方结合来曲唑治疗多囊卵巢综合征排卵障碍的临床观察及对内分泌的影响[J].中国综合临床,2016,32(10):943-946.
[13]杨彩荣,陈秀娟.补肾健脾活血汤在多囊卵巢综合征中的临床应用价值[J].世界中西医结合杂志,2016,11(9):1248-1251.
[14]史登玉,郑娅丽,陈书琴,等.补肾调经汤治疗多囊卵巢综合征所致不孕临床研究[J].中医学报,2017,32(11):2193-2195.
[15]刘亚平,任凤岩,赵艳梅,等.补肾健脾活血汤治疗多囊卵巢综合征的临床观察[J].中国中医药科技,2012,19(3):258-260.
[2]刘宇新,侯丽辉,吴效科.多囊卵巢综合征中医病因病机[J].天津中医药,2009,26(2):123-124.
[3]中华医学会妇产科学分会内分泌学组.多囊卵巢综合征的诊断和治疗专家共识[J].中华妇产科杂志,2008,43(7):553-555.
[4]国家食品药品管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:78-79.
[5]董焘.补肾健脾汤治疗多囊卵巢综合征临床观察[J].四川中医,2016,4(1):88-89.
[6]韩洁,雷玲,张丹英,等.补肾活血化痰组方治疗多囊卵巢综合征的临床疗效[J].吉林中医药,2011,31(2):141-143.
[7]瞿淑慧,于文博.补肾祛痰调经法对多囊卵巢综合征不孕临床研究[J].四川中医,2016,34(2):90-92.
[8]邱云,杨巧月,戴焕初,等.中医分期治疗多囊卵巢综合征诱发不孕症临床研究[J].中医学报,2016,31(5):711-714.
[9]李一北.自拟补肾活血汤治疗多囊卵巢综合征临床研究[J].四川中医,2014,32(9):60-61.
[10]刘翠华.补肾健脾活血汤治疗多囊卵巢综合征临床研究[J].中医学报,2016,31(8):1160-1162.
[11]徐丁洁,洪丽文,徐洪,等.补肾调经方、逍遥丸对雄激素致排卵障碍模型大鼠腺垂体、卵巢影响的比较研究[J].中国中西医结合杂志,2014,34(1):87-90.
[12]田野.补肾调经方结合来曲唑治疗多囊卵巢综合征排卵障碍的临床观察及对内分泌的影响[J].中国综合临床,2016,32(10):943-946.
[13]杨彩荣,陈秀娟.补肾健脾活血汤在多囊卵巢综合征中的临床应用价值[J].世界中西医结合杂志,2016,11(9):1248-1251.
[14]史登玉,郑娅丽,陈书琴,等.补肾调经汤治疗多囊卵巢综合征所致不孕临床研究[J].中医学报,2017,32(11):2193-2195.
[15]刘亚平,任凤岩,赵艳梅,等.补肾健脾活血汤治疗多囊卵巢综合征的临床观察[J].中国中医药科技,2012,19(3):258-260.