尹红章;万淑琼;

• 1:黄石中心医院妇产科

摘要(Abstract)：

目的观察中药调经汤对多囊卵巢综合征不孕(PCOS)的治疗效果,并探究其作用机制。方法患者共86例,并随机分为观察组和对照组各43例。对照组采用基础治疗方法:服用决雌醇环丙孕酮片和枸橼酸氯米芬,并注射用尿促性素(疗程为3个月经周期)。观察组在采用基础治疗的基础上加以调经汤治疗(疗程为3个月经周期)。用B超监测卵泡的发育情况,测定主导卵泡膜血流,并对搏动指数(PI)和阻力指数(RI)做好记录;分别监测并对比患者治疗前后的空腹血糖(FBG)水平、瘦素(PI)水平和空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-R);监测并记录人绒毛膜促性腺激素(HCG)水平(注射日)、黄体生成素(LH)水平、雌二醇(E2)水平、血清睾酮(T)水平以及卵泡刺激素(FSH)水平;对治疗后患者月经恢复率、排卵率以及妊娠率做好记录。结果 2组患者治疗后,观察组月经恢复率(93.02%),排卵率(86.04%)和妊娠率(72.09%)均比对照组月经恢复率(69.77%)、排卵率(55.81%)和妊娠率(39.53%)高,差异具有统计学意义(P<0.01);PI均较治疗前显著升高,且观察组比对照组高,差异具有统计学意义(P<0.01);RI比治疗前有较明显降低,且观察组比对照组低,差异具有统计学意义(P<0.001);观察组FSH水平,LH水平和E2水平相较于对照组均有显著提高,T水平比对照组低,差异均具有统计学意义(均P<0.001);2组FINS水平、IR水平和LP水平相较于治疗前均有明显降低,且观察组比对照组低,差异具有统计学意义(P<0.001)。结论基础治疗加上调经汤共同治疗,对患者卵巢血流、高雄激素血症、胰岛素抵抗质量起改善作用,提高卵泡质量,继而对排卵率和妊娠率起到显著的提高作用。

关键词(KeyWords)： 调经汤;多囊卵巢综合征;妊娠率;月经恢复率;卵泡质量

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作者(Author): 尹红章;万淑琼;

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参考文献(References)：

• [1]DANG H M,LIU Y Q,LIU R X,et al.Influence of Tiaojing Zhuyun Fang Combined with Letrozole on the Situation of Follicular Development and Anti-Mullerian Hormone Level in Infertility Patients with Polycystic Ovary Syndrome[J].Chinese Journal of Information on Traditional Chinese Medicine,2013,12(2):5-7.
• [2]ZHANG N,WANG L,WEI A.Intervention Effect of Yigao Tiaojing Decoction on Ovulatory Dysfunction of Model Rats with Polycystic Ovary Syndrome[J].Henan Traditional Chinese Medicine,2013,22(14):28-31.
• [3]SHI Y.Kidney nourishing decoction on kidney deficiency of Yin with blood stasis polycystic ovary syndrome infertility[J].China Modern Doctor,2014,3(2):8-11.
• [4]杨硕,尤昭玲.PCOS性不孕卵泡发育异常的中医研究进展[J].湖南中医药大学学报,2013,33(11):108-111.
• [5]李雪梅,唐细容.多囊卵巢综合征不孕患者状态-特质焦虑调查[J].中国临床心理学杂志,2012,20(1):56-57.
• [6]陈建玲.补肾调经汤内服加活血散结栓塞肛对子宫内膜异位症体液免疫及异位子宫内膜的影响[J].广东医学,2015,17(5):787-789.
• [7]FENG G,HU X H,ZHOU Y.Effect of Bushen Tiaojing Decoction on Serum Leptin,Insulin and Tes tosterone of Polycystic Ovary Syndrome Model Rats[J].Journal of Traditional Chinese Medicine,2010,29(4):34-35.
• [8]杜鑫,王雪,范丰田,等.温肾调经助孕汤联合中药人工周期治疗肾阳虚型排卵障碍性不孕症的临床疗效评价[J].实用临床医药杂志,2013,17(21):181-182.
• [9]LIU R,SHANG H,LIU Y.Clinical Observation on Polycystic Ovary Syndrome Treated by Tiaojing Zhuyun Recipe Combined with Metformin Hydrochloride[J].Journal of Traditional Chinese Medicine,2011,52(13):1115-1118.
• [10]JIN X T,KUN M A,SHANG J.Clinical efficacy observation on therepy ovulation failure infertility caursed by PCOS with reinforcing kidney,activating blood circulation and ovarian stimulation compound recipe[J].China Journal of Chinese Materia Medica,2014,13(3):342-343.
• [11]LIAN F,TIAN S,ZHANG X.Effect of Erzhi Tiaojing Granules on Follicle Quality in Infertility Patients with Polycystic Ovary Syndrome[J].Journal of Traditional Chinese Medicine,2011,52(2):114-117.
• [12]代晶芳,李晓林,孙宝治,等.多囊卵巢综合征易感基因多态性的研究进展[J].山东医药,2013,53(34):98-101.
• [13]郑东京,许鑫,郑伟达,等.郑伟达教授运用四期疗法治疗不孕症经验探析[J].世界中西医结合杂志,2014,9(2):130-132.
• [14]HUI L I,WANG X.Wang Xin Bushentiaojing Phlegm StasisInhibiting Progesterone Capsule Polycystic Ovary Syndrome Treated[J].Journal of Practical Traditional Chinese Internal Medicine,2013,13(2):10-12.
• [15]宓伟毅.星夏调经汤治疗高泌乳素血症65例临床观察[J].吉林大学学报(医学版),2012,38(2):224.
• [16]曹卫平,王东梅.调经毓麟汤治疗多囊卵巢综合征不孕症的临床研究[J].环球中医药,2010,03(5):339-343.
• [17]LI Q Q,SHI G X,XU Q,et al.Acupuncture effect and central autonomic regulation[J].Evidence-based complementary and alternative medicine:e CAM,2013(3):267959.
• [18]ZHANG H.Wenshen Huatan Tang Combined with Western Medicine Treatment of Polycystic Ovary Syndrome Random Parallel Control Study[J].Journal of Practical Traditional Chinese Internal Medicine,2013,17(5):654-655.
• [19]MANSOR F,GU H F,OSTENSON C G,et al.Labisia pumila Upregulates Peroxisome Proliferator-Activated Receptor Gamma Expression in Rat Adipose Tissues and 3T3-L1 Adipocytes.[J].Advances in Pharmacological Sciences,2013:808914.