摘要
目的探讨调经毓麟汤联合炔雌醇环丙孕酮片治疗肾虚血瘀型多囊卵巢综合征(PCOS)的临床疗效及对患者性激素水平、妊娠结局的影响。方法选择2022年1月至2024年1月安阳市中医院收治的98例肾虚血瘀型PCOS患者作为研究对象,按随机数表法分为对照组和观察组,每组49例,对照组患者给予炔雌醇环丙孕酮片治疗,观察组患者在对照组治疗的基础上联合调经毓麟汤治疗,两组患者均持续治疗3个月经周期。治疗结束后随访6个月,比较两组患者的临床疗效,以及治疗前、治疗结束后的性激素[促卵泡生成素(FSH)、促黄体生成素(LH)及LH/FSH比值]水平和中医证候积分;随访6个月,比较两组患者的妊娠结局(排卵率及妊娠率);治疗结束后,比较两组患者在治疗期间的不良反应情况。结果随访6个月,观察组患者的治疗总有效率为93.88%,明显高于对照组的69.39%,差异有统计学意义(P<0.05)。治疗前,两组患者的性激素比较差异无统计学意义(P>0.05);治疗后,两组患者的FSH水平均增加,LH、LH/FSH比值均降低,且观察组患者的FSH为(9.59±1.71)mIU/mL,明显高于对照组的(8.56±1.64)mIU/mL,LH、LH/FSH比值分别为(9.95±1.86)IU/L、1.04±0.22,明显低于对照组的(14.72±2.15)IU/L、1.72±0.25,差异均有统计学意义(P<0.05)。治疗前,两组患者的中医证候积分比较差异无统计学意义(P>0.05);治疗后,两组患者的中医证候积分均下降,且观察组患者的月经量少、经色暗紫、头晕耳鸣、腰膝酸软中医证候积分分别为(2.25±0.46)分、(2.29±0.51)分、(2.15±0.35)分、(2.19±0.25)分,明显低于对照组的(3.42±0.65)分、(3.56±0.64)分、(3.28±0.49)分、(3.30±0.42)分,差异均有统计学意义(P<0.05)。随访6个月,观察组患者的排卵率、妊娠率分别为73.47%、42.86%,明显高于对照组的34.69%、18.37%,差异均有统计学意义(P<0.05)。两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论调经毓麟汤联合炔雌醇环丙孕酮能调节PCOS患者的性激素水平,改善患者临床症状,提高排卵率和妊娠率,临床应用效果好且安全性高。
Objective To explore the clinical efficacy of Tiaojing Yulin Decoction combined with ethinylestra-diol and cyproterone acetate tablets in treating polycystic ovary syndrome(PCOS)with kidney deficiency and blood sta-sis,and its impact on sex hormone levels and pregnancy outcomes.Methods A total of 98 patients with PCOS and kid-ney deficiency and blood stasis admitted to Anyang Hospital of Traditional Chinese Medicine from January 2022 to Janu-ary 2024 were selected as the study subjects.They were divided into a control group and an observation group using a random number table,with 49 patients in each group.Patients in the control group were treated with ethinylestradiol and cyproterone acetate tablets,while those in the observation group received Tiaojing Yulin Decoction in addition to the con-trol group's treatment.Both groups were treated for three menstrual cycles.After treatment,patients were followed up for 6 months.The clinical efficacy,sex hormone levels(follicle-stimulating hormone[FSH],luteinizing hormone[LH],and LH/FSH ratio),and traditional Chinese medicine(TCM)syndrome scores before and after treatment were compared between the two groups.Pregnancy outcomes(ovulation rate and pregnancy rate)were compared during the 6-month follow-up,and adverse reactions during treatment were recorded.Results After 6 months of follow-up,the total effec-tive rate in the observation group was 93.88%,significantly higher than 69.39%in the control group(P<0.05).Before treatment,there were no significant differences in sex hormone levels between the two groups(P>0.05).After treatment,FSH levels increased,while LH levels and the LH/FSH ratio decreased in both groups.The FSH level in the observation group was(9.59±1.71)mIU/mL,significantly higher than(8.56±1.64)IU/L in the control group.The LH level and LH/FSH ratio in the observation group were(9.95±1.86)IU/L and 1.04±0.22,respectively,significantly lower than(14.72±2.15)IU/L and 1.72±0.25 in the control group(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores between the two groups(P>0.05).After treatment,TCM syndrome scores decreased in both groups.The scores for scanty menstruation,dark purple menstrual blood,dizziness,tinnitus,and soreness and weakness of the waist and knees in the observation group were(2.25±0.46)points,(2.29±0.51)points,(2.15±0.35)points,and(2.19±0.25)points,re-spectively,significantly lower than(3.42±0.65)points,(3.56±0.64)points,(3.28±0.49)points,and(3.30±0.42)points in the control group,with statistically significant differences(P<0.05).After 6 months of follow-up,the ovulation rate and preg-nancy rate in the observation group were 73.47%and 42.86%,respectively,significantly higher than 34.69%and 18.37%in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Tiaojing Yulin Decoction combined with ethinylestradiol and cyproterone acetate tablets can regulate sex hormone levels in PCOS patients,improve clinical symptoms,and increase ovulation and pregnancy rates,demonstrating good clinical efficacy and high safety.
作者
朱文芳
王苗苗
李光荣
ZHU Wen-fang;WANG Miao-miao;LI Guang-rong(Department of Obstetrics and Gynecology,Anyang Hospital of Traditional Chinese Medicine,Anyang 455000,Henan,CHINA)
出处
《海南医学》
2025年第8期1109-1113,共5页
Hainan Medical Journal
基金
全国名老中医药专家传承工作室建设项目(编号:国中医药人教函2022[75]号)
2024年度河南省中医药科学研究专项课题(编号:2024ZY2186)
河南省安阳市科技发展计划(编号:2022C01SF101)。
关键词
多囊卵巢综合征
不孕
调经毓麟汤
炔雌醇环丙孕酮片
妊娠结局
Polycystic ovary syndrome
Infertility
Tiaojing Yulin Decoction
Ethinylestradiol and cyproterone acetate tablets
Pregnancy outcomes
