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1.海南省人民医院,海南医学院 附属海南医院,海口 570311
2.海南医学院 第一附属医院,海口 570102
周松晶,硕士,副主任医师,从事中医妇科临床工作,E-mail:tommycai@126.com
韩平,主任医师,从事中医妇科临床工作,E-mail:Hanping88@126.com
收稿日期:2020-11-27,
网络出版日期:2020-12-31,
纸质出版日期:2021-07-05
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周松晶,史佳,韩平.疏肝补肾活血汤治疗围绝经期综合征肾虚肝郁兼血瘀证的临床疗效[J].中国实验方剂学杂志,2021,27(13):83-88.
ZHOU Song-jing,SHI Jia,HAN Ping.Clinical Efficacy on Shugan Bushen Huoxue Decoction in Treating Perimenopausal Perio Syndrome (Kidney Deficiency and Liver Depression and Blood Stasis Syndrome)[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):83-88.
周松晶,史佳,韩平.疏肝补肾活血汤治疗围绝经期综合征肾虚肝郁兼血瘀证的临床疗效[J].中国实验方剂学杂志,2021,27(13):83-88. DOI: 10.13422/j.cnki.syfjx.20210433.
ZHOU Song-jing,SHI Jia,HAN Ping.Clinical Efficacy on Shugan Bushen Huoxue Decoction in Treating Perimenopausal Perio Syndrome (Kidney Deficiency and Liver Depression and Blood Stasis Syndrome)[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):83-88. DOI: 10.13422/j.cnki.syfjx.20210433.
目的
2
观察疏肝补肾活血汤治疗围绝经期综合征(PPS)肾虚肝郁兼血瘀证的临床疗效及作用机制。
方法
2
将112例患者按随机数字表法分为对照组和观察组。两组均采用莉芙敏片,1片/次,早、晚2次吞服。对照组口服妇科养荣胶囊,4粒/次,3次/d;观察组口服疏肝补肾活血汤,1剂/d;两组疗程均为治疗12周。进行治疗前后改良Kupperman(KI),中医证候、绝经期生存质量量表(MENQOL),抑郁自评量表(SDS)和焦虑自评量表(SAS)评分;检测治疗前后促卵泡激素(FSH),促黄体生成素(LH),血清雌激素(E
2
),5-羟色胺(5-HT),多巴胺(DA),去甲肾上腺素(NE),5-羟吲哚乙酸(5-HIAA),内皮素(ET),一氧化氮(NO)水平。
结果
2
治疗后观察组改良KI,中医证候,SDS和SAS评分均低于对照组(
P
<
0.01);观察组MENQOL各维度评分均低于对照组(
P
<
0.01);观察组FSH,LH,ET水平均低于对照组(
P
<
0.01),5-HT,5-HIAA,DA,NE,NO和E
2
水平均高于对照组(
P
<
0.01);观察组临床疗效明显高于对照组(
Z
=2.073
,P
<
0.05);观察组中医证候疗效明显高于对照组(
Z
=2.086
,P
<
0.05)。
结论
2
疏肝补肾活血汤可明显减轻肾虚肝郁兼血瘀证PPS患者临床症状及抑郁、焦虑情况,并能调节性激素、血管舒缩因子和单胺类神经递质,提高生活质量,临床疗效显著,值得临床使用。
Objective
2
To observe the clinical efficacy and mechanism of Shugan Bushen Huoxue decoction in the treatment of perimenopausal perio syndrome (PPS) with kidney deficiency, liver depression and blood stasis syndrome.
Method
2
One hundred and twelve patients were randomly divided into control group and observation group according to random number table. Both groups took Remifemin orally, 1 tablet/time, by swallowing in the morning and evening. The patients in control group additionally took Fuke Yangrong capsules, 4 capsules/time, 3 times/day. The patients in observation group additionally took Shugan Bushen Huoxue decoction, 1 dose/day. The course of treatment was 12 weeks in both groups. Before and after treatment, scores were graded for modified Kupperman index (KI), traditional Chinese medicine (TCM) syndromes, menopausal quality of life scale (MENQOL), self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Follicle stimulating hormone (FSH),luteinizing hormone (LH),serum estrogen (E
2
), 5-hydroxytryptamine (5-HT), dopamine (DA), norepinephrine (NE), 5-hydroxyindole acetic acid (5-HIAA), endothelin (ET), and nitric oxide (NO) levels were detected before and after therapy.
Result
2
In the observation group, scores of KI, TCM syndrome, SDS and SAS were lower than those in the control group (
P
<
0.01). All dimensions of MENQOL scores in the observation group were lower than those in the control group (
P
<
0.01). FSH and LH levels in the observation group were lower than those in the control group, and the E
2
level was higher than that of the control group (
P
<
0.01). The levels of 5-HT, 5-HIAA, DA and NE in the observation group were higher than those in the control group (
P
<
0.01). The ET level in the observation group was lower than that in the control group, and the NO level was higher than that of the control group (
P
<
0.01). In observation group,the clinical efficacy was superior to that in control group (
Z
=2.073
,P
<
0.05), and the efficacy of TCM syndromes was also superior to that in control group (
Z
=2.086
,P
<
0.05).
Conclusion
2
Shugan Bushen Huoxue decoction in the treatment of PPS in patients with kidney deficiency and liver depression and blood stasis can significantly reduce clinical symptoms, depression and anxiety, regulate the sex hormones, vasomotor factors and monoamine neurotransmitters levels, and improve the quality of life, with obvious clinical efficacy and high safety, so it is worthy of clinical use.
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