补肾活血方联合炔雌醇环丙孕酮综合治疗多囊卵巢综合征随机平行对照研究
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摘要
[目的]观察补肾活血方联合炔雌醇环丙孕酮综合治疗多囊卵巢综合征疗效。[方法]采用随机平行对照方法,将70例门诊患者按随机数表法分为两组,心理干预、健康教育、运动和饮食指导。对照组35例炔雌醇环丙孕酮,黄体酮或自然月经撤退性出血第5d开始,1片/晚,连续用药3周,停用1周,再次服用。观察组35例补肾活血方(当归、地黄~生、杜仲、赤芍、枸杞子各10g,川芎6g,十大功劳叶9g,红景天15g),水煎温服,1剂/d,2次/d;炔雌醇环丙孕酮同对照组。连续治疗3个月经周期为1疗程。观测临床表现、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆固醇(TC)、、卵泡生成激素(FSH)、黄体生成素(LH)、睾酮(T)、不良反应。治疗1疗程(3个月经周期),随访3个月,判定疗效。[结果]观察组显效21例,有效12例,无效2例,总有效率94.29%;对照组显效15例,有效11例,无效9例,总有效率74.29%,临床疗效观察组优于对照组(P<0.05)。血脂及性激素均显著下降(P<0.01),观察组下降大于对照组(P<0.01)。[结论]补肾活血方联合炔雌醇环丙孕酮综合治疗多囊卵巢综合征,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Bushen Huoxue Recipe combined with ethinyl estradiol cyproterone on polycystic ovary syndrome. [Methods] Seventy-one outpatients were divided into two groups according to the random number table method. All patients underwent psychological intervention, health education, exercise and diet guidance. In the control group, 35 cases of ethinyl estradiol cyproterone, progesterone or natural menstrual withdrawal bleeding began on the 5 th day, 1 tablet/night, continuous medication for 3 weeks, discontinued for 1 week, and taken again. In the observation group, 35 cases of Bushen Huoxue Recipe(Danggui, Shengdihuang, Duzhong, Chishao, Gouqizi each 10 g each, Chuanxiong 6 g, Top Ten Powerful Leaves 9 g, Rhodiola 15 g), Shuijian Wenfu, 1 dose/d, 2 times/d;ethinyl estradiol cyproterone was the same as the control group. Continuous treatment for 3 menstrual cycles is a course of treatment. Observed clinical manifestations, triacylglycerol(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C), total cholesterol(TC), follicle stimulating hormone(FSH),luteinizing hormone(LH)), testosterone(T), adverse reactions. Treatment 1 course(3 menstrual cycle, followup 6 months), to determine the efficacy. [Results] In the treatment group, 21 cases were markedly effective,12 cases were effective, 2 cases were ineffective, and the total effective rate was 94.29%. In the control group,15 cases were markedly effective, 11 cases were effective, 9 cases were ineffective, and the total effective rate was 74.29%. The clinical efficacy treatment group was superior to the control group(P<0.05). Blood lipids and sex hormones were significantly decreased(P<0.01), and the treatment group decreased more than the control group(P<0.01). [Conclusion] Bushen Huoxue Recipe combined with ethinyl estradiol cyproterone combined treatment of polycystic ovary syndrome has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
[Objective] To observe the curative effect of Bushen Huoxue Recipe combined with ethinyl estradiol cyproterone on polycystic ovary syndrome. [Methods] Seventy-one outpatients were divided into two groups according to the random number table method. All patients underwent psychological intervention, health education, exercise and diet guidance. In the control group, 35 cases of ethinyl estradiol cyproterone, progesterone or natural menstrual withdrawal bleeding began on the 5 th day, 1 tablet/night, continuous medication for 3 weeks, discontinued for 1 week, and taken again. In the observation group, 35 cases of Bushen Huoxue Recipe(Danggui, Shengdihuang, Duzhong, Chishao, Gouqizi each 10 g each, Chuanxiong 6 g, Top Ten Powerful Leaves 9 g, Rhodiola 15 g), Shuijian Wenfu, 1 dose/d, 2 times/d;ethinyl estradiol cyproterone was the same as the control group. Continuous treatment for 3 menstrual cycles is a course of treatment. Observed clinical manifestations, triacylglycerol(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C), total cholesterol(TC), follicle stimulating hormone(FSH),luteinizing hormone(LH)), testosterone(T), adverse reactions. Treatment 1 course(3 menstrual cycle, followup 6 months), to determine the efficacy. [Results] In the treatment group, 21 cases were markedly effective,12 cases were effective, 2 cases were ineffective, and the total effective rate was 94.29%. In the control group,15 cases were markedly effective, 11 cases were effective, 9 cases were ineffective, and the total effective rate was 74.29%. The clinical efficacy treatment group was superior to the control group(P<0.05). Blood lipids and sex hormones were significantly decreased(P<0.01), and the treatment group decreased more than the control group(P<0.01). [Conclusion] Bushen Huoxue Recipe combined with ethinyl estradiol cyproterone combined treatment of polycystic ovary syndrome has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
引文
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[12]王凡,张正红,肖开转,等.下丘脑-垂体-肾上腺轴和下丘脑-垂体-卵巢轴在多囊卵巢综合征神经内分泌功能紊乱中的作用[J].中国医学科学院学报,2017,39(5):705-710.
[13]陈欣,宋岩,邓永志,等.补肾活血方对多囊卵巢综合征大鼠模型炎症因子的作用[J].中国妇幼保健,2016,31(21):4548-4549.
[14]周莉,高婧,陈慧,等.多囊卵巢综合征患者血脂异常与胰岛素抵抗的相关性研究[J].生殖医学杂志,2016,25(7):614-618.
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[17]孔冬冬,邸莎,马淑然,等.中医药治疗多囊卵巢综合征方剂用药规律分析[J].中国实验方剂学杂志,2015,2(22):169-173.
[18]程亚辉,孟焱,黄桂芹,等.补肾活血方联合盐酸吡格列酮片治疗多囊卵巢综合征不孕70例临床观察[J].河北中医,2014,36(1):58-60.
[19]王超玲,文颖娟.四物汤及其类方调治痛经规律探讨[J].中医学报2016,31(11):1706-1709.
[20]国家药典委员会.中华人民共和国药典·2015版·一部[M].北京中国医药科技出版社,2015.
[21]刘颖.浅议当归的化学成分与临床药理作用[J].中国医药指南,2010,8(27):51-53.
[22]续秋芝.补肾活血中药治疗肾虚血瘀型多囊卵巢综合征疗效观察[J].中国现代药物应用,2016,10(10):249-250.
[2]杨煜霞,柯昌禄.炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征型不孕症42例临床分析[J].海南医学,2015,27(14):2069-2071.
[3]赵素蕊,陈佳阳.燥湿化痰补肾活血方联合克罗米芬治疗痰湿阻滞型多囊卵巢综合征所致不孕症临床观察[J].世界中西医结合杂志,2015,10(9):1284-1286.
[4]王頔,杨竟,陈仲林,等.2013版《赫尔辛基宣言》的修订及其意义的分析研究[J].中国医学伦理学,2015,28(4):618-621.
[5]中华人民共和国卫生部涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2013-05-01].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[6]中华医学会妇产科学分会内分泌学组.多囊卵巢综合征的诊断和治疗专家共识[J].中华妇产科杂志,2008,43(7):553-555.
[7]国家中医药管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:239.
[8]周波,刘秀雯,邢精红.临床血脂的测定与标准化研究进展[J].检验医学与临床,2011,8(3):338-340.
[9]胡艳军,杨永妮.多囊卵巢综合征患者血清FSH、LH、睾酮检测的临床意义[J].包头医学院学报,2016,32(7):92-93.
[10]国家中医药管理局.中医病症诊断疗效标准[S].南京:南京大学出版社,1994:131-132.
[11]覃小华.中药补肾活血方对青春期多囊卵巢综合征内分泌激素水平的影响[J].西部中医药,2015,28(4):4-6.
[12]王凡,张正红,肖开转,等.下丘脑-垂体-肾上腺轴和下丘脑-垂体-卵巢轴在多囊卵巢综合征神经内分泌功能紊乱中的作用[J].中国医学科学院学报,2017,39(5):705-710.
[13]陈欣,宋岩,邓永志,等.补肾活血方对多囊卵巢综合征大鼠模型炎症因子的作用[J].中国妇幼保健,2016,31(21):4548-4549.
[14]周莉,高婧,陈慧,等.多囊卵巢综合征患者血脂异常与胰岛素抵抗的相关性研究[J].生殖医学杂志,2016,25(7):614-618.
[15]裴秀君,弭艳红,弭艳旭,等.达英-35联合补肾活血方治疗多囊卵巢综合征66例临床观察[J].中国妇幼保健,2014,29(2):263-264.
[16]郭梅珍.浅谈多囊卵巢综合症之中医研究[J].中国中医基础医学杂志,2012,18(10):1073-1074.
[17]孔冬冬,邸莎,马淑然,等.中医药治疗多囊卵巢综合征方剂用药规律分析[J].中国实验方剂学杂志,2015,2(22):169-173.
[18]程亚辉,孟焱,黄桂芹,等.补肾活血方联合盐酸吡格列酮片治疗多囊卵巢综合征不孕70例临床观察[J].河北中医,2014,36(1):58-60.
[19]王超玲,文颖娟.四物汤及其类方调治痛经规律探讨[J].中医学报2016,31(11):1706-1709.
[20]国家药典委员会.中华人民共和国药典·2015版·一部[M].北京中国医药科技出版社,2015.
[21]刘颖.浅议当归的化学成分与临床药理作用[J].中国医药指南,2010,8(27):51-53.
[22]续秋芝.补肾活血中药治疗肾虚血瘀型多囊卵巢综合征疗效观察[J].中国现代药物应用,2016,10(10):249-250.