首页|越鞠丸合毓麟珠汤对多囊卵巢综合征不孕症患者脂代谢和HPA轴功能的影响

越鞠丸合毓麟珠汤对多囊卵巢综合征不孕症患者脂代谢和HPA轴功能的影响

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目的:观察越鞠丸合毓麟珠汤对多囊卵巢综合征(PCOS)不孕症的治疗效果及对脂代谢和下丘脑-垂体-肾上腺轴(HPA)的影响。方法:选取 2020 年 1 月至2022 年6 月该院收治的PCOS不孕症患者100 例,按照计算机随机数字分组法分为对照组、观察组,各 50 例。对照组患者给予常规西药口服,观察组患者在对照组的基础上加用越鞠丸合毓麟珠汤。治疗 3 个月经周期后对两组患者的临床疗效进行评价,对两组患者治疗前后中医证候表现进行评分,并检测血清脂代谢指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]、HPA轴相关指标[卵泡刺激素(FSH)、黄体生成素(LH)、促肾上腺皮质激素(ACTH)和生长激素(GH)]水平,观察两组患者成熟卵泡数、宫颈黏液评分和排卵期子宫内膜厚度的变化。结果:与治疗前比较,两组患者治疗后中医证候评分明显降低,血清TG、TC和LDL-C水平明显降低,血清FSH、LH和ACTH水平明显降低,血清HDL-C、GH水平明显升高,成熟卵泡数、宫颈黏液评分和排卵期子宫内膜厚度均明显增加,差异均有统计学意义(P<0。05);观察组患者中医证候评分、血清脂代谢、HPA轴相关指标和排卵指标的改善均优于对照组,差异均有统计学意义(P<0。05)。观察组患者的临床总有效率为 90。0%(45/50),明显高于对照组的 76。0%(38/50),差异有统计学意义(P<0。05)。结论:越鞠丸合毓麟珠汤辅助治疗可有效缓解PCOS不孕症患者的症状,提高卵巢功能,调节脂代谢水平和HPA轴功能紊乱,效果较单独应用炔雌醇环丙孕酮片更佳。
Effects of Yueju Pills Combined with Yulinzhu Decoction on Lipid Metabolism and HPA Axis Function in Patients with Infertility of Polycystic Ovarian Syndrome
OBJECTIVE:To observe the therapeutic effect of Yueju pills combined with Yulinzhu decoction in the treatment of infertility of polycystic ovary syndrome(PCOS)and its effects on lipid metabolism and hypothalamic-pituitary-adrenal(HPA)axis.METHODS:A total of 100 patients with infertility of PCOS admitted into the hospital from Jan.2020 to Jun.2022 were extracted to be divided into the control group and observation group via the random number table method,with 50 cases in each group.The control group was given conventional Western medicine orally,while the observation group was given Yueju pills combined with Yulinzhu decoction based on the control group.The clinical efficacy of both groups was evaluated after 3 menstrual cycles of treatment,traditional Chinese medicine(TCM)symptoms of both groups before and after treatment were scored,the serum lipid metabolism indicators[triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)]and HPA axis-related indicators[follicle-stimulating hormone(FSH),luteinising hormone(LH),adrenocorticotrophic hormone(ACTH)and growth hormone(GH)]levels were detected,the number of mature follicles,score of cervical mucus and endometrial thickness during ovulation of both groups were observed.RESULTS:Compared with before treatment,the TCM symptom scores decreased significantly after treatment,the serum TG,TC and LDL-C levels decreased significantly,the serum FSH,LH and ACTH levels decreased significantly,the serum HDL-C and GH levels increased significantly,the numbers of mature follicles,scores of cervical mucus and endometrial thickness during ovulation increased significantly in both groups after treatment,with statistically significant differences(P<0.05).The improvements of TCM symptom scores,serum lipid metabolism,HPA axis-related indicators and ovulation indicators in the observation group were better than those in the control group,with statistically significant differences(P<0.05).The clinical total effective rate of the observation group was 90.0%(45/50),significantly higher than 76.0%(38/50)of the control group,with statistically significant difference(P<0.05).CONCLUSIONS:The adjuvant treatment of Yueju pills combined with Yulinzhu decoction can effectively relieve the symptoms of patients with infertility of PCOS,improve ovarian function,regulate lipid metabolism level and HPA axis dysfunction,which has better effects than Ethinylestradiol cyproterone tablets alone.

Polycystic ovary syndromeYueju pillsYulinzhu decoctionLipid metabolismHPA axis

张丽、潘宇、赵阅

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江苏省苏北人民医院中医科,江苏 扬州 225000

江苏省苏北人民医院生殖中心,江苏 扬州 225000

多囊卵巢综合征 越鞠丸 毓麟珠汤 脂代谢 HPA轴

江苏省妇幼健康科研项目

F201945

2024

中国医院用药评价与分析
中国医药生物技术协会,中国药房杂志社

中国医院用药评价与分析

CSTPCD
影响因子:1.142
ISSN:1672-2124
年,卷(期):2024.24(7)