北京中医药大学学报2025，Vol.48Issue(7)：943-953,11.DOI:10.3969/j.issn.1006-2157.2025.07.008
从"治未病"探讨真实世界养阴舒肝方治疗 307 例不同阶段卵巢功能减退患者的临床疗效
Exploring the clinical efficacy of Yangyin Shugan Formula in treating 307 patients with ovarian dysfunction at different stages based on the"preventive treatment of disease"theory:a real world study
摘要
Abstract
Objective Based on the"preventive treatment of disease"theory and real-world data,this study aimed to evaluate the clinical efficacy of Yangyin Shugan Formula in patients with ovarian dysfunction characterized by the syndrome of kidney deficiency and liver depression at different stages and to provide evidence for optimizing the timing of traditional Chinese medicine(TCM)in premature ovarian insufficiency(POI)management.Methods Ovarian dysfunction patients under 40 years old characterized by syndrome of kidney deficiency and liver depression,registered in the outpatient electronic medical records of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to December 2023,were stratified into three groups:subclinical POI,POI,and premature ovarian failure(POF)groups.The therapeutic outcomes of the three groups of patients were compared,including TCM syndrome total response rates,menstrual total response rates/normalization(cured)rates,base follicle-stimulating hormone(FSH)total response rate/normalization rates and anti-Müllerian hormone(AMH)levels.Results A total of 307 patients meeting the research criteria were included(97 cases in subclinical POI group,112 cases in POI group,and 98 cases in POF group).The TCM syndrome total response rates ranked as subclinical POI group(98.97%,96/97)>POI group(95.54%,107/112)>POF group(83.67%,82/98),with the POF group was lower than that of the subclinical POI and POI groups(P<0.017);while the difference of the subclinical POI group with the POI group was not significant.Menstrual total response rates ranked as subclinical POI group(97.22%,70/72)>POI group(72.32%,81/112)>POF group(51.02%,50/98),the differences among the three groups and in the post-hoc comparisons were significant(P<0.01,P<0.017);normalization rates ranked as subclinical POI group(90.28%,65/72)>POI group(54.46%,61/112)>POF group(26.53%,26/98),the differences among the three groups and in the post-hoc comparisons were significant(P<0.01,P<0.017).FSH total response rates ranked as subclinical POI group(89.69%,87/97)>POI group(81.25%,91/112)>POF group(60.20%,59/98),while POF group was lower than that of the other two groups(P<0.017),and the difference of the subclinical POI group with the POI group was not significant.Normalization FSH rates ranked as subclinical POI group(71.13%,69/97)>POI group(53.57%,60/112)>POF group(16.33%,16/98),the differences among the three groups and in the post-hoc comparisons were significant(P<0.01,P<0.017).Compared with before treatment,the FSH levels in all three groups decreased after treatment(P<0.01).The reduction of FSH in the POF and POI groups were better than that in the subclinical P OI group(P<0.017).No significant difference was observed in the reduction of FSH between the POI and POF groups.Post-treatment AMH elevation observed in the subclinical POI and POI groups(P<0.01).Conclusion Yangyin Shugan Formula improves the menstrual conditions and TCM syndromes across all the stages.It also improves elevated FSH levels across all the stages and has a specific effect on normalizing FSH and menstruation.Yangyin Shugan Formula increases the AMH levels of patients with subclinical POI and POI,highlighting the applicability of TCM in staged preventive management.关键词
养阴舒肝方/早发性卵巢功能不全/肾虚肝郁证/真实世界/回顾性研究/治未病Key words
Yangyin Shugan Formula/premature ovarian insufficiency/kidney deficiency and liver depression syndrome/real world/retrospective study/preventive treatment of disease分类
医药卫生引用本文复制引用
黄旭春,王菲菲,梁娜,黄爽,陈飘盈,侯佳睿,成芳平,曹晓静,王小云..从"治未病"探讨真实世界养阴舒肝方治疗 307 例不同阶段卵巢功能减退患者的临床疗效[J].北京中医药大学学报,2025,48(7):943-953,11.基金项目
国家重点研发计划项目(No.2018YFC1704102) （No.2018YFC1704102）
王小云全国名老中医药专家传承工作室建设项目([2016]42 号) （[2016]42 号）
岭南妇科流派传承工作室建设项目([2013]233 号) （[2013]233 号）
广东省中医院中医药科学技术研究专项(No.YN2023MS21) （No.YN2023MS21）
第七批全国老中医药专家学术经验继承工作项目(国中医药办人教函[2021]272 号) National Key R&D Program of China(No.2018YFC1704102) （国中医药办人教函[2021]272 号）
