摘要
目的观察中药调经汤对多囊卵巢综合征不孕(PCOS)的治疗效果,并探究其作用机制。方法患者共86例,并随机分为观察组和对照组各43例。对照组采用基础治疗方法:服用决雌醇环丙孕酮片和枸橼酸氯米芬,并注射用尿促性素(疗程为3个月经周期)。观察组在采用基础治疗的基础上加以调经汤治疗(疗程为3个月经周期)。用B超监测卵泡的发育情况,测定主导卵泡膜血流,并对搏动指数(PI)和阻力指数(RI)做好记录;分别监测并对比患者治疗前后的空腹血糖(FBG)水平、瘦素(PI)水平和空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-R);监测并记录人绒毛膜促性腺激素(HCG)水平(注射日)、黄体生成素(LH)水平、雌二醇(E2)水平、血清睾酮(T)水平以及卵泡刺激素(FSH)水平;对治疗后患者月经恢复率、排卵率以及妊娠率做好记录。结果 2组患者治疗后,观察组月经恢复率(93.02%),排卵率(86.04%)和妊娠率(72.09%)均比对照组月经恢复率(69.77%)、排卵率(55.81%)和妊娠率(39.53%)高,差异具有统计学意义(P<0.01);PI均较治疗前显著升高,且观察组比对照组高,差异具有统计学意义(P<0.01);RI比治疗前有较明显降低,且观察组比对照组低,差异具有统计学意义(P<0.001);观察组FSH水平,LH水平和E2水平相较于对照组均有显著提高,T水平比对照组低,差异均具有统计学意义(均P<0.001);2组FINS水平、IR水平和LP水平相较于治疗前均有明显降低,且观察组比对照组低,差异具有统计学意义(P<0.001)。结论基础治疗加上调经汤共同治疗,对患者卵巢血流、高雄激素血症、胰岛素抵抗质量起改善作用,提高卵泡质量,继而对排卵率和妊娠率起到显著的提高作用。
Objective To observe the traditional Chinese medicine Tiaojing decoction on polycystic ovary syndrome（ PCOS） in the treatment of infertility,and to explore its mechanism. Methods Selected 86 cases patients with PCOS were randomly divided them into observation group and control group with 43 cases in each group. The control group was treated with basic treatment method： let the patients taking ethinylestradiol and cyproterone acetate tablets and clomiphene citrate,and injected menotropins injection（ the period of treatment was 3 menstrual cycle）. On the basis of the basic treatment,the observation group used Tiaojing decoction（ the period of treatment was 3 menstrual cycle）. Monitored the development of follicle by B ultrasound,made a determination of dominant follicular membrane blood flow,and recorded the pulsatile index（ PI） and resistance index（ RI）; the levels of fasting blood glucose（ FBG）,pulsatility index（ PI） and fasting insulin（ FINS） were monitored and compared with the patients before and after treatment,and calculate insulin resistance index（ HOMA- IR）; monitored and recorded the level of human chorionic gonadotropin（ HCG）（ injection day）,corpus（ LH）,estradiol（ E2）,serum testosterone（ T） and follicle stimulating hormone（ FSH）; After treatment,the patients with menstrual recovery rate,ovulation rate and pregnancy rate were recorded. Results After made a treatment to the two groups of patients,the rate of menstruation recovery（ 93. 02%）,ovulation（ 86. 04%） and pregnancy（ 72. 09%） were higher than those of the control group（ 69. 77%）,the difference was statistically significant（ P〈0. 01）; PI was significantly higher than before treatment,and the observation group was higher than the control group,the difference was statistically significant; RI was significantly lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant（ P〈 0. 001）; the levels
出处
《吉林中医药》
2016年第7期695-699,共5页
Jilin Journal of Chinese Medicine
关键词
调经汤
多囊卵巢综合征
妊娠率
月经恢复率
卵泡质量
Tiaojing decoction
PCOS
pregnancy rate
menstrual recovery rate
follicle quality
