白术附子汤加减治疗多囊卵巢综合征临床研究
Clinical Study on Modified Rhizoma Atractylodis Macrocephalae and Aconite Decoction in the Treatment of Polycystic Ovarian Syndrome
于田华1
作者信息
- 1. 烟台市蓬莱中医医院,山东烟台 265600
- 折叠
摘要
目的:观察白术附子汤加减治疗多囊卵巢综合征的临床疗效.方法:将2022年10月至2023年9月就诊于烟台市蓬莱中医医院的80例多囊卵巢综合征患者按照随机数字表法分为对照组和观察组,每组各40例.对照组给予常规西医治疗,观察组在对照组治疗的基础上给予白术附子汤加减治疗.比较两组患者治疗前后血清激素水平[黄体生成素(luteinizing hor-mone,LH)、泌乳素(prolactin,PRL)、性激素结合球蛋白(sex hormone binding globuli,SHBG)、硫酸脱氢表雄酮(dehydroepiandro-sterone sulfate,DHEAS)、游离雄激素指数(free androgen index,FAI)]、凝血-纤溶系统指标[凝血因子X(factor X,FX)、凝血因子 Ⅷ(coagulation factor Ⅷ,FⅧ)、纤溶酶原激活物抑制物-1(plasminogen activatorinhibitor-1,PAI-1)]、血流动力学参数(卵巢血流搏动指数、卵巢阻力指数、卵巢舒张期最低血流速度)及卵巢储备功能(卵巢体积、卵巢窦卵泡数目)变化情况,观察两组患者的临床疗效.结果:两组患者治疗后LH、PRL、DHEAS、FAI低于本组治疗前,SHBG高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P＜0.05).两组患者治疗后FX、FVⅢ、PAI-1低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P＜0.05).两组患者治疗后卵巢血流搏动指数、卵巢阻力指数低于本组治疗前,卵巢舒张期最低血流速度高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P＜0.05).两组患者治疗后卵巢体积及卵巢窦卵泡数目小于本组治疗前,且治疗后观察组小于对照组,差异具有统计学意义(P＜0.05).对照组有效率为72.50％,低于观察组的90.00％,差异具有统计学意义(P＜0.05).结论:白术附子汤加减能改善多囊卵巢综合征患者的卵巢储备功能,促进卵巢血流动力学指标恢复正常,提高临床疗效,其作用机制可能与维持相关激素水平、凝血-纤溶系统平衡有关.
Abstract
Objective:To observe the clinical efficacy of Modified Rhizoma Atractylodis Macrocephalae and Aconite Decoction on poly-cystic ovarian syndrome(PCOS).Methods:A total of 80 patients with PCOS who were treated in Yan Tai Penglai Traditional Chinese Medicine Hospital from October 2022 to September 2023 were randomly divided into the control group and the observation group accord-ing to the random number table method,with 40 cases in each group,The control group was treated with conventional Western medi-cine,while the observation group was treated with Modified Rhizoma Atractylodis Macrocephalae and Aconite Decoction on the basis of the control group.The changes in the levels of serum hormones[including luteinizing hormone(LH),prolactin(PRL),sex hormone binding globuli(SHBG),dehydroepiandrosterone sulfate(DHEAS),free androgen index(FAI)],coagulation fibrinolysis system[factor(FX),coagulation factor VⅢ(FVⅢ),and plasminogen activator inhibitor-1(PAI-1)],hemodynamic parameters(such as o-varian pulsatility index,ovarian resistance index,minimum blood flow velocity during ovarian diastole)and ovarian reserve function(such as volume of left and right ovaries,number of ovarian antral follicles)before and after treatment between two groups were com-pared.The clinical efficacy of the two groups was observed.Results:After treatment,LH PRL,DHEAS,and FAI were lower than those before treatment in each same group,while SHBG was higher than that before treatment in each same group,and all the differences be-tween the two groups after treatment were statistically significant(P＜0.05).FX,FVⅢ and PAI-1 were lower than those before treat-ment in each same group,and after treatment,the observation group's above indexes were lower than those of the control group,and all the differences were statistically significant(P＜0.05).After treatment,the ovarian pulsatility index and ovarian resistance index of the two groups were lower than those before treatment,and the lowest ovarian diastolic blood flow velocity was higher than that before treat-ment.The differences between the two groups were statistically significant(P＜0.05).The volume and number of ovarian antral folli-cles in the two groups were smaller than those before treatment,and the observation group's above indexes were smaller than those of the control group,and the differences between the two groups were statistically significant(P＜0.05).The effective rate of the control group was 72.5％,lower than the observation group's 90.00％,and the difference was statistically significant(P＜0.05).Conclusion:Modified Rhizoma Atractylodis Macrocephalae and Aconite Decoction can improve ovarian reserve function in patients with PCOS,pro-mote the restoration of ovarian hemodynamic indicators to normal,and improve clinical efficacy.Its mechanism of action may be related to maintaining relevant hormone levels and the balance of coagulation fibrinolysis system.
关键词
多囊卵巢综合征/白术附子汤/炔雌醇环丙孕酮片/盐酸二甲双胍片/《金匮要略》/张仲景Key words
polycystic ovary syndrome(PCOS)/Rhizoma Atractylodis Macrocephalae and Aconite Decoction/Ethinylestradiol Cycloprot-erone Tablets/Metformin Hydrochloride Tablets/Synopsis of the Golden Chamber/Zhang Zhongjing引用本文复制引用
基金项目
山东省中医药管理局项目(20220852)
出版年
2024
国家科技期刊平台
NSTL
万方数据