摘要
目的 探讨加味二仙汤对多囊卵巢综合征(Polycystic ovarysyndrome, PCOS)不孕患者胰岛素抵抗及性激素水平的影响。方法 选取2020年1月—2022年1月期间河南省濮阳市妇幼保健院收治的PCOS不孕患者120例,按随机数字表法分为对照组和观察组,每组各60例。对照组常规服用二甲双胍治疗,观察组在对照组基础上加用加味二仙汤治疗。1个月经周期为1个疗程,两组患者均治疗3个疗程。观察比较两组患者临床疗效、治疗前后胰岛素指标[空腹血糖(Fasting plasma glucose, FPG)、空腹胰岛素(Fasting insulin, FINS)以及稳态模式胰岛素抵抗指数(Homeostasis model insulin resistanceindex, HOMA-IR)]变化、性激素水平[雌二酮(Estradiol, E_(2))、促卵泡雌激素(Follicle stimulating hormone, FSH)、睾酮(Testosterone, T)以及促黄体生成素(Luteinizing hormone, LH)]变化、子宫及卵巢功能[卵巢体积、子宫内膜厚度、成熟卵泡数量]变化以及治疗后排卵、妊娠、复发情况。结果 治疗后观察组临床总有效率96.67%(58/60)高于对照组85.00%(51/60),差异有统计学意义(P<0.05)。治疗后两组患者胰岛素指标FPG、FINS、HOMA-IR均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组胰岛素指标FPG、FINS、HOMA-IR均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者性激素E_(2)、FSH、T、LH水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组性激素E_(2)、FSH、T、LH水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者卵巢体积较治疗前降低,子宫内膜厚度以及成熟卵泡数量较治疗前升高,差异有统计学意义(P<0.05);且观察组卵巢体积明显低于对照组,子宫内膜厚度以及成熟卵泡数量明显高于对照组,差异有统计学意义(P<0.05)。随访3个月经周期,观察组排卵率86.67%(52/60)、妊娠率76.67%(46/60)均高于对照组71.67%(43/60)、58.33%(35/60),复发率1.67%(1/60)低于对照组11.67%(7/60),差异有统计学意义(P<0.05)。结论 加味二仙汤治疗PCOS的临床疗效显著,可有效降低患者的胰岛素抵抗以及调节性激素水平,改善卵巢功能,促进排卵,提高妊娠成功率,值得临床推广。
Objective To investigate the effect of Jiawei Erxian decoction on insulin resistance and sex hormone levels in infertility patients with polycystic ovary syndrome(PCOS).Method A total of 120 patients with PCOS infertility treated in Puyang Maternal and Child Health Hospital of Henan Province from January 2020 to January 2022 were selected as the study objects and randomly divided into a control group and an observation group,with 60 cases in each group.The control group was treated with metformin,and the observation group was treated with Jiawei Erxian decoction in addition to the treatment given to the control group.One menstrual cycle was considered as one course of treatment,and both groups underwent 3 courses of treatment.The clinical efficacy,fasting plasma glucose(FPG),fasting insulin(FINS)and homeostasis model insulin resistance index(HOMA-IR),sex hormone levels[estradiol(E_(2)),follicle stimulating hormone(FSH),testosterone(T),and luteinizing hormone(LH)],changes in uterine and ovarian function[ovarian volume,endometrial thickness,number of mature follicles],and post-treatment ovulation,pregnancy,and recurrence before and after treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group was 96.67%(58/60),which was higher than the control group′s 85.00%(51/60),with a statistically significant difference(P<0.05).After treatment,the insulin indicators FPG,FINS,and HOMA-IR in both groups significantly decreased compared to before treatment,with statistically significant differences(P<0.05);the insulin indicators FPG,FINS,and HOMA-IR in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,After treatment,the hormone levels E_(2),FSH,T,and LH in both groups significantly decreased compared to before treatment,with statistically significant differences(P<0.05);additionally,the hormone levels E_(2),FSH,T,and LH in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,ovarian volume decreased while endometrial thickness and the number of mature follicles increased compared to before treatment,with statistically significant differences(P<0.05)in both groups.Moreover,the observation group had a significantly lower ovarian volume and significantly higher endometrial thickness and number of mature follicles compared to the control group,with statistically significant differences(P<0.05).During the 3-month follow-up period,the ovulation rate in the observation group was 86.67%(52/60),and the pregnancy rate was 76.67%(46/60),both of which were higher than those in the control group,which were 71.67%(43/60)and 58.33%(35/60)respectively.The recurrence rate in the observation group was 1.67%(1/60),lower than the control group′s 11.67%(7/60),with statistically significant differences(P<0.05).Conclusion The clinical effect of Jiawei Erxian Decoction in treating PCOS is significant.It can effectively reduce the insulin resistance and regulate the level of sex hormones,improve ovarian function,promote ovulation,and increase the success rate of pregnancy.Therefore,Jiawei Erxian Decoction is worthy of clinical promotion.
作者
丁莉
周传亚
葛姗
DING Li;ZHOU Chuan-ya;GE Shan(Department of Gynecology of Traditional Chinese Medicine,Puyang Maternal and Child Health Hospital,Puyang Henan 457000)
出处
《世界中西医结合杂志》
2024年第2期302-306,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河南省医学科技攻关计划项目(LHGJ20210940)。
关键词
加味二仙汤
多囊卵巢综合征
不孕
胰岛素抵抗
性激素水平
Jiawei Erxian Decoction
Polycystic Ovary Syndrome
Infertility
Insulin Resistance
Sex Hormone Level
