滋肾益经活血汤治疗肾虚血瘀型卵巢储备功能减退的疗效及对T淋巴细胞亚群水平的影响OA北大核心CHSSCDCSTPCD
Zishen Yijing Huoxue Decoction in Treatment of Diminished Ovarian Reserve with Kidney Deficiency and Blood Stasis and Effect on T Lymphocyte Subset Level
目的:探讨滋肾益经活血汤治疗肾虚血瘀型卵巢储备功能减退(DOR)的疗效及对T淋巴细胞亚群水平的影响.方法:选取2019年4月至2022年4月陕西省中医医院收治的肾虚血瘀型DOR患者120例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组60例.对照组接受戊酸雌二醇环丙孕酮片治疗,观察组在对照组基础上接受滋肾益经活血汤治疗.治疗6个月经周期后,比较2组患者临床疗效和治疗后中医证候积分、窦卵泡计数(AFC)、卵巢动脉血流参数、促卵泡激素(FSH)、雌二醇(E2)、抗米勒管激素(AMH)、月经情况、T淋巴细胞亚群水平及不良反应发生率.结果:治疗后,观察组治疗总有效率为88.33％(53/60)高于对照组的71.67％(43/60),差异有统计学意义(P＜0.05)o治疗前,2组中医证候积分、AFC、FSH、E2、AMH、卵巢动脉血流参数、月经情况和T淋巴细胞亚群水平比较,差异无统计学意义(P＞0.05);治疗后,观察组中医证候积分、FSH、CD8+、阻力指数和月经周期、月经色质、月经量、经期评分低于对照组,AFC、舒张末期流速、收缩期峰值速度、E2、AMH、CD3+、CD4+、CD4+/CD8+高于对照组,差异有统计学意义(P＜0.05).2组患者不良反应率比较,差异无统计学意义(P＞0.05).结论:滋肾益经活血汤治疗肾虚血瘀型DOR疗效显著,能有效改善患者临床症状、卵巢储备功能、月经异常和免疫功能,且不良反应较少.
Objective:To investigate the efficacy of Zishen Yijing Huoxue Decoction in treating diminished ovarian reserve(DOR)with kidney deficiency and blood stasis and its effect on T lymphocyte subsets.Methods:A total of 120 DOR patients with kidney deficiency and blood stasis treated at Shaanxi Provincial Hospital of Chinese Medicine from April 2019 to April 2022 were enrolled and randomly divided into an observation group and a control group using a random number table,with 60 patients in each group.The control group received estradiol valerate and cyproterone acetate tablets,while the observation group received Zishen Yijing Huoxue Decoction in addition to the treatment given to the control group.After 6 menstrual cycles of treatment,clinical efficacy,tra-ditional Chinese medicine(TCM)syndrome scores,antral follicle count(AFC),ovarian artery blood flow parameters,follicle-stimu-lating hormone(FSH),estradiol(E2),anti-Müllerian hormone(AMH),menstrual conditions,T lymphocyte subsets,and the inci-dence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate in the observation group was 88.33％(53/60),significantly higher than 71.67％(43/60)in the control group(P＜0.05).Before treatment,there were no significant differences between the two groups in TCM syndrome scores,AFC,FSH,E2,AMH,ovarian artery blood flow pa-rameters,menstrual conditions,and T lymphocyte subsets(P＞0.05).After treatment,the observation group showed significantly lower TCM syndrome scores,FSH levels,CD8+levels,resistance index,menstrual cycle,menstrual color quality,menstrual volume,and menstrual period scores than the control group.Additionally,the observation group had significantly higher AFC,end-diastolic flow velocity,peak systolic velocity,E2,AMH,CD3+,CD4+,and CD4+/CD8+ratios than the control group(P＜0.05).The inci-dence of adverse reactions was not significantly different between the two groups(P＞0.05).Conclusion:Zishen Yijing Huoxue Decoction is highly effective in treating DOR with kidney deficiency and blood stasis.It can significantly improve clinical symp-toms,ovarian reserve function,menstrual abnormalities,and immune function with few adverse reactions.
田颖;杨东艳
陕西省中医医院妇科,西安,710003
中医学
卵巢储备功能减退肾虚血瘀型滋肾益经活血汤免疫功能T淋巴细胞亚群窦卵泡计数卵巢动脉血流参数雌二醇
Diminished ovarian reserveKidney deficiency and blood stasis syndromeZishen Yijing Huoxue DecoctionImmune functionT lymphocyte subsetsAntral follicle countOvarian artery blood flow parametersEstradiol
《世界中医药》 2024 (015)
2314-2318 / 5
国家自然科学基金项目(8187152103);陕西省重点研发计划项目(2017SF-084)
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