应用百合固金汤与利维爱对更年期综合征患者内分泌以及神经内分泌免疫网络的影响
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摘要
目的:探讨应用百合固金汤以及利维爱对更年期综合征患者内分泌以及神经内分泌免疫网络的影响,为更年期综合征患者的临床治疗提供参考。方法:选取2014年3月至2017年5月青海省中医院收治的更年期综合征患者86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43例,其中对照组患者给予利维爱治疗,观察组在对照组治疗基础上加百合固金汤联合治疗,比较2组治疗前后的中医症状积分以及Kupperman积分,并分析2组治疗前后的血清生殖内分泌激素水平、神经递质以及免疫学指标的变化,观察2组的中医证候疗效情况。结果:治疗前,2组血清生殖内分泌激素水平、神经递质以及免疫学差异无统计学意义(P> 0. 05)。治疗后,2组中医症状积分、Kupperman积分、血清黄体生成素(LH)、卵泡刺激素(FSH)水平、5-羟色胺(5-HT)和去甲肾上腺素(NE)神经递质指标均明显降低,血清雌激素(E2)水平以及白细胞介素-2(IL-2)免疫学指标明显升高,而观察组上述指标改善更为显著,差异有统计学意义(P <0. 05)。观察组的治疗有效率为95. 35%,明显高于对照组,差异有统计学意义(P <0. 05)。结论:百合固金汤联合利维爱治疗更年期综合征患者可以有效的调节神经内分泌免疫网络,提高雌激素的分泌,增强患者的免疫力,改善临床症状。
Objective: To investigate the effects of Baihe Gujin Decoction and Livial on endocrine and neuroendocrine immune networks in menopausal syndrome patients,and provide reference for the clinical treatment of menopausal syndrome patients. Methods: A total of 86 patients with climacteric syndrome who were admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from March 2014 to May 2017 were randomly divided into the observation group and the control group,with 43 patients in each group. The control group was treated with Livial. The observation group was additionally treated with Baihe Gujin Decoction on the basis of the treatment of control group. The TCM( traditional Chinese medicine) symptom scores and Kupperman scores before and after treatment were compared between the two groups of patients. The changes of serum reproductive and endocrine hormone levels,neurotransmitters,and immune parameters before and after treatment were analyzed. The efficacy of TCM syndromes in the two groups was observed. Results: There was no significant difference in the levels of serum reproductive hormones,neurotransmitters,and immune parameters before treatment between the two groups( P > 0. 05). The TCM symptom scores,Kupperman scores,serum LH and FSH levels,5-HT and NE neurotransmitters were significantly decrease in the two groups after treatment,while Serum E2 levels and IL-2 immune parameters were significantly increased. And in the observation group,the above indicators improved more significantly( P < 0. 05). The effective rate of treatment in the observation group was 95. 35%,which was significantly higher than that in the control group. The difference was statistically significant( P < 0. 05). Conclusion: The combination of Baihe Gujin Decoction with Livial in the treatment of patients with climacteric syndrome can effectively regulate the neuroendocrine immune network,improve the secretion of estrogen,enhance the patient' s immune system,and improve the clinical symptoms.
Objective: To investigate the effects of Baihe Gujin Decoction and Livial on endocrine and neuroendocrine immune networks in menopausal syndrome patients,and provide reference for the clinical treatment of menopausal syndrome patients. Methods: A total of 86 patients with climacteric syndrome who were admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from March 2014 to May 2017 were randomly divided into the observation group and the control group,with 43 patients in each group. The control group was treated with Livial. The observation group was additionally treated with Baihe Gujin Decoction on the basis of the treatment of control group. The TCM( traditional Chinese medicine) symptom scores and Kupperman scores before and after treatment were compared between the two groups of patients. The changes of serum reproductive and endocrine hormone levels,neurotransmitters,and immune parameters before and after treatment were analyzed. The efficacy of TCM syndromes in the two groups was observed. Results: There was no significant difference in the levels of serum reproductive hormones,neurotransmitters,and immune parameters before treatment between the two groups( P > 0. 05). The TCM symptom scores,Kupperman scores,serum LH and FSH levels,5-HT and NE neurotransmitters were significantly decrease in the two groups after treatment,while Serum E2 levels and IL-2 immune parameters were significantly increased. And in the observation group,the above indicators improved more significantly( P < 0. 05). The effective rate of treatment in the observation group was 95. 35%,which was significantly higher than that in the control group. The difference was statistically significant( P < 0. 05). Conclusion: The combination of Baihe Gujin Decoction with Livial in the treatment of patients with climacteric syndrome can effectively regulate the neuroendocrine immune network,improve the secretion of estrogen,enhance the patient' s immune system,and improve the clinical symptoms.
引文
[1]Gordon JL,Girdler SS,Meltzer-Brody SE,et al.Ovarian hormone fluctuation,neurosteroids,and HPA axis dysregulation in perimenopausal depression:a novel heuristic model[J].Am J Psychiatry,2015,172(3):227-236.
[2]倪青,郭赫.女性更年期综合征的诊断与中医药治疗策略[J].中国临床医生杂志,2018,46(11):1266-1268.
[3]Rubinow DR,Johnson SL,Schmidt PJ,et al.EFFICACY OF ESTRA-DIOL IN PERIMENOPAUSAL DEPRESSION:SO MUCH PROMISEAND SO FEW ANSWERS[J].Depress Anxiety,2015,32(8):539-549.
[4]Li RX,Ma M,Xiao XR,et al.Perimenopausal syndrome and mood disorders in perimenopause:prevalence,severity,relationships,and risk factors[J].Medicine(Baltimore),2016,95(32):e4466.
[5]Gregorio-Arenas E,Ruiz-Cabello P,Camiletti-Moirón D,et al.The associations between physical fitness and cardiometabolic risk and bodysize phenotypes in perimenopausal women[J].Maturitas,2016,92(5):162-167.
[6]陈旭锋,魏叶红,周先韦,等.集束化中医干预对肝气郁结型更年期综合征高血压患者血压的影响[J].中华全科医学,2018,16(10):1667-1669,1729.
[7]王延明,雷侠.滋肾宁心法治疗更年期综合征临床观察[J].陕西中医,2016,37(11):1508-1509.
[8]王钰婷,周咸莉,胡赟.六味地黄丸对更年期综合征患者神经内分泌免疫网络的影响[J].世界中医药,2017,12(12):3013-3015.
[9]郝瑞,郭惠岚,梁艳,等.四物汤加减治疗女性更年期综合征疗效观察[J].陕西中医,2016,37(10):1293-1294.
[10]陈玉玲,任福军,于海华.自拟滋补肝肾组方对肝肾阴虚型更年期综合征患者血清卵泡刺激素与儿茶酚胺水平的影响[J].中国妇幼保健,2017,32(18):4451-4454.
[11]Portman DJ,Gass ML.Vulvovaginal Atrophy Terminology Consensus Conference Panel.Genitourinary syndrome of menopause:new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North AmericanMenopause Society[J].Maturitas,2014,79(3):349-354.
[12]郭海燕,李梦梦,卢轩,等.张智龙治疗更年期综合征经验解析[J].江苏中医药,2015,47(6):24-25.
[13]覃炜.激素替代治疗对围绝经期综合征患者雌激素水平和体重指数的影响[J].白求恩医学杂志,2015,13(1):50-51.
[14]王黎,付晓敏,杨勇豪,等.益气活血方对乳腺癌患者术后免疫功能、炎症因子及VEGF水平的影响[J].贵州医药,2016,40(7):703-704.
[15]邓妙,刘元伟,张红艳,等.钙蛋白酶-10基因SNP-19与多囊卵巢综合征相关性研究[J].浙江医学,2015,37(11):912-915.
[16]张玲.滋肾宁心汤联合谷维素片对心肾不交型更年期综合征患者相关激素水平的影响[J].四川中医,2017,35(9):139-141.
[17]杨波,徐慧敏,朱亚芹,等.坤泰胶囊联合雌性激素替代疗法治疗更年期综合征的临床效果及可能的作用机制[J].中国性科学,2017,26(11):60-63.
[18]尚友琴,程文静,孙宏伟,等.替勃龙与坤泰胶囊治疗更年期综合征疗效及其对雌二醇、卵泡刺激素和子宫内膜厚度影响的比较[J].疑难病杂志,2016,15(7):725-728.
[19]Terauchi M,Hirose A,Akiyoshi M,et al.Prevalence and predictors of storage lower urinary tract symptoms in perimenopausal and postmenopausal women attending a menopause clinic[J].Menopause,2015,22(10):1084-1090.
[20]刘晓琴,高冬梅,张震.中医治疗女性更年期综合征研究进展[J].西部中医药,2016,29(4):131-133.
[21]郝瑞,郭惠岚,梁艳,等.四物汤加减治疗女性更年期综合征疗效观察[J].陕西中医,2016,37(10):1293-1294.
[22]石国令.二仙汤加味方治疗更年期综合征临床观察[J].四川中医,2017,35(1):125-127.
[23]王晓锋,刘雁峰,李靖,等.刘雁峰教授交通心肾法治疗更年期综合征的经验浅析[J].世界中医药,2017,12(2):366-368.
[24]黄燕,赵映红,王朝志,等.更年期综合征妇女门诊规范性治疗的临床研究[J].中国妇幼保健,2016,31(10):2120-2123.
[25]张文秀.百合固金汤治疗更年期综合症临床研究[J].现代中医药,2016,36(5):57-59.
[26]董雪松,李树义.百合固金汤合生脉散加减方对肺结核患者血清中白介素与相关因子的影响[J].陕西中医,2014,35(9):1156-1158.
[27]王志勇,杨惠民,李浩.从肝气虚辨治更年期综合征[J].北京中医药,2017,36(1):66-68.
[28]田莉.百合固金汤合桃红四物汤加减治疗多囊卵巢综合征30例[J].光明中医,2014,29(1):98-99.
[29]Mitchell RJ,Shaw RG.Heritability of floral traits for the perennial wild flower Penstemon centranthifolius(Scrophulariaceae):clones and crosses[J].Heredity,1993,71(2):185-192.
[30]Huang Y,Liu Z,Bo R,et al.The enhanced immune response of PCV-2 vaccine using Rehmannia glutinosa polysaccharide liposome as an adjuvant[J].Int J Biol Macromol,2016,86:929-936.
[31]Kim JE,Cho J,Kwon O,et al.Effect of Guizhifulingwan(Keishibukuryogan)on climacteric syndrome:study protocol for a randomized controlled pilot trial[J].Trials,2017,18(1):135.
[32]Kim M,Kim AR,Park HJ,et al.Danggwijagyaksan for climacteric syndrome in peri-and postmenopausal women with a blood-deficiency dominant pattern:study protocol for a randomized,double-blind,placebo-controlled pilot trial[J].Trials,2018,19(1):41.
[33]Nowakowska I,Rasińska R,Gowacka MD.Analysis of relationships between perimenopausal symptoms and professional functioning and life satisfaction--Subjective perception of the dependence in women aged 40+[J].Med Pr,2015,66(3):351-358.
[34]Vuksanovic M,Mihajlovic G,Beljic ZT,et al.Cross-talk between muscle and bone in postmenopausal women with hypovitaminosis D[J].Climacteric,2017,20(1):31-36.
[35]张慧.百合固金汤联合标准化疗方案治疗初治菌阳性肺结核50例[J].山东中医杂志,2017,36(11):945-947.
[36]Mc Curry SM,Guthrie KA,Morin CM,et al.Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms:A Ms FLASH Randomized Clinical Trial[J].JAMA Intern Med,2016,176(7):913-920.
[2]倪青,郭赫.女性更年期综合征的诊断与中医药治疗策略[J].中国临床医生杂志,2018,46(11):1266-1268.
[3]Rubinow DR,Johnson SL,Schmidt PJ,et al.EFFICACY OF ESTRA-DIOL IN PERIMENOPAUSAL DEPRESSION:SO MUCH PROMISEAND SO FEW ANSWERS[J].Depress Anxiety,2015,32(8):539-549.
[4]Li RX,Ma M,Xiao XR,et al.Perimenopausal syndrome and mood disorders in perimenopause:prevalence,severity,relationships,and risk factors[J].Medicine(Baltimore),2016,95(32):e4466.
[5]Gregorio-Arenas E,Ruiz-Cabello P,Camiletti-Moirón D,et al.The associations between physical fitness and cardiometabolic risk and bodysize phenotypes in perimenopausal women[J].Maturitas,2016,92(5):162-167.
[6]陈旭锋,魏叶红,周先韦,等.集束化中医干预对肝气郁结型更年期综合征高血压患者血压的影响[J].中华全科医学,2018,16(10):1667-1669,1729.
[7]王延明,雷侠.滋肾宁心法治疗更年期综合征临床观察[J].陕西中医,2016,37(11):1508-1509.
[8]王钰婷,周咸莉,胡赟.六味地黄丸对更年期综合征患者神经内分泌免疫网络的影响[J].世界中医药,2017,12(12):3013-3015.
[9]郝瑞,郭惠岚,梁艳,等.四物汤加减治疗女性更年期综合征疗效观察[J].陕西中医,2016,37(10):1293-1294.
[10]陈玉玲,任福军,于海华.自拟滋补肝肾组方对肝肾阴虚型更年期综合征患者血清卵泡刺激素与儿茶酚胺水平的影响[J].中国妇幼保健,2017,32(18):4451-4454.
[11]Portman DJ,Gass ML.Vulvovaginal Atrophy Terminology Consensus Conference Panel.Genitourinary syndrome of menopause:new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North AmericanMenopause Society[J].Maturitas,2014,79(3):349-354.
[12]郭海燕,李梦梦,卢轩,等.张智龙治疗更年期综合征经验解析[J].江苏中医药,2015,47(6):24-25.
[13]覃炜.激素替代治疗对围绝经期综合征患者雌激素水平和体重指数的影响[J].白求恩医学杂志,2015,13(1):50-51.
[14]王黎,付晓敏,杨勇豪,等.益气活血方对乳腺癌患者术后免疫功能、炎症因子及VEGF水平的影响[J].贵州医药,2016,40(7):703-704.
[15]邓妙,刘元伟,张红艳,等.钙蛋白酶-10基因SNP-19与多囊卵巢综合征相关性研究[J].浙江医学,2015,37(11):912-915.
[16]张玲.滋肾宁心汤联合谷维素片对心肾不交型更年期综合征患者相关激素水平的影响[J].四川中医,2017,35(9):139-141.
[17]杨波,徐慧敏,朱亚芹,等.坤泰胶囊联合雌性激素替代疗法治疗更年期综合征的临床效果及可能的作用机制[J].中国性科学,2017,26(11):60-63.
[18]尚友琴,程文静,孙宏伟,等.替勃龙与坤泰胶囊治疗更年期综合征疗效及其对雌二醇、卵泡刺激素和子宫内膜厚度影响的比较[J].疑难病杂志,2016,15(7):725-728.
[19]Terauchi M,Hirose A,Akiyoshi M,et al.Prevalence and predictors of storage lower urinary tract symptoms in perimenopausal and postmenopausal women attending a menopause clinic[J].Menopause,2015,22(10):1084-1090.
[20]刘晓琴,高冬梅,张震.中医治疗女性更年期综合征研究进展[J].西部中医药,2016,29(4):131-133.
[21]郝瑞,郭惠岚,梁艳,等.四物汤加减治疗女性更年期综合征疗效观察[J].陕西中医,2016,37(10):1293-1294.
[22]石国令.二仙汤加味方治疗更年期综合征临床观察[J].四川中医,2017,35(1):125-127.
[23]王晓锋,刘雁峰,李靖,等.刘雁峰教授交通心肾法治疗更年期综合征的经验浅析[J].世界中医药,2017,12(2):366-368.
[24]黄燕,赵映红,王朝志,等.更年期综合征妇女门诊规范性治疗的临床研究[J].中国妇幼保健,2016,31(10):2120-2123.
[25]张文秀.百合固金汤治疗更年期综合症临床研究[J].现代中医药,2016,36(5):57-59.
[26]董雪松,李树义.百合固金汤合生脉散加减方对肺结核患者血清中白介素与相关因子的影响[J].陕西中医,2014,35(9):1156-1158.
[27]王志勇,杨惠民,李浩.从肝气虚辨治更年期综合征[J].北京中医药,2017,36(1):66-68.
[28]田莉.百合固金汤合桃红四物汤加减治疗多囊卵巢综合征30例[J].光明中医,2014,29(1):98-99.
[29]Mitchell RJ,Shaw RG.Heritability of floral traits for the perennial wild flower Penstemon centranthifolius(Scrophulariaceae):clones and crosses[J].Heredity,1993,71(2):185-192.
[30]Huang Y,Liu Z,Bo R,et al.The enhanced immune response of PCV-2 vaccine using Rehmannia glutinosa polysaccharide liposome as an adjuvant[J].Int J Biol Macromol,2016,86:929-936.
[31]Kim JE,Cho J,Kwon O,et al.Effect of Guizhifulingwan(Keishibukuryogan)on climacteric syndrome:study protocol for a randomized controlled pilot trial[J].Trials,2017,18(1):135.
[32]Kim M,Kim AR,Park HJ,et al.Danggwijagyaksan for climacteric syndrome in peri-and postmenopausal women with a blood-deficiency dominant pattern:study protocol for a randomized,double-blind,placebo-controlled pilot trial[J].Trials,2018,19(1):41.
[33]Nowakowska I,Rasińska R,Gowacka MD.Analysis of relationships between perimenopausal symptoms and professional functioning and life satisfaction--Subjective perception of the dependence in women aged 40+[J].Med Pr,2015,66(3):351-358.
[34]Vuksanovic M,Mihajlovic G,Beljic ZT,et al.Cross-talk between muscle and bone in postmenopausal women with hypovitaminosis D[J].Climacteric,2017,20(1):31-36.
[35]张慧.百合固金汤联合标准化疗方案治疗初治菌阳性肺结核50例[J].山东中医杂志,2017,36(11):945-947.
[36]Mc Curry SM,Guthrie KA,Morin CM,et al.Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms:A Ms FLASH Randomized Clinical Trial[J].JAMA Intern Med,2016,176(7):913-920.