摘要
目的:观察调经抗衰汤加减联合西药治疗肾虚血瘀型卵巢功能减退的临床疗效。方法:选取120例肾虚血瘀型卵巢功能减退患者,根据随机数字表法分为对照A组、对照B组和观察组各40例。对照A组给予西药(戊酸雌二醇片、黄体酮胶囊)治疗,对照B组给予调经抗衰汤加减治疗,观察组同时给予调经抗衰汤加减联合西药治疗,3组均治疗3个月经周期。比较3组临床疗效、Kupperman评分、中医证候积分、性激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))]水平、卵巢功能指标[卵巢体积(OV)、窦卵泡计数(AFC)、抗苗勒管激素(AMH)]及不良反应发生率。结果:治疗后,观察组临床疗效总有效率92.50%,高于对照A组70.00%及对照B组75.00%(P<0.05)。3组Kupperman评分、中医证候积分均较治疗前降低(P<0.05),观察组Kupperman评分、中医证候积分均低于对照A组及对照B组(P<0.05)。3组FSH、LH水平均较治疗前降低(P<0.05),E_(2)水平均较治疗前升高(P<0.05);观察组FSH、LH水平均低于对照A组及对照B组(P<0.05),E_(2)水平高于对照A组及对照B组(P<0.05)。3组OV均较治疗前增大(P<0.05),AFC均较治疗前增多(P<0.05),AMH水平均较治疗前升高(P<0.05);观察组OV大于对照A组及对照B组(P<0.05),AFC多于对照A组及对照B组(P<0.05),AMH高于对照A组及对照B组(P<0.05)。观察组与对照B组胃肠不适、乳胀、体质量增加及头痛发生率均低于对照A组(P<0.05)。结论:调经抗衰汤加减联合西药治疗肾虚血瘀型卵巢功能减退,可缓解患者的临床症状,调节性激素水平,促进卵巢功能恢复,其治疗效果优于仅使用调经抗衰汤加减或西药治疗,且安全性高。
Objective:To observe the clinical effect of therapy of modified Tiaojing Kangshuai Decoction combined with western medicine on hypovarianism of kidney deficiency and blood stasis type.Methods:A total of 120 patients with hypovarianism of kidney deficiency and blood stasis type were selected and divided into the control group A,the control group B and the observation group according to the random number table method,with 40 cases in each group.The control group A was given western medicine,including Estradiol Valerate Tablets and Progesterone Capsules;the control group B was given modified Tiaojing Kangshuai Decoction,and the observation group was treated with the therapy of modified Tiaojing Kangshuai Decoction combined with western medicine.The three groups were treated for 3 menstrual cycles.The clinical effects,Kupperman scores,traditional Chinese medicine(TCM) syndrome scores,levels of sex hormones,including follicle stimulating hormone(FSH),luteinizing hormone(LH) and estradiol(E_(2)),indexes of ovarian activity,including ovarian volume(OV),antral follicle counting(AFC) and anti-mullerian hormone(AMH),and incidence of adverse reactions were compared between the three groups.Results:After treatment,the total clinical effective rate was 92.50% in the observation group,higher than that of 70.00% in the control group A and 75.00% in the control group B(P<0.05).The Kupperman scores and TCM syndrome scores in the three groups were decreased when compared with those before treatment(P<0.05),and the above two scores in the observation group were lower than those in the control group A and the control group B respectively(P<0.05).The levels of FSH and LH in the three groups were decreased when compared with those before treatment(P<0.05),the E_(2) levels were increased when compared with those before treatment(P<0.05);the FSH and LH levels in the observation group were lower than those in the control group A and control group B(P<0.05),and the E_(2) level was higher than that in the control group A and the control group B(P<0.05).The OV in the three groups were increased when respectively compared with those before treatment(P<0.05),the AFC were increased when respectively compared with those before treatment(P<0.05),and the AMH level were increased when respectively compared with those before treatment(P<0.05);the OV in the observation group was larger than that in the control group A and the control group B(P<0.05),the AFC was larger than that in the control group A and the control group B(P<0.05),and the AMH level was higher than that in the control group A and the control group B(P<0.05).The incidence of gastrointestinal discomfort,distension of the breasts,body mass gain and headache in the observation group and the control group B were lower than those in the control group A(P<0.05).Conclusion:The therapy of modified Tiaojing Kangshuai Decoction combined with western medicine can mitigate the clinical symptoms of patients with hypovarianism of kidney deficiency and blood stasis type,adjust the levels of sex hormones and promote the recovery of ovarian activity,whose curative effect is better than that of single modified Tiaojing Kangshuai Decoction or western medicine,with good safety.
作者
徐方丽
姜帅
喻向春
XU Fangli;JIANG Shuai;YU Xiangchun(Quzhou People's Hospital,Quzhou Zhejiang 324000,China)
出处
《新中医》
CAS
2023年第18期87-92,共6页
New Chinese Medicine
关键词
卵巢功能减退
肾虚血瘀型
调经抗衰汤
戊酸雌二醇片
黄体酮胶囊
性激素
卵巢功能
Hypovarianism
Kidney deficiency and blood stasis type
Tiaojing Kangshuai Decoction
Estradiol Valerate Tablets
Progesterone Capsules
Sex hormone
Ovarian activity
