摘要
目的观察加味半夏泻心汤联合二甲双胍治疗的多囊卵巢综合征(Polycystic ovary syndrome,PCOS)-胰岛素抵抗(Insulin resistance,IR)脾虚胃热证患者的临床治疗效果。方法选取2021年3月—2022年5月期间张家港市中医医院妇产科收治的PCOS-IR患者80例,采用随机数字表法分为对照组和研究组,每组各40例。对照组患者给予常规治疗,研究组患者在对照组基础上给予加味半夏泻心汤。治疗3个月后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分、炎症因子[血清高迁移率族蛋白1(High mobility group protein 1,HMGB1)、肿瘤坏死因子-α(Tumor necrosis factor,TNF-α)]水平、IR相关指标[空腹胰岛素(Fasting insulin,FINS)、空腹血糖(Fasting plasma glucose,FPG)、胰岛素抵抗指数(Homeostatic model assessment of insulin resistance,HOMA-IR)]。结果治疗后两组患者形体肥胖、月经错后、胃脘痞满、口臭、手足心热、大便溏泻评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组形体肥胖、月经错后、胃脘痞满、口臭、手足心热、大便溏泻评分均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后血清TNF-α、HMGB1水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组TNF-α、HMGB1水平较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后FPG、FINS、HOMA-IR均较治疗前降低,差异有统计学意义(P<0.05);且研究组FPG、FINS、HOMA-IR较对照组明显降低,差异有统计学意义(P<0.05)。治疗后研究组临床总有效率92.50%(37/40)明显高于对照组72.50%(29/40),差异有统计学意义(P<0.05)。治疗期间两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论加味半夏泻心汤联合二甲双胍治疗PCOS-IR脾虚胃热证患者,可有效改善临床症状,疗效优于单用二甲双胍治疗,可有效调节糖代谢,改善炎症因子水平,安全可靠。
Objective To observe the clinical effect of modified Banxia Xiexin Decoction combined with metform⁃in on polycystic ovary syndrome(PCOS)-insulin resistance(IR)patients with the syndrome of spleen deficiency and stom⁃ach heat.Methods Eighty PCOS-IR patients treated in the Zhangjiagang Traditional Chinese Medicine Hospital from March 2021 to May 2022 were selected andassigned by the random number table method into a control group(n=40)and an observation group(n=40).The patients in the control group received routine treatment,while those in the observation group received modified Banxia Xiexin Decoction combined with routine treatment.After treatment for 3 months,the clinical efficacy and adverse reactions were compared between the two groups.The TCM syndrome scores,levels of inflammatory cyto⁃kines[high-mobility group box-1(HMGB1)and tumor necrosis factor-α(TNF-α)],and IR-related indicators[fast⁃ing insulin(FINS),fasting plasma glucose(FPG),and homeostatic model assessment of insulin resistance(HOMA-IR)]were determined before and after treatment.Results After treatment,the scores of obesity,delayed menorrhea,abdominal fullness,bad breath,feverish feeling in palms and soles,loose stool,and diarrhea in the two groups decreased,and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the serum levels of TNF-αand HMGB1 declined in both groups and were lower in the observation group than in the control group(P<0.05).The treatment in both groups decreased FINS,FPG,and HOMA-IR,and the decreases in the observation group were more significant in the observation group(P<0.05).The total response rate in the observation group was 92.50%(37/40),which was higher than that(72.50%,29/40)in the control group(P<0.05).The incidence of adverse reactions showed no significant difference between the two groups(P>0.05).Conclusion Modified Banxia Xiexin Decoction com⁃bined with metformin outperformed metformin alone in mitigating the clinical symptoms of PCOS-IR patients with
作者
陈洁
徐桂冉
王丽梅
顾馨予
徐佳庆
张双
周娜
王忆原
戴凯丽
CHEN Jie;XU Gui-ran;WANG Li-mei;GU Xin-yu;XU Jia-qing;ZHANG Shuang;ZHOU Na;WANG Yi-yuan;DAI Kai-li(Department of Obstetrics and Gynecology,Zhangjiagang Traditional Chinese Medicine Hospital,Zhangjiagang Jiangsu 215600)
出处
《世界中西医结合杂志》
2023年第9期1817-1820,1825,共5页
World Journal of Integrated Traditional and Western Medicine
基金
江苏省张家港市社会发展技术创新研究项目(ZKS2139)
苏州市医疗卫生科技创新-新型临床诊疗技术及公共卫生项目(SKYD2022011)。
关键词
加味半夏泻心汤
二甲双胍
PCOS-IR脾虚胃热证
Modified Banxia Xiexin Decoction
Metformin
PCOS-IR with Syndrome of Spleen Deficiency and Stomach Heat
