苍附导痰汤加减联合来曲唑辨证治疗多囊卵巢综合征及对促排卵及生殖激素的影响
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摘要
目的:研究苍附导痰汤加减联合来曲唑辨证治疗多囊卵巢综合对患者促排卵及生殖激素的影响。方法:多囊卵巢综合征患者90例,按数字随机表法分为观察组与对照组,每组45例。所有患者从月经第5天开始给予来曲唑进行治疗,观察组在对照组基础上苍附导痰汤加减进行治疗。观察检测两组患者治疗前后子宫内膜厚度和卵巢体积,对患者痤疮症状及月经失调进行评分,并计算排卵率及妊娠率;测定治疗前后卵泡刺激素、黄体生成素、雌二醇、睾酮及催乳素水平。结果:观察组治疗后卵巢体积、痤疮评分、月经失调评分明显低于对照组(P<0.05);子宫内膜厚度与对照组比较无明显差异。观察组排卵率显著高于对照组(P<0.05);妊娠率略高于对照组,但无统计学差异(P>0.05)。观察组治疗后卵泡刺激素、黄体生成素、雌二醇、睾酮、泌乳素水平明显降低(P<0.05);且治疗后,观察组生殖激素水平明显低于对照组,两组比较有统计学差异(P<0.05)。结论:苍附导痰汤加减联合来曲唑能有效促进多囊卵巢综合征患者排卵,并改善其性激素水平。
Objective:To study the effect of Modified Cangfu Daotan Decoction combined with letrozole on ovulation induction and reproductive hormone in patients with polycystic ovary syndrome. Methods:A total of 90 cases of polycystic ovary syndrome diagnosed were divided into the observation group and the control group, with 45 cases in each group. All patients were given letrozole from the 5 d beginning of menstruation, and the observation group was additionally treated with Cangfu Daotan Decoction. We observed the two groups' endometrial thickness and ovarian volume of acne symptoms and menstrual dysfunction before and after treatment and the ovulation rate and pregnancy rate were measured. The follicle stimulating hormone, luteinizing hormone estradiol, testosterone and prolactin level were compared. Results:The ovarian volume, acne score and menstrual disorder score in the observation group were significantly lower than those of the control group(P<0.05), and there was no significant difference in endometrial thickness between the observation group and the control group. The ovulation rate of the observation group was significantly higher than that of the control group(P<0.05). The pregnancy rate was slightly higher than that of the control group, and there was no statistical difference(P>0.05). After treatment, the levels of follicle stimulating hormone, luteinizing hormone, estradiol, testosterone and prolactin in the observation group were significantly lower(P<0.05). After treatment, the level of reproductive hormones in the observation group was significantly lower than tha tof the control group, and the difference between two groups was statistically significant(P<0.05). Conclusion: The Modified Cangfu Daotan Decoction combined with letrozole can effectively promote ovulation and improve the levels of sex hormones in patients with polycystic ovary syndrome.
Objective:To study the effect of Modified Cangfu Daotan Decoction combined with letrozole on ovulation induction and reproductive hormone in patients with polycystic ovary syndrome. Methods:A total of 90 cases of polycystic ovary syndrome diagnosed were divided into the observation group and the control group, with 45 cases in each group. All patients were given letrozole from the 5 d beginning of menstruation, and the observation group was additionally treated with Cangfu Daotan Decoction. We observed the two groups' endometrial thickness and ovarian volume of acne symptoms and menstrual dysfunction before and after treatment and the ovulation rate and pregnancy rate were measured. The follicle stimulating hormone, luteinizing hormone estradiol, testosterone and prolactin level were compared. Results:The ovarian volume, acne score and menstrual disorder score in the observation group were significantly lower than those of the control group(P<0.05), and there was no significant difference in endometrial thickness between the observation group and the control group. The ovulation rate of the observation group was significantly higher than that of the control group(P<0.05). The pregnancy rate was slightly higher than that of the control group, and there was no statistical difference(P>0.05). After treatment, the levels of follicle stimulating hormone, luteinizing hormone, estradiol, testosterone and prolactin in the observation group were significantly lower(P<0.05). After treatment, the level of reproductive hormones in the observation group was significantly lower than tha tof the control group, and the difference between two groups was statistically significant(P<0.05). Conclusion: The Modified Cangfu Daotan Decoction combined with letrozole can effectively promote ovulation and improve the levels of sex hormones in patients with polycystic ovary syndrome.
引文
[1] 吕雪梅,王苏梅,董云玲,等.来曲唑与氯米芬应用于多囊卵巢综合征不孕患者临床疗效分析研究[J].中国性科学,2014,23(3):80-82.
[2] 任春琼,肖涌,李毅,等.二甲双胍对多囊卵巢综合征患者性激素水平、胰岛素抵抗及相关指标的影响[J].中国药房,2016,27(27):3791-3794.
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[11] 陶弢,刘伟,赵爱民,等.不同表型多囊卵巢综合征患者代谢综合征患病特点及风险研究[J].中华内分泌代谢杂志,2013,29(3):200-205.
[12] 赵越,阮祥燕,李扬璐,等.来曲唑联合高纯度尿促性素治疗克罗米芬耐药的多囊卵巢综合征不孕患者的临床研究[J].首都医科大学学报,2016,37(4):431-436.
[13] 李扬璐,阮祥燕,赵越,等.百令胶囊对多囊卵巢综合征代谢指标的影响[J].首都医科大学学报,2016,37(4):437-443.
[14] Harpal S Randeva, Bee K Tan, Martin O Weickert. Cardiometabolic Aspects of the Polycystic Ovary Syndrome[J]. Endocr Rev, 2012, 33(5): 812-841.
[15] 李扬璐,阮祥燕,Alfred O Mueck,等.多囊卵巢综合征对妊娠结局的影响研究进展[J].首都医科大学学报,2016,37(4):449-453.
[16] 洪艳丽,吴飞.补肾化痰方对多囊卵巢综合征胰岛素抵抗Akt通路调控的实验研究[J].中国中西医结合杂志,2014,34(2):230-234.
[17] 刘音吟,谈勇,徐菊芳,等.地屈孕酮对多囊卵巢综合征妊娠大鼠种植窗期 PR、ICAM-1的影响[J].东南大学学报(医学版),2016,35(4):514-518.
[18] 陈巍.胰岛素样生长因子-1和转化生长因子-β1在来曲唑诱导多囊卵巢综合征模型大鼠中的表达及意义[J].中国老年学杂志,2016,36(14):3395-3397.
[19] 曾文.苍附导痰汤辅助西药治疗痰湿阻滞型多囊卵巢综合征疗效观察[J].现代中西医结合杂志,2017,26(11):1182-1184.
[20] 曾小吉.苍附导痰汤在治疗多囊卵巢综合征中的可行性研究[J].中医临床研究,2015,7(19):101-102.
[21] 王慧颖,林暄.加减苍附导痰汤对痰湿阻滞型多囊卵巢综合征患者子宫内膜胰岛素及其受体作用研究[J].湖南中医药大学学报,2014,34(10):43-45.
[22] 张洪芳,龚瑾.中医药治疗痰湿型多囊卵巢综合征体会[J].河南中医,2014,34(6):1150-1151.
[23] 辛俊,郭慧梅,高希焕,等.苍附导痰汤结合达英-35治疗多囊卵巢综合征疗效观察[J].现代中西医结合杂志,2017,26(2):197-199.
[24] 王晨晔,孙忻,丁彩飞,等.苍附导痰汤加减联合针刺对肥胖型多囊卵巢综合征患者糖脂代谢及排卵率的影响[J].现代中西医结合杂志,2016,25(36):4056-4058.
[25] 万静.苍附导痰汤加减对肥胖型多囊卵巢综合征患者激素水平及脂代谢的影响[J].陕西中医,2017,38(2):219-221.
[2] 任春琼,肖涌,李毅,等.二甲双胍对多囊卵巢综合征患者性激素水平、胰岛素抵抗及相关指标的影响[J].中国药房,2016,27(27):3791-3794.
[3] Daniel A Dumesic, Sharon E Oberfield. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome[J]. Endocr Rev, 2015, 36(5): 487-525.
[4] 何丽,王蔼明.四种促排卵药物在多囊卵巢综合征促排卵治疗中的应用进展[J].山东医药,2016,56(35):101-104.
[5] 李美芝,李蓉.多囊卵巢综合征诊断的金标准:鹿特丹标准[J]. 中国实用妇科与产科杂志, 2007, 23(9):657.
[6] 孙永琴,李蓉,杨硕,等.多囊卵巢综合征患者的临床特征与生化改变相关性研究[J]. 中国妇幼保健, 2011, 26(9):1360.
[7] 李美芝.妇科内分泌学[M].北京:人民军医出版社,2001:202.
[8] 金炫廷,马堃,单婧,等.补肾活血中药治疗多囊卵巢综合征导致排卵障碍性不孕的临床研究[J].中国中药杂志,2014,39(1):140-143.
[9] 李文静,胡红波,马占忠,等.多囊卵巢综合征患者不同分型的酶类抗氧化应激状况分析[J].广东医学,2016,37(16):2431-2433.
[10] Bhaskar Venkata Kameswara Subrahmanya Lakkakula. Genetic variants associated with insulin signaling and glucose homeostasis in the pathogenesis of insulin resistance in polycystic ovary syndrome: a systematic review [J]. J Assist Reprod Genet, 2013, 30(7): 883-895.
[11] 陶弢,刘伟,赵爱民,等.不同表型多囊卵巢综合征患者代谢综合征患病特点及风险研究[J].中华内分泌代谢杂志,2013,29(3):200-205.
[12] 赵越,阮祥燕,李扬璐,等.来曲唑联合高纯度尿促性素治疗克罗米芬耐药的多囊卵巢综合征不孕患者的临床研究[J].首都医科大学学报,2016,37(4):431-436.
[13] 李扬璐,阮祥燕,赵越,等.百令胶囊对多囊卵巢综合征代谢指标的影响[J].首都医科大学学报,2016,37(4):437-443.
[14] Harpal S Randeva, Bee K Tan, Martin O Weickert. Cardiometabolic Aspects of the Polycystic Ovary Syndrome[J]. Endocr Rev, 2012, 33(5): 812-841.
[15] 李扬璐,阮祥燕,Alfred O Mueck,等.多囊卵巢综合征对妊娠结局的影响研究进展[J].首都医科大学学报,2016,37(4):449-453.
[16] 洪艳丽,吴飞.补肾化痰方对多囊卵巢综合征胰岛素抵抗Akt通路调控的实验研究[J].中国中西医结合杂志,2014,34(2):230-234.
[17] 刘音吟,谈勇,徐菊芳,等.地屈孕酮对多囊卵巢综合征妊娠大鼠种植窗期 PR、ICAM-1的影响[J].东南大学学报(医学版),2016,35(4):514-518.
[18] 陈巍.胰岛素样生长因子-1和转化生长因子-β1在来曲唑诱导多囊卵巢综合征模型大鼠中的表达及意义[J].中国老年学杂志,2016,36(14):3395-3397.
[19] 曾文.苍附导痰汤辅助西药治疗痰湿阻滞型多囊卵巢综合征疗效观察[J].现代中西医结合杂志,2017,26(11):1182-1184.
[20] 曾小吉.苍附导痰汤在治疗多囊卵巢综合征中的可行性研究[J].中医临床研究,2015,7(19):101-102.
[21] 王慧颖,林暄.加减苍附导痰汤对痰湿阻滞型多囊卵巢综合征患者子宫内膜胰岛素及其受体作用研究[J].湖南中医药大学学报,2014,34(10):43-45.
[22] 张洪芳,龚瑾.中医药治疗痰湿型多囊卵巢综合征体会[J].河南中医,2014,34(6):1150-1151.
[23] 辛俊,郭慧梅,高希焕,等.苍附导痰汤结合达英-35治疗多囊卵巢综合征疗效观察[J].现代中西医结合杂志,2017,26(2):197-199.
[24] 王晨晔,孙忻,丁彩飞,等.苍附导痰汤加减联合针刺对肥胖型多囊卵巢综合征患者糖脂代谢及排卵率的影响[J].现代中西医结合杂志,2016,25(36):4056-4058.
[25] 万静.苍附导痰汤加减对肥胖型多囊卵巢综合征患者激素水平及脂代谢的影响[J].陕西中医,2017,38(2):219-221.