补肾解郁调冲方治疗肾虚肝郁型多囊卵巢综合征不孕的临床研究OACSTPCD
Clinical Research of Bushen Jieyu Tiaochong Decoction(补肾解郁调冲方)in Treating Patients with Polycystic Ovary Syndrome and Infertility of Kidney Deficiency and Liver Stagnation Type
目的:观察补肾解郁调冲方联合来曲唑治疗肾虚肝郁型多囊卵巢综合征(PCOS)不孕患者的临床疗效.方法:选取83例肾虚肝郁型PCOS不孕患者按随机数字表法分为对照组41例和观察组42例.对照组采用来曲唑促排卵治疗,观察组加用补肾解郁调冲方进行治疗.观察两组治疗前后排卵率、妊娠率、中医证候评分、月经周期评分、性激素、超声学指标、多毛及痤疮积分、焦虑自评量表评分、抑郁自评量表评分,以及血清吻肽(Kiss1)、多巴胺(DA)、5-羟色胺(5-HT)和去甲肾上腺素(NE)水平.结果:与对照组相比,观察组患者的排卵率和妊娠率显著提高,患者痤疮、焦虑、抑郁和中医证候显著改善.与治疗前相比,治疗后观察组患者卵泡个数和卵巢体积显著减小,血清黄体生成素、黄体生成素与卵泡刺激素的比值、睾酮、泌乳素水平显著降低,Kiss1水平显著降低,DA、5-HT水平显著升高,差异均具有统计学意义(P＜0.05).观察组总有效率为88.10％,临床疗效显著优于对照组(P＜0.05).结论:补肾解郁调冲方能有效改善肾虚肝郁型PCOS不孕患者的临床症状,改善性激素紊乱状态,促进排卵,提高临床妊娠率,改善焦虑抑郁症状,这可能与其调节血清吻肽和单胺类神经递质水平有关.
Objective:To observe the efficacy of Bushen Jieyu Tiaochong Decoction(补肾解郁调冲方)in the treatment of patients with polycystic ovary syndrome(PCOS)and infertility of kidney deficiency and liver stagnation type.Methods:Eighty-three patients with PCOS and infertility of kidney deficiency and liver stagnation type treated were divided into control group(41 cases)and observation group(42 cases)using random number table method.The control group was treated with letrozole,and the observation group was treated with Bushen Jieyu Tiaochong Decoction combined with letrozole.Ovulation rate,pregnancy rate,traditional Chinese medicine syndrome,menstrual cycle score,sex hormone,ultrasound index,hairy and acne score,score of self-rating scale for anxiety and depression,and serum Kisspeptin(Kissi),dopamine(DA),5-hydroxytryptamine(5-HT)and norepinephrine(NE)levels were observed.Results:After treatment,compared with the control group,the observation group was significantly improved on the ovulation rate and pregnancy rate,symptoms of acne,anxiety,depression and traditional Chinese medicine syndrome.Compared to before treatment,the number of follicles and ovarian volume were significantly reduced,and the serum luteinizing hormone,the ratio of luteinizing hormone to follicle stimulating hormone,the levels of testosterone and prolactin,and the level of Kiss1 were significantly decreased,the levels of DA and 5-HT were significantly increased,which the differences are statistically significant(P＜0.05).The total effective rate of the observation group was 88.09％,and the clinical effect was significantly better than that of the control group(P＜0.05).Conclusions:Bushen Jieyu Tiaochong Decoction could effectively improve the clinical symptoms of patients with PCOS and infertility of kidney deficiency and liver stagnation type,restore the disorder of sex hormones,promote ovulation,improve clinical pregnancy,improve anxiety and depression symptoms,which might be related to its regulation of serum kisspeptin and monoamine neurotransmitter levels.
莫婷婷;刘雁峰;陈然;潘雪;徐子涵;郭霖霖
北京中医药大学东直门医院,北京 100700天津市西青区中医院,天津 300380北京中医药大学第三附属医院,北京 100029
中医学
多囊卵巢综合征不孕症补肾解郁调冲方肾虚肝郁心理应激
polycystic ovary syndromeinfertilityBushen Jieyu Tiaochong Decoctionkidney deficiency and liver stagnationpsychological stress
《山东中医杂志》 2024 (007)
700-706 / 7
国家自然科学基金青年科学基金项目(编号:82104922);首都卫生发展科研专项基金资助项目(编号:首发2020-2-4194)
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