三黄汤加减治疗痰湿热结型多囊卵巢综合征患者卵巢多囊样改变、内分泌及代谢的影响被引量：6

Effects of Modified Sanhuang Decoction on Polycystic Ovaries,Endocrine and Metabolism in the Patients with Polycystic Ovarian Syndrome of Phlegm-damp Accumulated with Heat Syndrome

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摘要目的:观察三黄汤对痰湿热结型多囊卵巢综合征的临床疗效,评估其对卵巢多囊样改变、内分泌水平以及代谢能力的影响。方法:选取2013年1月至2016年12月南阳市第二人民医院收治的多囊卵巢综合征患者50例,随机分为对照组和观察组,每组25例。对照组口服炔雌醇环丙孕酮及枸橼酸氯米芬片,共治疗3个疗程。观察组在对照组治疗基础上加用三黄汤,1剂/d,200 m L早晚温服分服。观察2组患者治疗前后症候积分变化情况、卵巢多囊样改变情况,同时比较2组治疗治疗前后促卵泡生成素(FSH),黄体生成素(LH)和睾酮(T)、雌二醇(E)含量变化,以及糖化血红蛋白(Hb Alc),空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)、内脂素(VF)、瘦素(LEP)、脂联素(APN)含量的变化。结果:1)治疗后观察组临床有效率为76%,明显优于对照组的36%,差异有统计学意义(P<0.05);2)与治疗前比较2组患者的中医证候积分均有下降,差异有统计学意义(P<0.05),其中观察组下降得更为明显,差异有统计学意义(P<0.05);3)2组患者治疗后卵巢体积以及卵泡数量均较治疗前下降,差异有统计学意义(P<0.05),其中观察组下降优于对照组,差异有统计学意义(P<0.05);4)与治疗前比较,2组患者治疗后FSH、LH、T水平均下降,E浓度升高,差异均有统计学意义(P<0.05),其中观察组改善的幅度明显大于对照组,差异有统计学意义(P<0.05);5)2组治疗后Hb Alc、FINS以及HOMA-IR均降低,与治疗前比较,差异有统计学意义(P<0.05),观察组优于对照组(P<0.05);6)与治疗前比较,2组患者治疗后VF、LEP水平均下降,APN浓度升高,差异均有统计学意义(P<0.05),其中观察组改善较对照组明显,差异有统计学意义(P<0.05)。结论:三黄汤可明显改善痰湿热结型多囊卵巢综合征的临床症状以及卵巢异常形态,同时可调节其内分泌及代谢能力。 Objective： To observe the clinical curative effect of the Sanhuang decoction on phlegm-damp accumulated with heat type polycystic ovarian syndrome,and to evaluate the impact on polycystic ovaries,the levels of endocrine and metabolic capacity.Methods： A total of 50 patients with polycystic ovarian syndrome in our hospital from January 2013 to December 2016 were included into the study and randomly divided into the control group and the observation group,with 25 cases in each group. The control group had oral ethinylestradiol cyproterone for 3 courses of treatment. The observation group had Sanhuang decoction based on the basic treatment of the control group,1 agent/d,taken 200 m L with warm water in the morning and evening. Syndrome integral changes and polycystic ovarian changes of the two groups before and after treatment were observed. The follicle-stimulating hormone（ FSH）,luteinizing hormone（ LH） and testosterone（ T）,estradiol（ E） content changes,and glycosylated hemoglobin（ Hb Alc）,fasting insulin（ FINS） and insulin resistance index（ HOMA IR）,visifatin（ VF）,leptin（ LEP）,adiponectin（ APN） content changes of the two groups before and after treatment were compared. Results： 1） After treatment,the clinical effective rate of observation group was 76%,which was superior to 36% of the control group（ χ2= 3. 19,P 〈0. 05）; 2） TCM syndrome integrals decreased in both groups compared with before treatment,and the differences were statistically significant（ P 〈0. 05）. The observation group decreased more significantly（ P 〈0. 05）; 3） The ovarian volume and number of follicles in patients of two groups after treatment declined than before the treatment（ P 〈0. 05）. The observation group was superior to that of control group（ P 〈0. 05）; 4） Compared with that before treatment,the levels of FSH,LH,and T all decreased in two groups of patients after treatment,and the concentration of E increased. The differences had statistical significance（ P 〈0. 05）. The improvement extent of observation group was obviously greater than the control group. The differences were statistically significant（ P 〈0. 05）; 5） Hb Alc,FINS and HOMA-IR all reduced in the two groups after treatment. The differences were statistically significant compared with before treatment（ P 〈0. 05）. The observation group was superior to that of control group（ P 〈0. 05）; 6） Compared with before treatment,VF,LEP levels of the two groups of the patients decreased after treatment. The concentration of APN increased. The differences were statistically significant（ P 〈0. 05）,and the improvement of observation group was more obviously than the control group. The differences were statistically significant（ P 〈0. 05）. Conclusion： Sanhuang decoction can obviously improve clinical symptoms of polycystic ovarian syndrome with phlegm-damp accumulated with heat syndrome and ovarian abnormal morphology,can simultaneous adjust the endocrine and metabolic ability.

作者徐冰刘志爽翟旋 Xu Bing;Liu Zhishuang;Zhai Xuan(Department of Traditional Chinese Medicine,Nanyang Second People＇s Hospital,Nanyang 473000,China)

机构地区南阳市第二人民医院中医科

出处《世界中医药》 CAS 2018年第8期1913-1917,共5页 World Chinese Medicine

基金 2014年河南重点科技攻关计划项目(142102310104)

关键词多囊卵巢综合征痰湿热结型三黄汤化痰清热卵巢多囊样改变内分泌水平代谢水平 Polycystic ovarian syndrome Phlegm-damp accumulated with heat Sanhuang decoction Resolving phlegm and clearing heat Polycystic ovaries Level of endocrine secretion Metabolic levels