摘要
目的:观察补肾活血方治疗多囊卵巢综合征(PCOS)的临床疗效,分析补肾活血方对PCOS患者下丘脑-垂体-卵巢轴(HPO轴)及抑制素(INH)-激活素(ACT)-卵泡抑素(FS)系统的影响。方法:纳入61例PCOS患者,采用完全随机方法分为中药组31例和西药组30例。中药组患者给予补肾活血方颗粒口服,西药组患者给予炔雌醇环丙孕酮片口服,两组治疗周期均为3个月。评价两组患者的中医证候疗效及多毛、痤疮的改善情况,检测患者的血清促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_2)、睾酮(T)、抗苗勒氏管激素(AMH)、INH、ACT、FS水平及B超下测定患者的卵巢体积(OV)、窦卵泡计数(AFC)。结果:①治疗后,中药组的中医证候疗效总有效率为83.87%,西药组为76.67%,两组中医证候疗效比较,差异无统计学意义(P>0.05)。②治疗后,两组患者的多毛情况与治疗前比较,差异无统计学意义(P>0.05);两组患者的痤疮情况均明显改善(P<0.01),但组间比较差异无统计学意义(P>0.05)。③治疗后,两组患者的LH、T水平及LH/FSH比值均明显降低(P<0.01),且西药组患者的T水平低于中药组(P<0.05)。④治疗后,两组患者的AMH、INH、FS水平均明显降低(P<0.01),ACT水平明显升高(P<0.01);且中药组患者的INH水平低于西药组、ACT水平高于西药组(P<0.05)。⑤治疗后,两组患者的OV均明显减小(P<0.01)、AFC明显减少(P<0.05,P<0.01),但组间OV、AFC比较差异无统计学意义(P>0.05)。结论:补肾活血方能有效改善PCOS患者的临床症状,并可通过下调性激素水平调节HPO轴功能;通过降低AMH、INH、FS水平及升高ACT水平,改善卵巢局部环境,促进卵泡生长发育;通过缩小OV、减少AFC,恢复卵巢形态和排卵功能。
Objective: To observe the clinical efficacy of Bushen Huoxue Recipe in the treatment of polycystic ovary syndrome(PCOS),and analyze the effects of Bushen Huoxue Recipe on the hypothalamic-pituitary-ovarian axis(HPO axis) and inhibin(INH)-activin(ACT)-follistatin(FS) system in patients with PCOS. Methods: Sixty-one patients with PCOS were included,and were divided into the Chinese medicine group( 31 cases) and the western medicine group( 30 cases) by a completely randomized method. The patients in the Chinese medicine group were orally treated with Bushen Huoxue Recipe granules,and the patients in the western medicine group were orally treated with ethylestradiol cycloproprogesterone tablets,with a course of 3 months. The Chinese medical syndromes efficacy and the improvement on crinosity and acne were evaluated,the serum levels of luteinizing hormone( LH),follicle stimulating hormone( FSH),estradiol( E2),testosterone( T),anti-Mullerian hormone( AMH),INH,ACT and FS were detected,and the ovarian volume( OV) and antral follicle count( AFC) were measured by B-ultrasound. Results:(1) After treatment,the total effective rate on Chinese medical syndromes of the Chinese medicine group was 83.87%,and that of the western medicine group was 76.67%,with no statistically significant difference between the two groups( P>0.05).(2)In both groups,there was no statistically significant difference on the degree of crinosity between treatment before and after( P>0.05). After treatment,the acne condition was significantly improved in both groups( P<0.01),but with no statistically significant difference between the two groups( P>0.05).(3)After treatment,the serum levels of LH and T and the LH/FSH ratio were significantly decreased in the two groups( P<0.01),and the level of T in the western medicine group was lower than that in the Chinese medicine group( P<0.05).(4)After treatment,the serum levels of AMH,INH and FS were significantly decreased( P<0.01),and the level of ACT was significantly increased( P<0.01) in both groups. The level of INH in the Chinese medicine group was lower than that in the western medicine group,and the level of ACT in the Chinese medicine group was higher than that in the western medicine group( P<0.05).(5)After treatment,the OV was significantly decreased in both groups( P<0.01) and the AFC was also decreased( P<0.05,P<0.01),but there were no statistically significant differences on the OV and AFC between the two groups( P>0.05). Conclusion:Bushen Huoxue Recipe can effectively improve the clinical symptoms of patients with PCOS,and regulate the function of HPO axis by down-regulating the sex hormone levels. It can improve the ovarian local environment and promote the follicular growth and development by decreasing the AMH,INH and FS levels and increasing the ACT level;and can restore the ovarian morphology and ovulation by lessening OV and reducing AFC.
作者
谢源
董莉
XIE Yuan;DONG Li(Department of Gynaecology, Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to Shanghai University ofTraditional Chinese Medicine, Shanghai 200437, China;Department of Chinese Medicine, Second Affiliated Hospital of SuzhouUniversity, Suzhou 215000, Jiangsu, China)
出处
《上海中医药大学学报》
CAS
2019年第2期41-45,共5页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
上海市进一步加快中医药事业发展三年行动计划建设项目[ZY3-CCCX-1-1013
ZY(2018-2020)-CCCX-1008]
上海市科委科研计划项目(16ZR143800
16401931900)
第三届国医大师传承工作室建设项目(DSGZS-2017001)
上海市促进市级医院临床技能与临床创新能力三年行动计划项目(16CR3040A)
上海中医药大学附属岳阳中西医结合医院科研项目(2017YJ06)
