摘要
目的 观察化痰消瘀汤联合炔雌醇环丙孕酮治疗多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)患者的疗效及对其妊娠的影响.方法 选取2020年6月—2021年6月期间山东省枣庄市妇幼保健院生殖医学中心及妇科就诊的PCOS患者80例,采用随机数字表法分为对照组和观察组,每组各40例.对照组予炔雌醇环丙孕酮治疗,观察组在对照组基础上加用化痰消瘀汤治疗.两组患者均治疗3个月.观察比较两组患者治疗前后中医证候积分、血清激素[促黄体生成素(Luteinizing hormone,LH)、促卵泡生成素(Follicle stimulating hor-mone,FSH)、睾酮(Testosterone,T)、雌二醇(Estradiol,E2)]水平、卵巢体积、卵泡数目、子宫内膜厚度(Endometrial thickness,EM)、阻力指数(Resistance Index,RI)、螺旋动脉搏动指数(Spiral artery pulsatilityindex,PI),并比较两组患者妊娠结局.结果 治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者血清激素E2、LH及T水平均较治疗前明显降低,FSH水平较治疗前升高,差异有统计学意义(P＜0.05);且观察组血清激素E2、LH及T水平均明显低于对照组,FSH水平明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者卵巢体积及卵泡数目均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组卵巢体积及卵泡数目均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者EM值均较治疗前升高,PI、RI值均较治疗前降低,差异有统计学意义(P＜0.05);且观察组EM值明显高于对照组,PI、RI值均明显低于对照组,差异有统计学意义(P＜0.05).治疗后观察组妊娠率71.05％(27/38)、排卵率89.47％(34/38)及生产率57.59％(22/38)明显高于对照组51.36％(19/37)、75.68％(28/37)、24.32％(9/37),且早期流产率 13.16％(5/38)明显低于对照组 27.02％(10/37),差异有统计学意义(P＜0.05).结论 化痰消瘀汤的应用能进一步有效减轻PCOS患者临床症状,改善其卵巢异常状态,改变机体多囊性,调节激素水平和子宫容受性,有利于促进患者排卵及妊娠,提高妊娠率.
Abstract
Objective To observe the therapeutic effect of Huatan Xiaoyu Decoction combined with ethinylestra-diol-cyproterone on patients with polycystic ovary syndrome(PCOS)and its impact on pregnancy.Methods Eighty P-COS patients who visited the Reproductive Medicine Center and Gynecology Department of Maternal and Child Health Hos-pital in Zaozhuang,Shandong Province,from June 2020 to June 2021 were selected as the research subjects.The patients were randomly divided into a control group and an observation group,with 40 patients in each group.The control group was treated with ethinylestradiol-cyproterone,while the observation group was treated with Huatan Xiaoyu Decoction combined with ethinylestradiol-cyproterone.Both groups were treated for 3 months.The traditional Chinese medicine(TCM)syn-drome score,serum hormone levels[luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),es-tradiol(E2)],ovarian volume,number of follicles,endometrial thickness(EM),resistance index(RI),and spiral artery pulsatility index(PI)were observed and compared before and after treatment between the two groups.Pregnancy outcomes were also compared between the two groups.Results After treatment,the TCM syndrome scores in both groups were sig-nificantly lower than before treatment,with a statistically significant difference(P＜0.05);the TCM syndrome scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P＜0.05).After treatment,serum hormone levels of E2,LH,and T in both groups were significantly lower,while FSH levels were higher than before treatment,with a statistically significant difference(P＜0.05).The serum hormone levels of E2,LH,and T in the observation group were significantly lower,while the FSH levels were significantly higher than those in the control group,with a statistically significant difference(P＜0.05).After treatment,ovarian volume and follicle number in both groups were significantly lower than before treatment,with a statistically significant difference(P＜0.05).The ovarian volume and follicle number in the observation group were significantly lower than those in the control group,with a statisti-cally significant difference(P＜0.05).After treatment,the EM values in both groups were higher,while PI and RI values were lower than before treatment,with a statistically significant difference(P＜0.05).The EM values in the observation group were significantly higher,while the PI and RI values were significantly lower than those in the control group,with a statistically significant difference(P＜0.05).After treatment,the pregnancy rate(71.05％,27/38),the ovulation rate(89.47％,34/38),and the birth rate(57.59％,22/38)in the observation group were significantly higher than those in the control group(51.36％,19/37;75.68％,28/37;24.32％,9/37).The early abortion rate(13.16％,5/38)was significant-ly lower than that in the control group(27.02％,10/37),with a statistically significant difference(P＜0.05).Conclusion The application of Huatan Xiaoyu Decoction can effectively alleviate the clinical symptoms of PCOS patients,improve ovari-an abnormalities,change polycystic conditions,regulate hormone levels and uterine receptivity,promote ovulation and preg-nancy,and improve the pregnancy rate.
基金项目
山东省医药卫生科技发展计划(202005030722)
维普
万方数据