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1.海南省妇女儿童医学中心,海口 570206
2.华中科技大学 同济医学院 附属协和医院,武汉 430011
李雪娇,本科,主治医师,从事妇产科疾病的临床工作,E-mail:lixuejiao430@163.com
收稿日期:2020-08-26,
网络出版日期:2020-09-15,
纸质出版日期:2021-04-20
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李雪娇,赵锐,陈惠丽等.二术二陈汤加减对脾虚痰湿证多囊卵巢综合征患者的调理作用[J].中国实验方剂学杂志,2021,27(08):101-106.
LI Xue-jiao,ZHAO Rui,CHEN Hui-li,et al.Regulatory Effect of Modified Erzhu Erchentang on Patients with Polycystic Ovary Syndrome and Spleen Deficiency and Phlegm Dampness[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(08):101-106.
李雪娇,赵锐,陈惠丽等.二术二陈汤加减对脾虚痰湿证多囊卵巢综合征患者的调理作用[J].中国实验方剂学杂志,2021,27(08):101-106. DOI: 10.13422/j.cnki.syfjx.20201232.
LI Xue-jiao,ZHAO Rui,CHEN Hui-li,et al.Regulatory Effect of Modified Erzhu Erchentang on Patients with Polycystic Ovary Syndrome and Spleen Deficiency and Phlegm Dampness[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(08):101-106. DOI: 10.13422/j.cnki.syfjx.20201232.
目的
2
观察二术二陈汤加减对脾虚痰湿证多囊卵巢综合征(PCOS)代谢的调节效果,以及对脂肪细胞因子的影响。
方法
2
将140例患者按随机数字表法分为对照组和观察组各70例。两组均口服盐酸二甲双胍片,500 mg/次,3次/d。对照组口服越鞠二陈丸,0.5 g/次,3次/d;观察组内服二术二陈汤加减,1剂/d;两组疗程均为24周。检测治疗前后空腹血糖(FBG),空腹胰岛素(FINS),糖化血红蛋白(HbA1c),餐后2 h血糖(2 h PG)水平,计算胰岛素抵抗指数(HOMA-IR);检测治疗前后血脂水平;测量治疗前后腰围(WC),体质量指数(BMI),腰臀比(WHR);检测治疗前后黄体生成素(LH),卵泡刺激素(FSH),血清睾酮(T),雌二醇(E
2
),硫酸脱氢表雄酮(DHEAS),性激素结合球蛋白(SHBG)水平;记录月经和排卵恢复情况;进行治疗前后脾虚痰湿证评分;测量治疗前后卵巢体积;检测治疗前后瘦素(LP),脂联素(APN),抵抗素,内脂素和肿瘤坏死因子-
α
(TNF-
α
)水平。
结果
2
观察组FBG,2 hPG,HbA1c,FINS和HOMA-IR均低于对照组(
P
<
0.01);观察组甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C)均低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组(
P
<
0.01);观察组BMI,WC和WHR均低于对照组(
P
<
0.05);观察组LH,FSH,T,E
2
,DHEAS水平均低于对照组(
P
<
0.01),SHBG水平高于对照组(
P
<
0.01);观察组脾虚痰湿证评分低于对照组(
P
<
0.01),卵巢体积小于对照组(
P
<
0.01);观察组LP,抵抗素,内脂素和TNF-
α
水平均低于对照组(
P
<
0.01),APN水平高于对照组(
P
<
0.01);观察组患者BMI正常率为49.23%(32/65),高于对照组的30.30%(20/66)(
χ
2
=5.151,
P
<
0.05),观察组患者血脂正常率为93.85%(61/65),高于对照组的81.82 %(54/66)(
χ
2
=4.418,
P
<
0.05);观察组患者血糖正常率为96.92%(63/65),高于对照组的86.36%(57/66)(
χ
2
=4.474,
P
<
0.05)。
结论
2
在口服二甲双胍治疗的基础上,二术二陈汤加减可调节脾虚痰湿证PCOS患者脂肪细胞因子,改善糖、脂代谢和超重情况,并能调节内分泌激素,减轻临床症状,改善卵巢的结构,为受孕创造成了条件。
Objective
2
To observe the regulatory effect of modified Erzhu Erchentang on metabolization of polycystic ovary syndrome (PCOS) with spleen deficiency and phlegm dampness syndrome.
Method
2
Patients 140 cases were divided into control group and observation group. Both groups were given metformin hydrochloride tablets, 500 mg/time, 3 times/day. Control group was given Yuejun Erchen pills, 0.5 g/time, 3 times/day, while observation group was given modified Erzhu Erchentang, 1 dose/day. The course of treatment lasted for 24 weeks. Before and after treatment, levels of fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin Alc (HbA1c), 2-hour postprandial blood glucose (2 h PG), blood lipid, waist circumference (WC), body mass index (BMI), waist hip ratio (WHR), luteinizing hormone (LH), follicle stimulating hormone (FSH), serum testosterone (T), estradiol (E
2
), dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), leptin (LP), adiponectin (APN), resistin, visfatin and tumor necrosis factor-
α
(TNF-
α
) were detected. Homeostasis model assessment insulin resistance (HOMA-IR) was calculated, modified Erzhu Erchentang was scored, and recovery of menstruation and ovulation and ovarian volume were recorded.
Result
2
Levels of FBG, 2 h PG, HbA1c, FINS, HOMA-IR, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), LH, FSH, T, E
2
, DHEAS, LP, resistin, visfatin and TNF-
α
in observation group were lower than those in control group (
P
<
0.01), and levels of BMI, WC and WHR were lower than those of control group (
P
<
0.05). And levels of high-density lipoprotein cholesterol (HDL-C), SHBG and APN were higher than those in control group (
P
<
0.01). Score of modified Erzhu Erchentang was lower than that in control group (
P
<
0.01), and ovarian volume was smaller than that in control group (
P
<
0.01). The normal rate of BMI was 49.23% (32/65), which was higher than 30.30% (20/66) in control group (
χ
2
=5.151,
P
<
0.05). The normal rate of blood lipid was 93.85% (61/65), which was higher than 81.82 % (54/66) in control group (
χ
2
=4.418,
P
<
0.05). The normal rate of blood glucose was 96.92% (63/65), which was higher than 86.36% (57/66) in control group (
χ
2
=4.474,
P
<
0.05).
Conclusion
2
In addition to adipocytokines, modified Erzhu Erchentang could regulate adipokines of patients of PCOS with spleen deficiency and phlegm dampness, improve glucose, lipid metabolism and overweight, adjust endocrine hormone, reduce clinical symptoms and improve ovarian structure, so as to create conditions for conception.
袁莹莹 , 赵君利 . 多囊卵巢综合征流行病学特点 [J]. 中国实用妇科与产科杂志 , 2019 , 35 ( 3 ): 261 - 264 .
中华医学会妇产科学分会内分泌学组及指南专家组 . 多囊卵巢综合征中国诊疗指南 [J]. 中华妇产科杂志 , 2018 , 53 ( 1 ): 2 - 6 .
王浩 , 程玲 , 丁永芬 , 等 . 中医中药治疗多囊卵巢综合征研究进展 [J]. 吉林中医药 , 2018 , 38 ( 12 ): 1483 - 1487 .
高金金 , 侯丽辉 , 李妍 . 多囊卵巢综合征痰湿证患者糖代谢的临床研究 [J]. 中华中医药学刊 , 2017 , 35 ( 3 ): 615 - 617 .
王颖 , 侯丽辉 , 匡洪影 , 等 . 多囊卵巢综合征患者痰湿体质与代谢异常的相关性研究 [J]. 中国中医基础医学杂志 , 2016 , 22 ( 10 ): 1357 - 1359 .
刘桢 , 梁瑞宁 , 李佩双 . 多囊卵巢综合征代谢异常特点及中医认识 [J]. 中国中医基础医学杂志 , 2017 , 23 ( 5 ): 654 - 656 .
王志宏 , 季旭明 , 吴智春 , 等 . 苍白二陈汤对代谢综合征大鼠血脂水平和主动脉ICAM1表达的影响 [J]. 中华中医药学刊 , 2013 , 31 ( 6 ): 1243 - 1245,1474 .
王志宏 , 吴智春 . 苍白二陈汤对代谢综合征模型大鼠脂肪组织NF- κ B表达的影响 [J]. 山东中医杂志 , 2012 , 31 ( 8 ): 594 - 596 .
中华中医药学会 . 中医妇科常见病诊疗指南 [M]. 北京 : 中国中医药出版社 , 2012 : 104 - 108 .
中国成人血脂异常防治指南修订联合委员会 . 中国成人血脂异常防治指南(2016年修订版) [J]. 中国循环杂志 , 2016 , 31 ( 10 ): 937 - 953 .
中华医学会糖尿病学分会 . 中国2型糖尿病防治指南(2017年版) [J]. 中华糖尿病杂志 , 2018 , 10 ( 1 ): 4 - 67 .
中国医师协会内分泌代谢科医师分会 . 多囊卵巢综合征诊治内分泌专家共识 [J]. 中华内分泌代谢杂志 , 2018 , 34 ( 1 ): 1 - 7 .
MOGHETTI P . Insulin resistance and polycystic ovary syndrome [J]. Curr Pharm Des , 2016 , 22 ( 36 ): 5526 - 5534 .
吕英 , 施艳秋 . 中医药治疗痰湿型多囊卵巢综合征机制研究 [J]. 河北中医 , 2019 , 41 ( 3 ): 470 - 475 .
李雨薇 , 虞莉青 , 孙洁 , 等 . 多囊卵巢综合征高雄激素血症和胰岛素抵抗的中医认识及诊疗思路 [J]. 中华中医药学刊 , 2017 , 35 ( 9 ): 2436 - 2440 .
POLAK K , CZYZYK A , SIMONCINI T , et al . New markers of insulin resistance in polycystic ovary syndrome [J]. J Endocrinol Invest , 2017 , 40 ( 1 ): 1 - 8 .
DELITALA A P , CAPOBIANCO G , DELITALA G , et al . Polycystic ovary syndrome, adipose tissue and metabolic syndrome [J]. Arch Gynecol Obstet , 2017 , 296 ( 3 ): 405 - 419 .
周月琴 , 凌迎春 , 沈群弟 , 等 . 中国女性血清瘦素与多囊卵巢综合征关系的 Meta 分析 [J]. 中国妇幼健康研究 , 2019 , 30 ( 3 ): 385 - 388 .
WIWEKO B , INDRA I , SUSANTO C , et al . The correlation between serum AMH and HOMA-IR among PCOS phenotypes [J]. BMC Res Notes , 2018 , 11 ( 1 ): 114 - 119 .
SINGH A , BORA P , KRISHNA A . Systemic adiponectin treatment reverses polycystic ovary syndrome-like features in an animal model [J]. Reprod Fertil Dev , 2018 , 30 ( 4 ): 571 - 584 .
MOHAMMADI S , KAYEDPOOR P , KARIMZADEH-BARDEI L , et al . The effect of curcumin on TNF- α , IL-6 and CRP expression in a model of polycystic ovary syndrome as an inflammation state [J]. J Reprod Infertil , 2017 , 18 ( 4 ): 352 - 360 .
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