调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证的临床观察

向玉; 杨惠林; 马英兰; 马玉秀

doi:10.13422/j.cnki.syfjx.2016220170

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调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证的临床观察

临床 | 更新时间：2024-01-04

- 调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证的临床观察
- Clinical Observation of Tiaojing Zhuyu Decoction on Polycystic Ovarian Syndrome with Ovulation Inhibition and Syndrome of Kidney Deficiency and Blood Stasis
- 中国实验方剂学杂志 2016年22卷第22期页码：170-174
- 作者机构：
- 作者简介：
- 基金信息：
  
  青海省卫生厅医学基金项目（201403WS2501）
- DOI：10.13422/j.cnki.syfjx.2016220170
  中图分类号： R271.9
- 纸质出版日期：2016
- 稿件说明：
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向玉, 杨惠林, 马英兰, 等. 调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证的临床观察[J]. 中国实验方剂学杂志, 2016,22(22):170-174.

XIANG Yu, YANG Hui-lin, MA Ying-lan, et al. Clinical Observation of Tiaojing Zhuyu Decoction on Polycystic Ovarian Syndrome with Ovulation Inhibition and Syndrome of Kidney Deficiency and Blood Stasis[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(22): 170-174.
向玉, 杨惠林, 马英兰, 等. 调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证的临床观察[J]. 中国实验方剂学杂志, 2016,22(22):170-174. DOI： 10.13422/j.cnki.syfjx.2016220170.

XIANG Yu, YANG Hui-lin, MA Ying-lan, et al. Clinical Observation of Tiaojing Zhuyu Decoction on Polycystic Ovarian Syndrome with Ovulation Inhibition and Syndrome of Kidney Deficiency and Blood Stasis[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(22): 170-174. DOI： 10.13422/j.cnki.syfjx.2016220170.

摘要

目的：探讨调经助育汤对多囊卵巢综合征排卵障碍（肾虚血瘀证）的排卵、妊娠的疗效和及对胰岛素样生长因子-1（IGF-1），肿瘤坏死因子-α（TNF-α），瘦素（LP）水平的影响。方法：将145例患者随机按数字表法分为西医组72例和观察组73例。西医组采用盐酸二甲双胍片+克罗米芬的方案。观察组在西医组治疗的基础上加用调经助育汤内服。两组疗程均为6个月经周期或至妊娠终止。记录治疗期和随访期共12个月内的妊娠率、异位妊娠率、多胎率、未破裂卵泡黄素化综合征（LUFS）发生率、卵巢过度刺激征（OHSS）发生率；记录月经恢复正常情况、恢复排卵情况和优势卵泡率；检测治疗前后黄体生成素（LH），血清睾酮（T），雌二醇（E2）水平和卵泡刺激素（FSH），催乳素（PRL）水平；采用B超测量治疗前后子宫内膜厚度，进行治疗前后宫颈黏液情况评分和肾虚血瘀证评分；检测治疗前后IGF-1，TNF-α和LP水平。结果：治疗后观察组妊娠率为56.16%，西医组为37.5%，观察组妊娠率高于西医组（P<0.05），两组患者异位妊娠率、多胎率，LUFS和OHSS发生率组间比较，差异无统计学意义；治疗后观察组月经恢复率为89.13%，高于西医组的80.59%（P<0.01），排卵恢复率为70.77%，高于西医组的61.67%（P<0.01），其中优势卵泡率占73.04%，高于西医组的62.55%（P<0.01）；治疗后观察组子宫内膜厚度和宫颈黏液评分的改善优于西医组，肾虚血瘀证评分低于西医组（P<0.01）；治疗后观察组PRL，T和LH水平低于西医组，E2和FSH水平高于西医组（P<0.01）；治疗后观察组IGF-1，TNF-α和LP水平均低于西医组（P<0.01）。结论：调经助育汤治疗多囊卵巢综合征排卵障碍肾虚血瘀证患者，能促使患者排卵，提高排卵质量，调节下丘脑-垂体-卵巢轴（HPOA轴），下调IGF-1，TNF-α和LP，调节性激素，从而提高临床妊娠率。

Abstract

Objective: To discuss the clinical effect of Tiaojing Zhuyu decoction in treating polycystic ovarian syndrome with ovulation inhibition with kidney deficiency and blood stasis syndrome

and its effect on levels of insulin-like growth factor-1 (IGF-1)

tumor necrosis factor-α (TNF-α) and leptin (LP). Method: One hundred and forty-five patients were divided into western medicine group (72 cases) and observation group (73 cases) by random number table. Patients in western medicine group got metformin hydrochloride tablets and clomifene citrate. In addition to the therapy of western medicine group

patients in integrated traditional Chinese and western medicine was given Tiaojing Zhuyu decoction. The courses of treatment were six menstrual cycle or until the end of pregnancy. Pregnancy rate

ectopic pregnancy rate

multiple-gestation pregnancy rate

rates of luteinized unruptured follicle syndrome (LUFS) and ovarian hyperstimulus syndrome (OHSS) were recorded during treatment period and 12-month follow-up period. And menstruation recovery to normal

ovulation recovery and rates of dominant follicle were also recorded. Before and after the treatment

levels of luteinizing hormone (LH)

testosterone (T)

estradiol (E2)

follicle-stimulating hormone (FSH) and prolactin (PRL) were detected. Sizes of endometrial thickness were detected by B ultrasonic

and cervical mucus and kidney deficiency and blood stasis pattern were graded

and levels of IGF-1

TNF-α and LP were scored. Result: After treatment

pregnancy rate in observation was 56.16%

which was higher than 37.5% in western medicine group (P<0.05). And there were no statistical significant in the difference of ectopic pregnancy rate

multiple-gestation pregnancy rate

LUFS and OHSS in two groups. Menstruation recovery rate in observation group was 89.13%

which was higher than 80.59% in western medicine group (P<0.01)

ovulation recovery rate was 70.77%

which was higher than 61.67% in western medicine group (P<0.01)

and rate of dominant follicle was 73.04%

which was higher than 62.55% in western medicine group (P<0.01). Scores of endometrial thickness and cervical mucus in observation were superior to that in western medicine group

but scores of kidney deficiency and blood stasis syndrome was lower than that in western medicine group (P<0.01). Levels of PRL

IGF-1

TNF-α and LP were lower than those in western medicine group

but levels of E2 and FSH were higher than those in western medicine group (P<0.01). Conclusion: Tiaojing Zhuyu decoctiocan can treat polycystic ovarian syndrome with ovulation inhibition with kidney deficiency and blood stasis syndrome

promote ovulation

improve the quality of ovulation

ameliorate Hypothalamic pituitary ovary axis(HPOA) axis

reduce levels of IGF-1

TNF-α and LP

regulate sex hormone

so as to increase the clinical pregnancy rate.

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