摘要
目的 分析温肾化痰方联合西药治疗对肾虚痰湿型多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)不孕症患者性激素、糖代谢、排卵率、妊娠率、疗效及不良反应的影响.方法 选取2022年12月至2023年7月河南省中医院生殖医学科门诊收治的61例肾虚痰湿型PCOS伴IR不孕症患者作为研究对象,随机分为试验组(31例)和对照组(30例).对照组给予盐酸二甲双胍片、来曲唑片进行治疗,试验组在此基础上加用温肾化痰方治疗,两组均治疗3个月经周期.观察治疗前后患者血清睾酮(T)、促黄体生成素(LH)、卵泡刺激素(FSH)水平、LH/FSH比值、体质量指数(BMI)、空腹血糖(FBG)、空腹胰岛素(FINS)、稳态指数模型(HOMA-IR)、排卵率、妊娠率和疗效情况,并进行安全性评估.结果 治疗前两组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FSH、FBG、FINS水平比较,差异均无统计学意义(P＞0.05);治疗后,两组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FBG、FINS水平低于治疗前,血清FSH水平高于治疗前,且试验组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FBG、FINS水平低于对照组,血清FSH水平高于对照组,差异均有统计学意义(P＜0.05).试验组治疗的总有效率、排卵率、妊娠率高于对照组,不良反应总发生率低于对照组,差异均有统计学意义(P＜0.05).结论 温肾化痰方联合常规西药治疗肾虚痰湿型PCOS伴IR不孕症疗效优于单用常规西药,可提高排卵率及妊娠率,改善女性性激素及糖代谢指标水平,缓解IR,改善中医临床症状,且安全性良好.
Abstract
Objective To analyze the effects of Wenshen Huatan decoction combined with Western medi-cine on sex hormone,glucose metabolism,ovulation rate,pregnancy rate,efficacy and adverse reactions in pa-tients with polycystic ovary syndrome(PCOS)and insulin resistance(IR)infertility.Methods A total of 61 kidney deficiency phlegm-dampness PCOS with IR infertility patients admitted to the Department of Repro-ductive Medicine of Henan Provincial Hospital of Traditional Chinese Medicine from December 2022 to July 2023 were selected as the study objects and randomly divided into the experimental group(31 cases)and the control group(30 cases).The control group was treated with metformin hydrochloride tablets and letrozole tablets,and the experimental group was treated with Wenshen Huatan decoction on the basis of this treat-ment.Both groups were given 3 menstrual cycles.Serum testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH)levels,LH/FSH ratio,body mass index(BMI),fasting blood glucose(FBG),fasting insulin(FINS),homeostasis index model(HOMA-IR),ovulation rate,pregnancy rate and efficacy of patients were observed before and after treatment,and security assessment was carried out.Results Before treatment,there were no significant differences in BMI,HOMA-IR,LH/FSH ratio and serum T,LH,FSH,FBG,FINS levels between the two groups(P＞0.05).After treatment,BMI,HOMA-IR,LH/FSH ratio and serum T,LH,FBG and FINS levels in two groups were lower than before treatment,serum FSH level was higher than before treatment,and BMI,HOMA-IR,LH/FSH ratio and serum T,LH,FBG,FINS levels in the experimental group were lower than those in the control group,and serum FSH level in the experimental group was higher than those of the control group,and the differences were statistically significant(P＜0.05).The total effective rate,ovulation rate and pregnancy rate of experimental group were higher than those of the control group,and the incidence of total adverse reactions was lower than that of the control group,with sta-tistical significances(P＜0.05).Conclusion The efficacy of Wenshen Huatan decoction combined with con-ventional Western medicine in treating infertility associated with kidney deficie-ncy and phlegm-dampness pat-tern of PCOS with IR is superior to conventional Western medicine alone,which can increase ovulation rate and pregnancy rate,improve female sex hormone,glucose metabolism index levels,alleviate IR,improve clini-cal symptoms of traditional Chinese medicine,with good safety.
维普
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