加减滋肾生肝饮治疗肝经郁火型青春期多囊卵巢综合征的临床研究
|
摘要
目的：本研究为运用中医古方滋肾生肝饮加减治疗肝经郁火型青春期多囊卵巢综合征的临床研究。经中药治疗,通过比较治疗前后患者的月经、中医症候等临床症状,以及性激素、B超等实验室检查指标变化,探讨加减滋肾生肝饮治疗肝经郁火型青春期多囊卵巢综合征的临床疗效,并阐明性激素结合球蛋白与青春期多囊卵巢综合征发病机制之间的关系。
方法：42例证属肝经郁火型青春期多囊卵巢综合征患者,服用中药“滋肾生肝饮”加减方,3月为一个疗程。在治疗前及治疗3个月后,于月经第3天采集空腹静脉血,测定血清性激素结合球蛋白(SHBG)、睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_2)等,并观察月经、中医症候、体重、基础体温(BBT)等变化。
结果：中药加减滋肾生肝饮治疗肝经郁火型青春期PCOS患者42例,总有效率为64.29%。治疗后月经评分较前下降41.32%,中医症候评分较前下降51.72%,统计学差异具有显著性(P<0.05)。性激素水平、基础体温(BBT)、体重指数(BMI)等方面也疗效显著(P<0.05)
结论：通过本研究,证实加减滋肾生肝饮能明显改善肝经郁火型青春期多囊卵巢综合征患者的临床症状,临床应用无明显副反应,值得进一步研究和推广。其作用机制可能为通过降低体内T水平、调节脂代谢,促进SHBG与T、E2、胰岛素等激素水平间的动态平衡,以及使PCOS患者下丘脑-垂体-卵巢轴的功能得到调整恢复,整体上改善内分泌环境,调整月经周期。
Purpose:This study is a clinical research of treating liver meridian fermented type of adolescence polycystic ovarian syndrome by using traditional chinese medicine Ancient formula "add and subtract zishenshenggan drink". Through the comparison of patients before and after the treatment of menstruation, TCM clinical symptoms, such as sickness, type-b ultrasonic sex hormones, discusses laboratory indicators in addition and subtraction born AIDS treatment of liver kidney by liver drink depressed fire type adolescence, the clinical curative effect of polycystic ovarian syndrome, explore zishenshenggan drink treatment liver meridian fermented type of adolescence polycystic ovarian syndrome, and discuss the clinical curative effect of sex hormone binding globulin and adolescence polycystic ovarian syndrome pathogenesis the relationship between them.
Method:42 examples patients of liver meridian fermented type of adolescence polycystic ovarian syndrome, take herbal subtract" zishenshenggan drinking" for three months as a period of treatment. Before the treatment and three months after treatment, gather fasting blood in her menstrual the first three days, Determination of serum sex hormone binding globulin (SHBG), testosterone (T), luteinizing hormone (LH), eery follicle-stimulating hormone (FSH), estradiol (E2), and the observation of menstruation, TCM symptoms, weight, fundamental temperature (BBT) change.
Result:Traditional Chinese medicine to "add and subtract zishenshenggan drink" by liver meridian fermented type of adolescence polycystic ovarian syndrome patients, with the total effective rate of 42 cases (64.29%). After treatment 41.32% menstrual score dropped earlier, TCM symptoms score dropped earlier 51.72% and statistically with significant difference (P< 0.05). Reproductive hormone levels, fundamental temperature (BBT), body mass index (BMI) etc also curative effect is significant (P<0.05).
Conclusion:Through this research, confirm "add and subtract zishenshenggan drink" can significantly improve liver meridian fermented type adolescence polycystic ovarian syndrome patients with clinical symptoms and clinical application no significant side effects and deserves further research and extension. The mechanism of its action by lowering the body may be T level, adjusting lipid metabolism, promote with T SHBG, E2 and hormones such as insulin levels, and the dynamic balance between that PCOS patients hypothalamus-pituitary-adrenal axis function has been adjusted ovarian endocrine, the overall improve recovery environment and promote follicular and ovulation.
方法：42例证属肝经郁火型青春期多囊卵巢综合征患者,服用中药“滋肾生肝饮”加减方,3月为一个疗程。在治疗前及治疗3个月后,于月经第3天采集空腹静脉血,测定血清性激素结合球蛋白(SHBG)、睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_2)等,并观察月经、中医症候、体重、基础体温(BBT)等变化。
结果：中药加减滋肾生肝饮治疗肝经郁火型青春期PCOS患者42例,总有效率为64.29%。治疗后月经评分较前下降41.32%,中医症候评分较前下降51.72%,统计学差异具有显著性(P<0.05)。性激素水平、基础体温(BBT)、体重指数(BMI)等方面也疗效显著(P<0.05)
结论：通过本研究,证实加减滋肾生肝饮能明显改善肝经郁火型青春期多囊卵巢综合征患者的临床症状,临床应用无明显副反应,值得进一步研究和推广。其作用机制可能为通过降低体内T水平、调节脂代谢,促进SHBG与T、E2、胰岛素等激素水平间的动态平衡,以及使PCOS患者下丘脑-垂体-卵巢轴的功能得到调整恢复,整体上改善内分泌环境,调整月经周期。
Purpose:This study is a clinical research of treating liver meridian fermented type of adolescence polycystic ovarian syndrome by using traditional chinese medicine Ancient formula "add and subtract zishenshenggan drink". Through the comparison of patients before and after the treatment of menstruation, TCM clinical symptoms, such as sickness, type-b ultrasonic sex hormones, discusses laboratory indicators in addition and subtraction born AIDS treatment of liver kidney by liver drink depressed fire type adolescence, the clinical curative effect of polycystic ovarian syndrome, explore zishenshenggan drink treatment liver meridian fermented type of adolescence polycystic ovarian syndrome, and discuss the clinical curative effect of sex hormone binding globulin and adolescence polycystic ovarian syndrome pathogenesis the relationship between them.
Method:42 examples patients of liver meridian fermented type of adolescence polycystic ovarian syndrome, take herbal subtract" zishenshenggan drinking" for three months as a period of treatment. Before the treatment and three months after treatment, gather fasting blood in her menstrual the first three days, Determination of serum sex hormone binding globulin (SHBG), testosterone (T), luteinizing hormone (LH), eery follicle-stimulating hormone (FSH), estradiol (E2), and the observation of menstruation, TCM symptoms, weight, fundamental temperature (BBT) change.
Result:Traditional Chinese medicine to "add and subtract zishenshenggan drink" by liver meridian fermented type of adolescence polycystic ovarian syndrome patients, with the total effective rate of 42 cases (64.29%). After treatment 41.32% menstrual score dropped earlier, TCM symptoms score dropped earlier 51.72% and statistically with significant difference (P< 0.05). Reproductive hormone levels, fundamental temperature (BBT), body mass index (BMI) etc also curative effect is significant (P<0.05).
Conclusion:Through this research, confirm "add and subtract zishenshenggan drink" can significantly improve liver meridian fermented type adolescence polycystic ovarian syndrome patients with clinical symptoms and clinical application no significant side effects and deserves further research and extension. The mechanism of its action by lowering the body may be T level, adjusting lipid metabolism, promote with T SHBG, E2 and hormones such as insulin levels, and the dynamic balance between that PCOS patients hypothalamus-pituitary-adrenal axis function has been adjusted ovarian endocrine, the overall improve recovery environment and promote follicular and ovulation.
引文
[1]张丽珠.临床生殖内分泌与不育症[M].北京：科学出版社,2001：384;393
[2]Jakubowicz D J, Morno M J, Jakwbowicz S. Effects of metforimn on early—pergnancy loss in the polycystic ovary syndrome [J].J Clin Endrocinol Metab,2002,87 (2):524-529
[3]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂志,2008,24(1)：51-52
[4]禹安琪,李秀然.疏肝泻火法治疗青春期肝经郁火型多囊卵巢综合征22例[J].中医药导报,2009,15(12)：17-18
[5]柴丽宏.疏肝清解汤治疗肝经郁热型青春期多囊卵巢综合征临床观察[J].北京中医,2006,25(6)：323-326
[6]韦雄.自拟通经汤治疗肾虚肝郁型青春期闭经63例[J].广西中医院学报,2007,10(02)：9-10
[7]陈小平,谢波,陈靓芬.补肾疏肝汤治疗肾虚肝郁型青春期多囊卵巢综合征21例临床观察[J].云南中医中药杂志,2008,29(4)：9-10
[8]王燕萍,顺慧芳.补肾化痰活血法治疗青春期多囊卵巢综合征[J]. Chinese Journal of Information on TCM,2008,15(2):66-67.
[9]尤昭玲,杨正望,傅灵梅.多囊卵巢综合征从肾虚血瘀调治的探讨[J].湖南中医学院学报,2005,25(1)：25-26.
[10]张凤掸,薛耀.中医经治疗多囊卵巢综合征方法初探.新中医.1991,3(1)：167
[11]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂,2008,24(1)：51-52.
[12]李丽,孙维峰.中药补肾活血.法纠正青春期多囊卵巢综合征内分泌状态的临床研究[J].实用中医杂志,2009,25(13)：2177-2179
[13]王燕萍,顺慧芳.补肾化痰活血法治疗青春期多囊卵巢综合征33例临床观察[J].中国中医药信息杂志,2008,15(2)：66-67
[14]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂志,2008,24(1)：51-52
[15]禹安琪,李秀然.疏肝泻火法治疗青春期肝经郁火型多囊卵巢综合征22例[J].中医药导报,2009.15(12)：17-18
[16]陈小平,谢波,陈靓芬.补肾疏肝汤治疗肾虚肝郁型青春期多囊卵巢综合征21例临床观察[J].云南中医药杂志,2008,29(4)：9-10
[17]侣雪平,冯晓玲.益肾消囊饮治疗青春期多囊卵巢综合征35例临床观察[J].中国中医药科技,2007,14(4)：276
[18]柴丽宏.疏肝清解汤治疗肝经郁热型青春期多囊卵巢综合征临床观察[J].北京中医,2006,25(6)：323-326
[19]韦雄.自拟通经汤治疗肾虚肝郁型青春期闭经63例[J].广西中医院学报,2007,10(02)：9-10
[20]郝兰枝,魏俊英.中药人工周期治疗青春期多囊卵巢综合征40例[J].中医研究,2003,16(3)： 35-36
[21]韩字研.重视多囊卵巢综合征的诊治[J].实用医院临床杂志,2008,5(6)：1-2
[22]满玉晶,芦金男,吴效科等.青春期多囊卵巢综合征研究进展[J].现代中西医结合杂志,2009,18(35)：4448-4449
[23]彭艳,李威,吴效科等.青春期易患多囊卵巢综合征的危险因素[J].中国妇幼健康研究,2008,19(2)：162-164
[24]LegroRS, Bentley-LewisR, DriscollD, eta.l Insulin resistance inthe sisters ofwomen with polycystic ovary syndrome:association withhyperandrogenemia rather thanmenstrual irregularity. JournalofClini-calEndocrinology andMetabolism,2002,87: 2128^2133.
[25]FranksS, McCarthyM. Genetics ofovarian disorders:polycystic ova-ry syndrome. Endocrine&Metabolic Disorders,2004,5:69-76.
[26]Joseph FMaher, RandalISHines, WalterFutterweit, et a.1 FEM1A isa candidate gene for polycystic ovary syndrome. GynecologicalEndo-crinology,2005,21(6):330^335.
[27]Fer-YangDiao, MinXu, JiayinLiu, etal. Globalanalysisofgeneexpression profiliinpolyeysti. ovarysyndromeovaryusinghumanovaryCdnami。roarrav.全国多囊卵巢综合征专题研讨会资料汇编：54
[28]Abbott DH, Dumesic DA, Franks S. Developmental origin of polycystic ovary syndrome—a hypothesis [J]. J Endocrinol,2002,174(1):1-5.
[29]胡燕宁.青少年多囊卵巢综合征与其父母代谢综合征的相关性研究[J].现代中西医结合杂志,2008,17(3)：335-337.
[30]KoppHP, Festa A, KruglugerW, et al·Low levels sex hormone-binding globulin predict insulin requirement in patientswith gestationaldiabetesmellitus [J] ·Exp Clin Endocrinol Diabetes,2001,109(7):365
[31]李金凤,张红花,刘巍.生活方式干预联合药物治疗肥胖型多囊卵巢综合征的临床观察[J].中国药物与临床.2009,9(12)：12381239
[32]杨冬梓,石一复.小儿和青春期妇科学[M].北京：人民卫生出版社,2003：169
[33]薄晓莉,丁岩,赵金萍等.复方醋酸环丙孕酮对多囊卵巢综合征患者临床疗效观察[J]. 新疆医科大学学报,2007,30(6)：626-629
[34]杨冬梓,冯淑英,李琳等.青春期多囊卵巢综合征[J].现代妇产科进展,2006,15(10)：721-734
[35]Evangelia Z, Erasmia K, Dimitrios L. Treatment options of polycystic ovary syndrome in adoescence[J].Pediatr Endocrinol Rev,2006,3(1):208-21
[36]王爱玲,于翠革,石紫云.二甲双胍联合妈富隆治疗青春期多囊卵巢综合征疗效观察[J].陕西医学杂志,2009,38(6)：718-720
[37]Mendizabal S, Zamora I.Berbel 0, et al. Mycophenolate mofetil in ste-roid/ cyclosporine-dependent/resistant nephrotic syndrome[J]. PediatrNephrol,2005,20(7):914-919.
[38]宋珍,邓晓惠.二甲双胍联合达英-35治疗青春期多囊卵巢综合征疗效观察[J].中国医疗前沿,2009,4(9)：69-70
[39]杜静,梁晓燕.二甲双胍联合复方醋酸环丙孕酮治疗青春期PCOS疗效分析[J].国际妇产科学杂志,2008,35(1)：69-71
[40]杨冰,叶元,冯艳等.青春期多囊卵巢综合征的早期诊断及治疗[J].中国妇幼保健,2008,23(27)3828-3829
[41]郑文宾.滋肾生肝饮加减治疗围绝经期乳痛症[J].四川中医.2008,26(10)：83-84.
[42]赵瑞.中药治疗免疫性不孕症的临床研究[J].中医药研究.2001,17(3)：41
[43]边宝林,王宏浩,倪幕云地黄及其炮制品中糖及儿种主要糖的含量测定[J]中国中药杂志,1995.20(8)：469
[44]袁媛.侯土良,连天顺血作用的实验研究[j]1992.17(60)：366
[45]李兰青地黄药理研究进展[J]中成药.1994.6(9)：47
[46]陈丁丁.戴德哉.章涛,等.地黄煎剂消退I—甲状腺素诱发的大鼠心肌肥厚并抑制其升高的心、脑线粒体Na、K—ATP酶活力[J].中药药理与临床,1997,13(4)：27-28
[47]边宝林,王宏浩,倪幕云地黄及其炮制品中糖及几种主要糖的含量测定[J]中国中药杂志,1995.20(8)：469
[48]王萍.陈青莲.柴胡炮制品对小白鼠全血胆碱酯酶活力的影响[J]中药材,2000,23(4)：219.
[49]陈东鸿.李平.柴胡及甘草酸对小鼠肝细胞凋亡的影响[J].第四军医大学学报,1998,19(3)：279
[50]下胜春,王玲。柴胡及五灵丸对慢性肝损伤小鼠的影响[J].第四军医大学学报,2002,23(2)：133.
[51]邵淑丽.柴胡、姜黄对小白鼠实验性高脂血症的预防作用[J].中医药学报,2002,30(4)：59-59
[52]梁云,崔若兰.柴胡皂苷d治疗抗肾小球基膜型肾炎的实验研究[J]。第二军医大学学报,1999,20(7)：416-416.
[53]徐安平,崔若兰。柴胡皂苷d对实验性膜性肾炎疗效及作用机理研究。肾脏病与透析肾移植杂志,2006,(6)：215
[54]张亮,胡海宝.南柴胡多精分离与组成的初步研究[J].中草药.2000,31(9)：647.
[55]姜蓉,吴宏,王亚平.当归多糖对造血生长因子受体表达调控的实验研究[刀.解剖科学进展,2004;10(8)：55-55.
[56]梅全喜,毕焕新.现代中药药理手册[M].北京：中国中医药出版社.1998：577
[57]余鸿,刘敦玉,吴雨岭,等.当归对缺氧鼠胚模型神经干细胞增殖的影响[J].中国现代医学 杂志,2005；21(15)：3226-3228.
[58]杭悦宇.国产日本薯蓣主要化学成分含量和药理实验测定.植物资源与环境,1996,5(2)：5-8.
[59]王秩,邓洁英.C肽研究进展[J].国外医学内分泌学分册,1996,16(4)：169.
[60]李树英.山药健脾胃作用的研究.中药药理与临床,1990,9(4)：232.
[61]韩璩超,季晖,薛城锋.山茱英总萜的降血糖作用[J].中国天然药物,2006,(2)：53—57.
[62]郭红艳,栾晶,张鹏霞,等.山茱萸醇提物对D一半乳糖致衰大鼠非酶糖化及AR活性的影响[J].黑龙江医药科学,2004,27(6)：1-2.
[63]纪芳,李鹏飞,徐胜元,等.羧甲基茯苓多糖的制备及体内抗肿瘤实验研究[J].中国微生态学杂志。2003,15(6)：333—334.
[64]陈春霞.羧甲基茯苓多糖的保肝和催眠作用[J].食用菌,2003。(增刊)：46-47.
[65]陈宏,曾凡波,雷学峰,等.伏苓多糖的抗肿瘤作用及其机理的研究[J].中药药理与临床,1995,(2)：34-35.
[66]夏树,姚生莲,郭晓梅.芎归失笑散治疗宫内节育器所致出血112例fJl.陕西中医,2000,21(12)：530.
[67]YoshikawaM,etal.中药牡丹皮中5种新的抗氧化糖苷没食子酰氧化芍药苷及酚糖苷的分离.国外医学中医中药分册,1994；16(1)：43.
[68]余上才,张育正,赵慧娟,等.枸杞子和白术免疫调节作用的实验室研究[J],上海免疫学杂志.1994,14(1)：12.
[69]吴翰桂,马勇军,马国芳.白术对小鼠小肠平滑肌作用的影响[J],台洲学院学报,2004.26(6)：48.
[70]刘超,王静,杨军.赤芍总营活血化瘀作用的研究[J].中药材,2000,23(9)：557-5印.
[71]吴望明,吴应建.赤芍总甙对大鼠肾缺血再灌注损伤的保护作用研究[J].湖南中医杂志,2004,20(3)：68-69.
[72]袁冬生,周兰芳,石磊。等.赤芍总苷对D.氨基半乳糖胺所致小鼠肝损伤的保护作用[J].热带医学杂志,2007,7(2)：139-142.
[73]吴芳.赤芍总苷／淫羊藿总黄酮对实验性抑郁及脑5.Irr和辟肾上腺索受体的影响[J].现代预防医学,2005,32(7)：744-746.
[74]杨军,王静,张继训,等.赤芍总苷对小鼠学习记忆能力的改善作用[J].中国药理学通报,2000,16(1)：46-49.
[75]获野信义.汉方医学.当归芍药的药理作用[J]国外医学中医册,1998,22(7),221-223
[76]梁若等.白芍的抗炎免疫药理作用研究[J].新中医,1989;21(3)：51)(王永祥等.白芍总甘的镇痛作用研究[J].中国药理学通报,1993；9(1)：58
[77]丁正康.重用白芍治肠道激惹综合症[J].浙江中医杂志,1990；25(10)：445
[78]韩景兰,李晓萍,刘翠红.保肝中药研究进展[J].中医药信息,2001.18(2)：22-23.
[79]李廷利,黄莉莉,郝丽莉,等.具有镇静催眠作用的中药活性成分研究[J].中医药信息,2003, 20(3)：18-20.
[80]苗明三,方晓艳.五味子多糖对正常小鼠免疫细胞的影响[J].中国中医药科技,2003,10(2)：100-101.
[81]秦建国,王亚红,梁晋普,等泽泻萜类化合物对ApoE基因敲除动脉粥样硬化小鼠肝脏基底膜HSPG的调节作用[J]中华中医药学刊,2007,25(4)：699-698.
[82]彭贤,黄舒,郦皆秀,等.泽泻属植物化学成分与药理活性[J].国外医药植物药分册,2000,15(6)：245.
[83]杨新波,黄正明,曹文彬,等.泽泻水提取物对正常小鼠及高血糖小鼠血糖的影响[J].中药药理与临床,1998,14(6)：29.
[84]戴岳,杭秉茜.泽泻对谷氨酸钠肥胖大鼠的影响[J].中成药,1992,14(2)：28.
[85]Al-QarawiAA, Abdel-RahmanHA, AliBH, et. Liquoriec (Glycyrrhizaslabm) nadtheadrenal-kidneypituitaryaxisinrast. Food andChemiad Toxicology.2002,40: 1525-1527.
[86]JiaoWJ(焦文建),LiXH(李笑宏),xuc(徐潮),et. Protcetiveroleoflsycyrrhizinonrenalischemia/reepfusionnirast.ChinJModemMed(中国现代医学杂志),2002,12(3)：50-51.
[87]Fuhrman B, Volkova N. Anifatherosclemf ic efects fo licoriceextractssupplenmentaifonon hypercholestemlemic paitents:ni—cnxlsodresistanceofLDL toatherogenicmodiifcations.reducedplasma lipid levels, and decreased systolic blood pressure. Nutrition,2002,18:268。273.
[88]LeungYK,NgTB, HoJW.Transcriptionalregulaitonoffosl-lbylicoricein ratclone9 cells.Sc /ences,2003,73: 3109-3121.
[89]夏桂成.实用中医妇科学[M].北京：中国中医药出版社.2009,248-250.
[90]杜莹,张玉珍.黄体功能不全的中医治疗概述[J].新中医,2006,38：22-23.
[91]孙斐,俞瑾等.中药天癸方对雄激素致不孕大鼠下丘脑Leptin受体及神经肽YmRNA的影响.中国中西医结合杂志,2000,20(5)：362
[92]王佳,邹大进.女性痤疮患者血清雄激素水平的变化.实用医药杂志[J].2009,26(6)：1-2
[93]倪张俊,张玉珍.青春期与育龄期多囊卵巢综合征临床比较研究[D].广州中医药大学,2007.
[94]归绥琪,俞瑾,魏美娟等.补肾中药对雄激素致不孕大鼠垂体、卵巢及肾上腺作用的实验研究[J].中国中西医结合杂志,1997,17(12)：735.
[95]周丽容,俞瑾.补肾阴药治疗高胰岛素高雄激素无排卵临床观察.中国中西医结合杂志,1996,16(9)：515-518
[96]Cunnigham SK. et. al. J Clin Endocrilnol. Metab.1981.58.915
[97]Thiboutot D,Harris G, Iles V,et al.Activity of the type 15-a-reductase exhibits regional differences in isolated sebaceousglands and whole skin. J Invest Dermatol,1995,105:209.
[98]Degitz K,Placzek M, Borelli C, et al. Pathophysiology of acne. J Dtsch Dermatol Ges,2007,5(4):316.
[99]Zouboulis CC, Degitz K. Androgen action on human skin-formbasic research to clinical significance. Exp Dermatol,2004,13(Suppl 4):5.
[100]Hanfner SM·Sex hormone-binding globulin protein hyperinsulinemia, insulin resistance and noninsulin-dependent diabetes [J]·HormRes,1996,45 (3-5):233
[101]Birkeland KI, Hanssen KF, Tojesen PA, etal·Level of sex hormone-binding globulin is positively correlated with insulin sensitivity in menwith type 2 diabetes [J]·JClin EndocrinolMetab,1993,76:275
[102]PeirisAN, Stagner JI, Plymate SR, et al·Relationship of insulin se-cretory pulse to sex hormone-binding globulin levels in normal men [J]·JClin EndocrinolMetab,1993, 76 (2):275
[103]Plymate SR, Metej LA, Jones Re,et al·Inhibition of sex hormone-binding globulin production in the human hepatoma (HepG2) cell byinsulin and prolactin [J]·J Clin EndocrinolMetab,1988,67 (3):460
[104]Birkeland KI, Hanssen KF, Tojesen PA, etal·Level of sex hormone-binding globulin is positively correlated with insulin sensitivity in menwith type 2 diabetes [J]·JClin EndocrinolMetab,1993,76:275
[105]SherifK, KushnerH, FalknerBE·Sex hormone-binding globulin andinsulin resistance in African -American women [J]·Metabolism,1998,47 (1):70
[106]刘向红,陆一俊,荣周艳丽.养阴化瘀中药对大鼠实验性高脂血症血及肝脏脂质代谢的影响.河北中医.2000,22(9)：710-711
[2]Jakubowicz D J, Morno M J, Jakwbowicz S. Effects of metforimn on early—pergnancy loss in the polycystic ovary syndrome [J].J Clin Endrocinol Metab,2002,87 (2):524-529
[3]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂志,2008,24(1)：51-52
[4]禹安琪,李秀然.疏肝泻火法治疗青春期肝经郁火型多囊卵巢综合征22例[J].中医药导报,2009,15(12)：17-18
[5]柴丽宏.疏肝清解汤治疗肝经郁热型青春期多囊卵巢综合征临床观察[J].北京中医,2006,25(6)：323-326
[6]韦雄.自拟通经汤治疗肾虚肝郁型青春期闭经63例[J].广西中医院学报,2007,10(02)：9-10
[7]陈小平,谢波,陈靓芬.补肾疏肝汤治疗肾虚肝郁型青春期多囊卵巢综合征21例临床观察[J].云南中医中药杂志,2008,29(4)：9-10
[8]王燕萍,顺慧芳.补肾化痰活血法治疗青春期多囊卵巢综合征[J]. Chinese Journal of Information on TCM,2008,15(2):66-67.
[9]尤昭玲,杨正望,傅灵梅.多囊卵巢综合征从肾虚血瘀调治的探讨[J].湖南中医学院学报,2005,25(1)：25-26.
[10]张凤掸,薛耀.中医经治疗多囊卵巢综合征方法初探.新中医.1991,3(1)：167
[11]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂,2008,24(1)：51-52.
[12]李丽,孙维峰.中药补肾活血.法纠正青春期多囊卵巢综合征内分泌状态的临床研究[J].实用中医杂志,2009,25(13)：2177-2179
[13]王燕萍,顺慧芳.补肾化痰活血法治疗青春期多囊卵巢综合征33例临床观察[J].中国中医药信息杂志,2008,15(2)：66-67
[14]桑霞,张玉珍.青春期多囊卵巢综合征从肝论治体会[J].湖南中医杂志,2008,24(1)：51-52
[15]禹安琪,李秀然.疏肝泻火法治疗青春期肝经郁火型多囊卵巢综合征22例[J].中医药导报,2009.15(12)：17-18
[16]陈小平,谢波,陈靓芬.补肾疏肝汤治疗肾虚肝郁型青春期多囊卵巢综合征21例临床观察[J].云南中医药杂志,2008,29(4)：9-10
[17]侣雪平,冯晓玲.益肾消囊饮治疗青春期多囊卵巢综合征35例临床观察[J].中国中医药科技,2007,14(4)：276
[18]柴丽宏.疏肝清解汤治疗肝经郁热型青春期多囊卵巢综合征临床观察[J].北京中医,2006,25(6)：323-326
[19]韦雄.自拟通经汤治疗肾虚肝郁型青春期闭经63例[J].广西中医院学报,2007,10(02)：9-10
[20]郝兰枝,魏俊英.中药人工周期治疗青春期多囊卵巢综合征40例[J].中医研究,2003,16(3)： 35-36
[21]韩字研.重视多囊卵巢综合征的诊治[J].实用医院临床杂志,2008,5(6)：1-2
[22]满玉晶,芦金男,吴效科等.青春期多囊卵巢综合征研究进展[J].现代中西医结合杂志,2009,18(35)：4448-4449
[23]彭艳,李威,吴效科等.青春期易患多囊卵巢综合征的危险因素[J].中国妇幼健康研究,2008,19(2)：162-164
[24]LegroRS, Bentley-LewisR, DriscollD, eta.l Insulin resistance inthe sisters ofwomen with polycystic ovary syndrome:association withhyperandrogenemia rather thanmenstrual irregularity. JournalofClini-calEndocrinology andMetabolism,2002,87: 2128^2133.
[25]FranksS, McCarthyM. Genetics ofovarian disorders:polycystic ova-ry syndrome. Endocrine&Metabolic Disorders,2004,5:69-76.
[26]Joseph FMaher, RandalISHines, WalterFutterweit, et a.1 FEM1A isa candidate gene for polycystic ovary syndrome. GynecologicalEndo-crinology,2005,21(6):330^335.
[27]Fer-YangDiao, MinXu, JiayinLiu, etal. Globalanalysisofgeneexpression profiliinpolyeysti. ovarysyndromeovaryusinghumanovaryCdnami。roarrav.全国多囊卵巢综合征专题研讨会资料汇编：54
[28]Abbott DH, Dumesic DA, Franks S. Developmental origin of polycystic ovary syndrome—a hypothesis [J]. J Endocrinol,2002,174(1):1-5.
[29]胡燕宁.青少年多囊卵巢综合征与其父母代谢综合征的相关性研究[J].现代中西医结合杂志,2008,17(3)：335-337.
[30]KoppHP, Festa A, KruglugerW, et al·Low levels sex hormone-binding globulin predict insulin requirement in patientswith gestationaldiabetesmellitus [J] ·Exp Clin Endocrinol Diabetes,2001,109(7):365
[31]李金凤,张红花,刘巍.生活方式干预联合药物治疗肥胖型多囊卵巢综合征的临床观察[J].中国药物与临床.2009,9(12)：12381239
[32]杨冬梓,石一复.小儿和青春期妇科学[M].北京：人民卫生出版社,2003：169
[33]薄晓莉,丁岩,赵金萍等.复方醋酸环丙孕酮对多囊卵巢综合征患者临床疗效观察[J]. 新疆医科大学学报,2007,30(6)：626-629
[34]杨冬梓,冯淑英,李琳等.青春期多囊卵巢综合征[J].现代妇产科进展,2006,15(10)：721-734
[35]Evangelia Z, Erasmia K, Dimitrios L. Treatment options of polycystic ovary syndrome in adoescence[J].Pediatr Endocrinol Rev,2006,3(1):208-21
[36]王爱玲,于翠革,石紫云.二甲双胍联合妈富隆治疗青春期多囊卵巢综合征疗效观察[J].陕西医学杂志,2009,38(6)：718-720
[37]Mendizabal S, Zamora I.Berbel 0, et al. Mycophenolate mofetil in ste-roid/ cyclosporine-dependent/resistant nephrotic syndrome[J]. PediatrNephrol,2005,20(7):914-919.
[38]宋珍,邓晓惠.二甲双胍联合达英-35治疗青春期多囊卵巢综合征疗效观察[J].中国医疗前沿,2009,4(9)：69-70
[39]杜静,梁晓燕.二甲双胍联合复方醋酸环丙孕酮治疗青春期PCOS疗效分析[J].国际妇产科学杂志,2008,35(1)：69-71
[40]杨冰,叶元,冯艳等.青春期多囊卵巢综合征的早期诊断及治疗[J].中国妇幼保健,2008,23(27)3828-3829
[41]郑文宾.滋肾生肝饮加减治疗围绝经期乳痛症[J].四川中医.2008,26(10)：83-84.
[42]赵瑞.中药治疗免疫性不孕症的临床研究[J].中医药研究.2001,17(3)：41
[43]边宝林,王宏浩,倪幕云地黄及其炮制品中糖及儿种主要糖的含量测定[J]中国中药杂志,1995.20(8)：469
[44]袁媛.侯土良,连天顺血作用的实验研究[j]1992.17(60)：366
[45]李兰青地黄药理研究进展[J]中成药.1994.6(9)：47
[46]陈丁丁.戴德哉.章涛,等.地黄煎剂消退I—甲状腺素诱发的大鼠心肌肥厚并抑制其升高的心、脑线粒体Na、K—ATP酶活力[J].中药药理与临床,1997,13(4)：27-28
[47]边宝林,王宏浩,倪幕云地黄及其炮制品中糖及几种主要糖的含量测定[J]中国中药杂志,1995.20(8)：469
[48]王萍.陈青莲.柴胡炮制品对小白鼠全血胆碱酯酶活力的影响[J]中药材,2000,23(4)：219.
[49]陈东鸿.李平.柴胡及甘草酸对小鼠肝细胞凋亡的影响[J].第四军医大学学报,1998,19(3)：279
[50]下胜春,王玲。柴胡及五灵丸对慢性肝损伤小鼠的影响[J].第四军医大学学报,2002,23(2)：133.
[51]邵淑丽.柴胡、姜黄对小白鼠实验性高脂血症的预防作用[J].中医药学报,2002,30(4)：59-59
[52]梁云,崔若兰.柴胡皂苷d治疗抗肾小球基膜型肾炎的实验研究[J]。第二军医大学学报,1999,20(7)：416-416.
[53]徐安平,崔若兰。柴胡皂苷d对实验性膜性肾炎疗效及作用机理研究。肾脏病与透析肾移植杂志,2006,(6)：215
[54]张亮,胡海宝.南柴胡多精分离与组成的初步研究[J].中草药.2000,31(9)：647.
[55]姜蓉,吴宏,王亚平.当归多糖对造血生长因子受体表达调控的实验研究[刀.解剖科学进展,2004;10(8)：55-55.
[56]梅全喜,毕焕新.现代中药药理手册[M].北京：中国中医药出版社.1998：577
[57]余鸿,刘敦玉,吴雨岭,等.当归对缺氧鼠胚模型神经干细胞增殖的影响[J].中国现代医学 杂志,2005；21(15)：3226-3228.
[58]杭悦宇.国产日本薯蓣主要化学成分含量和药理实验测定.植物资源与环境,1996,5(2)：5-8.
[59]王秩,邓洁英.C肽研究进展[J].国外医学内分泌学分册,1996,16(4)：169.
[60]李树英.山药健脾胃作用的研究.中药药理与临床,1990,9(4)：232.
[61]韩璩超,季晖,薛城锋.山茱英总萜的降血糖作用[J].中国天然药物,2006,(2)：53—57.
[62]郭红艳,栾晶,张鹏霞,等.山茱萸醇提物对D一半乳糖致衰大鼠非酶糖化及AR活性的影响[J].黑龙江医药科学,2004,27(6)：1-2.
[63]纪芳,李鹏飞,徐胜元,等.羧甲基茯苓多糖的制备及体内抗肿瘤实验研究[J].中国微生态学杂志。2003,15(6)：333—334.
[64]陈春霞.羧甲基茯苓多糖的保肝和催眠作用[J].食用菌,2003。(增刊)：46-47.
[65]陈宏,曾凡波,雷学峰,等.伏苓多糖的抗肿瘤作用及其机理的研究[J].中药药理与临床,1995,(2)：34-35.
[66]夏树,姚生莲,郭晓梅.芎归失笑散治疗宫内节育器所致出血112例fJl.陕西中医,2000,21(12)：530.
[67]YoshikawaM,etal.中药牡丹皮中5种新的抗氧化糖苷没食子酰氧化芍药苷及酚糖苷的分离.国外医学中医中药分册,1994；16(1)：43.
[68]余上才,张育正,赵慧娟,等.枸杞子和白术免疫调节作用的实验室研究[J],上海免疫学杂志.1994,14(1)：12.
[69]吴翰桂,马勇军,马国芳.白术对小鼠小肠平滑肌作用的影响[J],台洲学院学报,2004.26(6)：48.
[70]刘超,王静,杨军.赤芍总营活血化瘀作用的研究[J].中药材,2000,23(9)：557-5印.
[71]吴望明,吴应建.赤芍总甙对大鼠肾缺血再灌注损伤的保护作用研究[J].湖南中医杂志,2004,20(3)：68-69.
[72]袁冬生,周兰芳,石磊。等.赤芍总苷对D.氨基半乳糖胺所致小鼠肝损伤的保护作用[J].热带医学杂志,2007,7(2)：139-142.
[73]吴芳.赤芍总苷／淫羊藿总黄酮对实验性抑郁及脑5.Irr和辟肾上腺索受体的影响[J].现代预防医学,2005,32(7)：744-746.
[74]杨军,王静,张继训,等.赤芍总苷对小鼠学习记忆能力的改善作用[J].中国药理学通报,2000,16(1)：46-49.
[75]获野信义.汉方医学.当归芍药的药理作用[J]国外医学中医册,1998,22(7),221-223
[76]梁若等.白芍的抗炎免疫药理作用研究[J].新中医,1989;21(3)：51)(王永祥等.白芍总甘的镇痛作用研究[J].中国药理学通报,1993；9(1)：58
[77]丁正康.重用白芍治肠道激惹综合症[J].浙江中医杂志,1990；25(10)：445
[78]韩景兰,李晓萍,刘翠红.保肝中药研究进展[J].中医药信息,2001.18(2)：22-23.
[79]李廷利,黄莉莉,郝丽莉,等.具有镇静催眠作用的中药活性成分研究[J].中医药信息,2003, 20(3)：18-20.
[80]苗明三,方晓艳.五味子多糖对正常小鼠免疫细胞的影响[J].中国中医药科技,2003,10(2)：100-101.
[81]秦建国,王亚红,梁晋普,等泽泻萜类化合物对ApoE基因敲除动脉粥样硬化小鼠肝脏基底膜HSPG的调节作用[J]中华中医药学刊,2007,25(4)：699-698.
[82]彭贤,黄舒,郦皆秀,等.泽泻属植物化学成分与药理活性[J].国外医药植物药分册,2000,15(6)：245.
[83]杨新波,黄正明,曹文彬,等.泽泻水提取物对正常小鼠及高血糖小鼠血糖的影响[J].中药药理与临床,1998,14(6)：29.
[84]戴岳,杭秉茜.泽泻对谷氨酸钠肥胖大鼠的影响[J].中成药,1992,14(2)：28.
[85]Al-QarawiAA, Abdel-RahmanHA, AliBH, et. Liquoriec (Glycyrrhizaslabm) nadtheadrenal-kidneypituitaryaxisinrast. Food andChemiad Toxicology.2002,40: 1525-1527.
[86]JiaoWJ(焦文建),LiXH(李笑宏),xuc(徐潮),et. Protcetiveroleoflsycyrrhizinonrenalischemia/reepfusionnirast.ChinJModemMed(中国现代医学杂志),2002,12(3)：50-51.
[87]Fuhrman B, Volkova N. Anifatherosclemf ic efects fo licoriceextractssupplenmentaifonon hypercholestemlemic paitents:ni—cnxlsodresistanceofLDL toatherogenicmodiifcations.reducedplasma lipid levels, and decreased systolic blood pressure. Nutrition,2002,18:268。273.
[88]LeungYK,NgTB, HoJW.Transcriptionalregulaitonoffosl-lbylicoricein ratclone9 cells.Sc /ences,2003,73: 3109-3121.
[89]夏桂成.实用中医妇科学[M].北京：中国中医药出版社.2009,248-250.
[90]杜莹,张玉珍.黄体功能不全的中医治疗概述[J].新中医,2006,38：22-23.
[91]孙斐,俞瑾等.中药天癸方对雄激素致不孕大鼠下丘脑Leptin受体及神经肽YmRNA的影响.中国中西医结合杂志,2000,20(5)：362
[92]王佳,邹大进.女性痤疮患者血清雄激素水平的变化.实用医药杂志[J].2009,26(6)：1-2
[93]倪张俊,张玉珍.青春期与育龄期多囊卵巢综合征临床比较研究[D].广州中医药大学,2007.
[94]归绥琪,俞瑾,魏美娟等.补肾中药对雄激素致不孕大鼠垂体、卵巢及肾上腺作用的实验研究[J].中国中西医结合杂志,1997,17(12)：735.
[95]周丽容,俞瑾.补肾阴药治疗高胰岛素高雄激素无排卵临床观察.中国中西医结合杂志,1996,16(9)：515-518
[96]Cunnigham SK. et. al. J Clin Endocrilnol. Metab.1981.58.915
[97]Thiboutot D,Harris G, Iles V,et al.Activity of the type 15-a-reductase exhibits regional differences in isolated sebaceousglands and whole skin. J Invest Dermatol,1995,105:209.
[98]Degitz K,Placzek M, Borelli C, et al. Pathophysiology of acne. J Dtsch Dermatol Ges,2007,5(4):316.
[99]Zouboulis CC, Degitz K. Androgen action on human skin-formbasic research to clinical significance. Exp Dermatol,2004,13(Suppl 4):5.
[100]Hanfner SM·Sex hormone-binding globulin protein hyperinsulinemia, insulin resistance and noninsulin-dependent diabetes [J]·HormRes,1996,45 (3-5):233
[101]Birkeland KI, Hanssen KF, Tojesen PA, etal·Level of sex hormone-binding globulin is positively correlated with insulin sensitivity in menwith type 2 diabetes [J]·JClin EndocrinolMetab,1993,76:275
[102]PeirisAN, Stagner JI, Plymate SR, et al·Relationship of insulin se-cretory pulse to sex hormone-binding globulin levels in normal men [J]·JClin EndocrinolMetab,1993, 76 (2):275
[103]Plymate SR, Metej LA, Jones Re,et al·Inhibition of sex hormone-binding globulin production in the human hepatoma (HepG2) cell byinsulin and prolactin [J]·J Clin EndocrinolMetab,1988,67 (3):460
[104]Birkeland KI, Hanssen KF, Tojesen PA, etal·Level of sex hormone-binding globulin is positively correlated with insulin sensitivity in menwith type 2 diabetes [J]·JClin EndocrinolMetab,1993,76:275
[105]SherifK, KushnerH, FalknerBE·Sex hormone-binding globulin andinsulin resistance in African -American women [J]·Metabolism,1998,47 (1):70
[106]刘向红,陆一俊,荣周艳丽.养阴化瘀中药对大鼠实验性高脂血症血及肝脏脂质代谢的影响.河北中医.2000,22(9)：710-711