补肾养血法治疗肾精亏虚型黄体功能不全性不孕症的临床观察
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摘要
目的:观察补肾养血为主的滋肾养血汤与益肾种玉汤序贯治疗肾精亏虚型黄体功能不全性不孕症的疗效,并探讨其疗效机理。方法:将40例LPD性不孕患者随机分为治疗组和对照组2组,治疗组20例,序贯服用滋肾养血汤与益肾种玉汤;对照组20例,序贯服用六味地黄软胶囊与佳蓉片,观察两组患者的临床症状、疗效、基础体温、女性内分泌(T,P,E2 ,LH,FSH,PRL)、卵泡发育等的改善情况并进行比较。结果:(1)治疗后两组患者的症状均较治疗前有显著性改善(P<0.05)。(2)两组疗效比较有显著性差异(P<0.05)。(3)治疗组治疗后在BBT类型等指标上有显著改善,对照组则无显著性改善。治疗后组间比较有显著性差异(P<0.05)。(4)治疗后两组在E2,LH水平上较治疗前均无显著性差异(P>0.05);治疗后两组T,PRL水平均有显著性下降(P<0.05),FSH,P水平显著升高(P<0.05),且两组间治疗后PRL,FSH,P比较亦有显著性差异(P<0.05)。(5)能够有效刺激不良卵泡的生长发育,治疗前后排卵前优势卵泡最大直径相比较有显著性差异(P<0.01),疗效两组无显著性差异对照组(P>0.05)。结论:LPD是下丘脑-垂体-卵巢-子宫轴各个环节不同程度的失调导致的一种综合征,临床上多表现为肾精亏虚症状,补肾养血为主滋肾养血汤与益肾种玉汤治以补肾填精,养血活血为主,可从整体上调节HPOA轴,使其恢复平衡,从而达到治疗LPD的目的,其临床疗效明显优于对照组。
Objective:To probe the reasons of LPD causing infertility furtherly, to evaluate the efficiency and to study the principle of Zishen Yangxue decoction and Yishen Zhongyu decoction tonifying kidney and invigorating vital energy,and to explore the mechanism of its efficacy.Methods:40 cases of infertility in patients with LPD were randomly divided into treatment group and control group 2 group, 20 cases of treatment group, sequential use of ZishenYangxue decoction and Yishen Zhongyu decoction; 20 cases of the control group, taking sequential Liuwei Dihuang soft capsules and Jiarong films , the two groups were observed in patients with clinical symptoms, the efficacy of basal body temperature, for female serum hormone such as luteinizing hormone(LH), folicles timulating hormone (FSH),prolactin(PRL),estrodiol(E2),progesterone(P),and Testosterone (T), such as the improvement of follicular development and comparison.Results:(1) After treatment two groups of patients than before treatment of the symptoms was significant improvement (P<0.05).(2)there significantly difference in the effective rate of the two groups(P<0.05).(3) After treatment, the type of indicators in the BBT significant improvement in the control group no significant improvement. Comparison of treatment groups were significantly different (P<0.05).(4) after treatment in two groups of E2, LH levels than before treatment were not significantly different (P> 0.05); treatment group T, PRL levels were significantly decreased (P <0.05), FSH, P levels significantly increased (P<0.05), between the two groups after treatment and PRL, FSH, P Comparison is also significant difference (P<0.05).(5)Able to effectively stimulate the growth of non-performing follicle, treatment before and after the preovulatory dominant follicle compared to the largest diameter were significantly different (P<0.01), efficacy of the two groups was no significant difference in the control group (P>0.05).Conclusion:LPD is the hypothalamus - pituitary - ovarian - uterine axis to varying degrees in all aspects of the disorder caused by a syndrome of clinical performance for more essence deficiency symptoms, mainly Yangxue Bushen kinds of soup ZishenYangxue decoction and Yishen Zhongyu decoction to tonifying kidney and invigorating vital energy, nourishing and activating-blood mainly from the overall HPOA axis adjustment to restore balance to achieve the purpose of the treatment of LPD, and its clinical efficacy is superior to the control group.
Objective:To probe the reasons of LPD causing infertility furtherly, to evaluate the efficiency and to study the principle of Zishen Yangxue decoction and Yishen Zhongyu decoction tonifying kidney and invigorating vital energy,and to explore the mechanism of its efficacy.Methods:40 cases of infertility in patients with LPD were randomly divided into treatment group and control group 2 group, 20 cases of treatment group, sequential use of ZishenYangxue decoction and Yishen Zhongyu decoction; 20 cases of the control group, taking sequential Liuwei Dihuang soft capsules and Jiarong films , the two groups were observed in patients with clinical symptoms, the efficacy of basal body temperature, for female serum hormone such as luteinizing hormone(LH), folicles timulating hormone (FSH),prolactin(PRL),estrodiol(E2),progesterone(P),and Testosterone (T), such as the improvement of follicular development and comparison.Results:(1) After treatment two groups of patients than before treatment of the symptoms was significant improvement (P<0.05).(2)there significantly difference in the effective rate of the two groups(P<0.05).(3) After treatment, the type of indicators in the BBT significant improvement in the control group no significant improvement. Comparison of treatment groups were significantly different (P<0.05).(4) after treatment in two groups of E2, LH levels than before treatment were not significantly different (P> 0.05); treatment group T, PRL levels were significantly decreased (P <0.05), FSH, P levels significantly increased (P<0.05), between the two groups after treatment and PRL, FSH, P Comparison is also significant difference (P<0.05).(5)Able to effectively stimulate the growth of non-performing follicle, treatment before and after the preovulatory dominant follicle compared to the largest diameter were significantly different (P<0.01), efficacy of the two groups was no significant difference in the control group (P>0.05).Conclusion:LPD is the hypothalamus - pituitary - ovarian - uterine axis to varying degrees in all aspects of the disorder caused by a syndrome of clinical performance for more essence deficiency symptoms, mainly Yangxue Bushen kinds of soup ZishenYangxue decoction and Yishen Zhongyu decoction to tonifying kidney and invigorating vital energy, nourishing and activating-blood mainly from the overall HPOA axis adjustment to restore balance to achieve the purpose of the treatment of LPD, and its clinical efficacy is superior to the control group.
引文
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[3]张玉珍.中医妇科学,[M]新世纪全国高等中医药院校规划教材,北京,中国中医药出版社,73-74.
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[5]葛秦生.临床生殖内分泌学[M],北京,科学技术文献出版社,2001版543.
[6]秦达念.佘白蓉.佘运初.菟丝子黄酮对实验动物及人绒毛组织生殖功能的影响. [J]中药新药与临床药理,2000,11(6):349-351.
[7]王建红.王敏球.伍庆华.等菟丝子黄酮对应激大鼠卵巢内分泌的影响. [J]中草药,2002.33(12):1099-1101.
[8]马红霞,尤昭玲,王若光等菟丝子总黄酮对大鼠流产模型妊娠结局及胎盘、蜕膜形态学的影响[J]中药材Journal of Chinese Medicinal Materials第3l卷第7期2008,31(7):1044-1049.
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