二仙汤加减治疗卵巢早衰的临床观察
|
摘要
目的:通过观察二仙汤加减治疗卵巢早衰的临床疗效,从改善围绝经期症状、血清内分泌激素FSH、LH、E_2的变化及改善卵巢储备功能等方面,为临床治疗该病提供依据。
方法:将60名符合标准的卵巢早衰患者按随机分组原则均分为治疗组和对照组,两组病例数均为30例,疗程相同(3个月为1个疗程,连续2个疗程)。分别观察治疗组和对照组在治疗前后的临床症状改变、月经来潮情况,并于治疗前和治疗结束3个月(如逢月经来潮则在月经周期第3天)检测血清性激素(FSH、LH、E_2),并观察两组中抗苗勒管激素AMH及抗卵巢抗体AOAb,将两组得出的数据进行对比分析。
结果:①治疗组和对照组临床疗效的总有效率分别为86.67%、90.00%;在提高苗勒氏管抑制物AMH和改善卵巢自身免疫抗卵巢抗体AOAb方面,治疗组均明显优于对照组,(P<0.05)。②两组在改善POF患者的围绝经期的症状有明显差异,治疗组尤其在改善烘热汗出、头晕耳鸣、腰膝酸软、畏寒肢冷、倦怠乏力等症状方面优于对照组。③在促进FSH下降、E_2上升均有极显著性差异(P<0.01),两组间疗效对比差异有显著性(P<0.05),说明治疗组对促进雌激素分泌优于对照组。
结论:两组方法在临床上都取得了较好的疗效。经临床观察及对比分析后发现治疗组在促进性激素分泌、临床症状的改善方面优于对照组,且能明显提高卵巢储备功能,改善卵巢自身免疫。说明二仙汤加减治疗卵巢早衰有确切疗效又安全可靠,并能明显改善卵巢储备功能具有一定的临床推广价值。
Objective: Through the observation two fairy tonga reduce premature aging of the clinical effect of treatment ovarian, from perimenopausal symptoms improve, serum endocrine hormone FSH and LH, E_2 change and improvement of ovarian function, reserve for clinical treatment provides the basis for the disease.
Methods: 60 standard ovarian grouping principle according to random premature senility patients were divided into treatment group and control group, two groups of cases are 30 cases, the same treatment (3 months for a period of treatment, two consecutive period of treatment). The treatment group and control group were observed before and after treatment in the clinical symptoms change, menstrual cramps, and in the end of therapy before treatment and 3 months (such as wel menstrual cramps in menstrual cycle is the third day) test (FSH and LH serum sex hormones, E_2), and looking at the two groups of resistant mullerian tube hormone AMH and resistance to ovarian antibody AOAb, two groups of data that will were analyzed.
Results: (1) the treatment group and control group clinical curative effect of the total effective rate was 86.67%, 90.00%; In improving mullerian's tube inhibit content and improve their own immune AMH ovarian AOAb aspects of ovarian antibody, the treatment group were significantly better than control group, (P < 0.05). (2) the two groups of patients improve POF perimenopausal symptoms have obvious difference, the treatment group especially in improving the sweat out, dizziness tinnitus, waist sour leg soft, chills limb cold, burnout, such as the lack of the symptoms than control group. (3) in promoting FSH decline, E_2 rise all have significantly difference (P < 0.01) between the two groups, the difference was obvious contrast effect (P < 0.05), indicating that the treatment group than in control group to promote the secretion of estrogen.
Conclusion: two groups have clinical methods in the good effect. The clinical observation and comparison analysis found that the treatment group in promoting the secretion of clinical symptoms, estrogen improvement of better than control group, and can obviously improve the ovarian function reserves. Explain two fairy tonga reduce premature aging treatment of ovarian effective exactly and safe and reliable, and can improve the ovarian function reserves has certain clinical value of popularization.
方法:将60名符合标准的卵巢早衰患者按随机分组原则均分为治疗组和对照组,两组病例数均为30例,疗程相同(3个月为1个疗程,连续2个疗程)。分别观察治疗组和对照组在治疗前后的临床症状改变、月经来潮情况,并于治疗前和治疗结束3个月(如逢月经来潮则在月经周期第3天)检测血清性激素(FSH、LH、E_2),并观察两组中抗苗勒管激素AMH及抗卵巢抗体AOAb,将两组得出的数据进行对比分析。
结果:①治疗组和对照组临床疗效的总有效率分别为86.67%、90.00%;在提高苗勒氏管抑制物AMH和改善卵巢自身免疫抗卵巢抗体AOAb方面,治疗组均明显优于对照组,(P<0.05)。②两组在改善POF患者的围绝经期的症状有明显差异,治疗组尤其在改善烘热汗出、头晕耳鸣、腰膝酸软、畏寒肢冷、倦怠乏力等症状方面优于对照组。③在促进FSH下降、E_2上升均有极显著性差异(P<0.01),两组间疗效对比差异有显著性(P<0.05),说明治疗组对促进雌激素分泌优于对照组。
结论:两组方法在临床上都取得了较好的疗效。经临床观察及对比分析后发现治疗组在促进性激素分泌、临床症状的改善方面优于对照组,且能明显提高卵巢储备功能,改善卵巢自身免疫。说明二仙汤加减治疗卵巢早衰有确切疗效又安全可靠,并能明显改善卵巢储备功能具有一定的临床推广价值。
Objective: Through the observation two fairy tonga reduce premature aging of the clinical effect of treatment ovarian, from perimenopausal symptoms improve, serum endocrine hormone FSH and LH, E_2 change and improvement of ovarian function, reserve for clinical treatment provides the basis for the disease.
Methods: 60 standard ovarian grouping principle according to random premature senility patients were divided into treatment group and control group, two groups of cases are 30 cases, the same treatment (3 months for a period of treatment, two consecutive period of treatment). The treatment group and control group were observed before and after treatment in the clinical symptoms change, menstrual cramps, and in the end of therapy before treatment and 3 months (such as wel menstrual cramps in menstrual cycle is the third day) test (FSH and LH serum sex hormones, E_2), and looking at the two groups of resistant mullerian tube hormone AMH and resistance to ovarian antibody AOAb, two groups of data that will were analyzed.
Results: (1) the treatment group and control group clinical curative effect of the total effective rate was 86.67%, 90.00%; In improving mullerian's tube inhibit content and improve their own immune AMH ovarian AOAb aspects of ovarian antibody, the treatment group were significantly better than control group, (P < 0.05). (2) the two groups of patients improve POF perimenopausal symptoms have obvious difference, the treatment group especially in improving the sweat out, dizziness tinnitus, waist sour leg soft, chills limb cold, burnout, such as the lack of the symptoms than control group. (3) in promoting FSH decline, E_2 rise all have significantly difference (P < 0.01) between the two groups, the difference was obvious contrast effect (P < 0.05), indicating that the treatment group than in control group to promote the secretion of estrogen.
Conclusion: two groups have clinical methods in the good effect. The clinical observation and comparison analysis found that the treatment group in promoting the secretion of clinical symptoms, estrogen improvement of better than control group, and can obviously improve the ovarian function reserves. Explain two fairy tonga reduce premature aging treatment of ovarian effective exactly and safe and reliable, and can improve the ovarian function reserves has certain clinical value of popularization.
引文
[1]乐杰主编.妇产科学[M].第7版.北京:人民卫生出版社,2009:59
[2]沈慰,俞超芹.从肾论治卵巢早衰[J].中西医结合学报,2006,4(6):653-656
[3]高慧,杨涓,李巧芬.中医学对卵巢早衰病因病机的认识[J].甘肃中医,2007,20(8):47-48.
[4]张蕾,曲秀芬.曲秀芬教授治疗卵巢早衰经验拾萃[J].吉林中医药,2009,29(7): 565.
[5]施艳秋,时燕萍,朱萱萱等.乌鳖口服液治疗卵巢功能早衰的临床与实验研究总结[J].中华实用中西医杂志,2004,17(4):3 .
[6]乔球飞.补肾养血汤合心理调护治疗卵巢早衰120例[J].现代中西医结合杂志,2011,20(2):196-197
[7]李云君.指导:姜惠中.姜惠中治疗卵巢早衰的经验[J].湖北中医杂志, 2006,28(6):28-29
[8]杜晓萍.指导:梅乾茵.梅乾茵治疗卵巢早衰经验[J].江西中医药,2008,10(39): 16-17
[9]魏智慧,邓琳文,曹旭升等.浅议从肾论治卵巢早衰[J].甘肃中医,2007,20(9):39-40.
[10]滕秀香.122例卵巢早衰患者中医证候分析及致病因素调查[J].中国中医药信息杂志,2008,15(4):18-20
[11]孙永忠,程泾,石其贤.滋肾益冲抗衰汤治疗卵巢早衰实验研究[J],实用中医药杂志,2008,24(2):18-19
[12]原迪.刘字新教授益气生精法治疗卵巢早衰经验[J].现代中西医结合杂志,2009,18(8):2188-2199
[13]蔡连香,黄欲晓,李亚俐.填精补肾、养血疏肝法治疗卵巢早衰的经验[J].世界中医药,2007,2(6):341-342
[14]武淑慧,庆璐,崔晓萍.崔晓萍教授循期阴阳序贯疗法治疗卵巢早衰[J].陕西中医学院学报,2010,33(4):30-31
[15]宁艳,林琼霞,单志群等.补肾益冲丸治疗肾虚性卵巢早衰患者的临床观察[J].河北医学,2010,16(2):129-132
[16]张景丽,指导施艳秋.施艳秋治疗卵巢早衰经验撷要[J].山西中医,2008,24(9):7-8
[17]王菊素.田淑霄教授对卵巢早衰与肾虚血瘀相关性的见解及治疗经验[J].陕西中医,2003,24(11):1015-1016
[18]李艳石,王禹.王秀云教授治疗卵巢早衰经验拾萃[J].中医药学刊,2005,23(1):31
[19]邢红梅,王蕊,杨华.自拟补肾健脾方配合艾灸治疗卵巢早衰的临床研究[J].疑难病杂志,2008,7(2):101-102
[20]马景,何嘉琳.何嘉琳治疗卵巢早衰的临床经验[J].浙江中医杂志,200 9,4(4):260-261
[21]刘思敏,指导张丽君.补益阳明津气对围卵巢早衰女性卵巢的影响[J].湖北中医杂志,2010,32(4):43-44
[22]詹杰.中西医结合治疗卵巢早衰22例临床观察[J],中国实用中医药,2009,4(l6):93-94
[23]钟雪梅,代嘉莉,李宗恒.补肾养经汤合人工周期法治疗卵巢早衰38例临床观察[J].江苏中医药,2005,26(8):21-22
[24]许学风.理冲汤联合激素替代治疗卵巢早衰32例临床分析[J].中国妇幼保健,2008,23:1883-1884
[25]刘娜,王永宏,熊利.益肾抗衰汤配合克龄蒙治疗肾虚型卵巢早衰的临床观察[J].湖南中医药大学学报,2009,29(3):49-51
[26]刘晓燕.中西医结合治疗卵巢早衰31例疗效观察[J].山东中医杂志,2010,29(2):113-114
[27]杨晓虹,赖晓梅,黄祖波.针灸治疗卵巢早衰60例临床观察[J].四川中医,2008,26(5):106-107
[28]刘红姣,彭剑虹,许学兵.俞募穴埋线治疗卵巢早衰疗效观察[J],中国针灸,2008,28(5):325-327
[29]王蕊,邢红梅,何芳.健脾补肾方联合艾灸对卵巢早衰患者生存质量及阴道脱落细胞成熟度的影响[J].中医杂志,2009,50(7):607-608
[30]冯晓军,孙伟,王力.电针联合盆底肌按摩治疗卵巢早衰疗效观察[J].山东中医药大学学报,2011,35(1):43-44
[31]史云,蔡平平,邓高玉.张玉珍教授治疗卵巢早衰经验介绍[J].新中医,2008,8(38):15-16
[32]刘霞,谢萍.浅析卵巢早衰的病机和证治[J].江西中医学院学报,2007,19(4):13-20.
[33]韩璐,孙玲等.浅议“治未病”在卵巢早衰诊疗思路的应用[J].四川中医,2007,25(8):28-29
[34] LamlT, SchulZ 2lomeyrI,et al . Premature ovarian failure: etiology and P rosP ects[J] . Gynecol Enclocrinol, 2000 Aug,14 :292
[35] Gos wamiD,Conway GS. Premature ovarian failure [J]. HormRes, 2007, 68(4):1962-2021
[36]谢梅青.卵巢早衰的病因[J].实用妇产科杂志,2003,19(4):193-195
[37]何慧芳.卵巢早衰的病因及诊治[J].华夏医学,2008,4期(21):855-857
[38]林芸,彭幼玲,闫安民.卵巢早衰42例临床观察[J].实用医学杂志, 2009,25(l0):1650-1652
[39]陈建英,祁小玲,林晓桃.卵巢早衰26例临床分析[J],临床医学,2010,30(8):78-79.
[40]王秀霞,王天任.卵巢早衰与闭经[J],辽宁中医学院学报,2008,24(12):890—893.
[41]哈春芳,于黎明等.卵巢早衰相关因素及治疗进展[J].辽夏医学杂志, 2004,26(12):838-839.
[42] Weenen C,Laven JS,et al. Anti-mullerian hormone ex-pression pattern in the human ovary: potential implications for initial and cyclic follicle recruitmnent[J]. Mol Hum Reprod,2004,10(2):77-83
[43]杨小岗,王芳.血清抗苗勒管激素诊断卵巢早衰的临床意义[J].检验医学与临床,2010,7(1):51-52
[44]秦辛玲,叶元,石青峰等.血清抗苗勒管激素预测卵巢早衰的临床价值[J].现代中西医结合杂志,2010,19(25):3240-3241
[45] HoekA, Schoae akerJ, Draxhage HA. Premature ovarian failure and ovarian autoimmu-nity.Endoerine reviews, 1997,18:107.
[46]赵建英,宋阳,史樱.41例卵巢早衰患者血清抗卵巢抗体测定分析[J].中华实用中西医杂志,2004,4(17):1036-1037.
[47]陈丽,尤昭玲.抗卵汤加减对免疫性卵巢早衰小鼠模型血清A zpAb表达的影响[J].实用中医药杂志,2011,27(2):78-79.
[48]王秀贤,李群.补肾疏肝法对卵巢早衰模型小鼠的作用研究[J].中外健康文摘,2010,18(7):166-167.
[49]徐苓,宋亦军.卵巢早衰的临床表现和诊断标准[J].实用妇产科杂志,2003,19 (4):195-196.
[50]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,1999:2 138.
[51]国家中医药管理局.医病症诊断标准[S].南京:南京大学出版社,1994:66.
[2]沈慰,俞超芹.从肾论治卵巢早衰[J].中西医结合学报,2006,4(6):653-656
[3]高慧,杨涓,李巧芬.中医学对卵巢早衰病因病机的认识[J].甘肃中医,2007,20(8):47-48.
[4]张蕾,曲秀芬.曲秀芬教授治疗卵巢早衰经验拾萃[J].吉林中医药,2009,29(7): 565.
[5]施艳秋,时燕萍,朱萱萱等.乌鳖口服液治疗卵巢功能早衰的临床与实验研究总结[J].中华实用中西医杂志,2004,17(4):3 .
[6]乔球飞.补肾养血汤合心理调护治疗卵巢早衰120例[J].现代中西医结合杂志,2011,20(2):196-197
[7]李云君.指导:姜惠中.姜惠中治疗卵巢早衰的经验[J].湖北中医杂志, 2006,28(6):28-29
[8]杜晓萍.指导:梅乾茵.梅乾茵治疗卵巢早衰经验[J].江西中医药,2008,10(39): 16-17
[9]魏智慧,邓琳文,曹旭升等.浅议从肾论治卵巢早衰[J].甘肃中医,2007,20(9):39-40.
[10]滕秀香.122例卵巢早衰患者中医证候分析及致病因素调查[J].中国中医药信息杂志,2008,15(4):18-20
[11]孙永忠,程泾,石其贤.滋肾益冲抗衰汤治疗卵巢早衰实验研究[J],实用中医药杂志,2008,24(2):18-19
[12]原迪.刘字新教授益气生精法治疗卵巢早衰经验[J].现代中西医结合杂志,2009,18(8):2188-2199
[13]蔡连香,黄欲晓,李亚俐.填精补肾、养血疏肝法治疗卵巢早衰的经验[J].世界中医药,2007,2(6):341-342
[14]武淑慧,庆璐,崔晓萍.崔晓萍教授循期阴阳序贯疗法治疗卵巢早衰[J].陕西中医学院学报,2010,33(4):30-31
[15]宁艳,林琼霞,单志群等.补肾益冲丸治疗肾虚性卵巢早衰患者的临床观察[J].河北医学,2010,16(2):129-132
[16]张景丽,指导施艳秋.施艳秋治疗卵巢早衰经验撷要[J].山西中医,2008,24(9):7-8
[17]王菊素.田淑霄教授对卵巢早衰与肾虚血瘀相关性的见解及治疗经验[J].陕西中医,2003,24(11):1015-1016
[18]李艳石,王禹.王秀云教授治疗卵巢早衰经验拾萃[J].中医药学刊,2005,23(1):31
[19]邢红梅,王蕊,杨华.自拟补肾健脾方配合艾灸治疗卵巢早衰的临床研究[J].疑难病杂志,2008,7(2):101-102
[20]马景,何嘉琳.何嘉琳治疗卵巢早衰的临床经验[J].浙江中医杂志,200 9,4(4):260-261
[21]刘思敏,指导张丽君.补益阳明津气对围卵巢早衰女性卵巢的影响[J].湖北中医杂志,2010,32(4):43-44
[22]詹杰.中西医结合治疗卵巢早衰22例临床观察[J],中国实用中医药,2009,4(l6):93-94
[23]钟雪梅,代嘉莉,李宗恒.补肾养经汤合人工周期法治疗卵巢早衰38例临床观察[J].江苏中医药,2005,26(8):21-22
[24]许学风.理冲汤联合激素替代治疗卵巢早衰32例临床分析[J].中国妇幼保健,2008,23:1883-1884
[25]刘娜,王永宏,熊利.益肾抗衰汤配合克龄蒙治疗肾虚型卵巢早衰的临床观察[J].湖南中医药大学学报,2009,29(3):49-51
[26]刘晓燕.中西医结合治疗卵巢早衰31例疗效观察[J].山东中医杂志,2010,29(2):113-114
[27]杨晓虹,赖晓梅,黄祖波.针灸治疗卵巢早衰60例临床观察[J].四川中医,2008,26(5):106-107
[28]刘红姣,彭剑虹,许学兵.俞募穴埋线治疗卵巢早衰疗效观察[J],中国针灸,2008,28(5):325-327
[29]王蕊,邢红梅,何芳.健脾补肾方联合艾灸对卵巢早衰患者生存质量及阴道脱落细胞成熟度的影响[J].中医杂志,2009,50(7):607-608
[30]冯晓军,孙伟,王力.电针联合盆底肌按摩治疗卵巢早衰疗效观察[J].山东中医药大学学报,2011,35(1):43-44
[31]史云,蔡平平,邓高玉.张玉珍教授治疗卵巢早衰经验介绍[J].新中医,2008,8(38):15-16
[32]刘霞,谢萍.浅析卵巢早衰的病机和证治[J].江西中医学院学报,2007,19(4):13-20.
[33]韩璐,孙玲等.浅议“治未病”在卵巢早衰诊疗思路的应用[J].四川中医,2007,25(8):28-29
[34] LamlT, SchulZ 2lomeyrI,et al . Premature ovarian failure: etiology and P rosP ects[J] . Gynecol Enclocrinol, 2000 Aug,14 :292
[35] Gos wamiD,Conway GS. Premature ovarian failure [J]. HormRes, 2007, 68(4):1962-2021
[36]谢梅青.卵巢早衰的病因[J].实用妇产科杂志,2003,19(4):193-195
[37]何慧芳.卵巢早衰的病因及诊治[J].华夏医学,2008,4期(21):855-857
[38]林芸,彭幼玲,闫安民.卵巢早衰42例临床观察[J].实用医学杂志, 2009,25(l0):1650-1652
[39]陈建英,祁小玲,林晓桃.卵巢早衰26例临床分析[J],临床医学,2010,30(8):78-79.
[40]王秀霞,王天任.卵巢早衰与闭经[J],辽宁中医学院学报,2008,24(12):890—893.
[41]哈春芳,于黎明等.卵巢早衰相关因素及治疗进展[J].辽夏医学杂志, 2004,26(12):838-839.
[42] Weenen C,Laven JS,et al. Anti-mullerian hormone ex-pression pattern in the human ovary: potential implications for initial and cyclic follicle recruitmnent[J]. Mol Hum Reprod,2004,10(2):77-83
[43]杨小岗,王芳.血清抗苗勒管激素诊断卵巢早衰的临床意义[J].检验医学与临床,2010,7(1):51-52
[44]秦辛玲,叶元,石青峰等.血清抗苗勒管激素预测卵巢早衰的临床价值[J].现代中西医结合杂志,2010,19(25):3240-3241
[45] HoekA, Schoae akerJ, Draxhage HA. Premature ovarian failure and ovarian autoimmu-nity.Endoerine reviews, 1997,18:107.
[46]赵建英,宋阳,史樱.41例卵巢早衰患者血清抗卵巢抗体测定分析[J].中华实用中西医杂志,2004,4(17):1036-1037.
[47]陈丽,尤昭玲.抗卵汤加减对免疫性卵巢早衰小鼠模型血清A zpAb表达的影响[J].实用中医药杂志,2011,27(2):78-79.
[48]王秀贤,李群.补肾疏肝法对卵巢早衰模型小鼠的作用研究[J].中外健康文摘,2010,18(7):166-167.
[49]徐苓,宋亦军.卵巢早衰的临床表现和诊断标准[J].实用妇产科杂志,2003,19 (4):195-196.
[50]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,1999:2 138.
[51]国家中医药管理局.医病症诊断标准[S].南京:南京大学出版社,1994:66.