补肾阴药治疗高胰岛素高雄激素无排卵症的临床观察

Clinical Observation on Treatment of Hyperinsulinemia and Hyperandrogenism Anovulatory Patient with Replenishing Kidney-Yin Drugs

本研究对高胰岛素高雄激素无排卵症患者３５例采用补肾阴为主的中药治疗３个周期。治疗期间选用基础体温（ＢＢＴ）、系列Ｂ超和血中激素测定以监测排卵，并测定治疗前后口服糖耐量试验（ＯＧＴＴ）中血糖及胰岛素水平的变化。３５例患者的血睾酮及胰岛素水平均高于正常，而脱氢表雄酮（ＤＨＥＡ）则属正常。１０例（２８．６％）患者黄体生成激素／卵泡激素（ＬＨ／ＦＳＨ）比例在正常范围。２４例患者接受了规则的治疗，其中２０例４３个周期有排卵，排卵率为５９．７％；合并不孕的１７例患者中有７例妊娠，妊娠率为４１．２％。经用中药治疗后血糖反应显著下降（Ｐ＜０．０５），胰岛素水平也显著下降（Ｐ＜０．０５），但尚未达正常。血睾酮水平则显著下降达正常水平（Ｐ＜０．０１）。提示卵巢微环境得到改善，使卵泡发育而排卵、妊娠。

In order to investigate the effect of Chinese herbal medicine for replenishing Kidney-Yin in treating hyperinsulinemia and hyperandrogenism anovulatory syndrome, 35 patients were treated with replenishing kidney-Yin drugs for 3 months, basic body temperature, ultrasonic examination and blood levels of sex hormones were taken for monitoring the ovulation, and changes of serum insulin, blood sugar as well as oral glucose tolerence test were observed before and after treatment.Thirty-five patients showed high serum insulin and testosterone levels but normal dehydroepiandrosterone (DHEA) level. Twenty-nine percent of their luteinizing hormone/folliclestimulating hormone (LH/FSH) ratio were in normal range. Twenty four cases completed the regular treatment and 20 of them showed ovulation in the 43 menstrual cycles (59. 7%). Seven of 17 (41. 2%) infertile cases become pregnant within 6 months. After 3 months of treatment, blood sugar and insulin level significantly decreased but the latter was still slightly higher than normal level. Serum testosterone level decreased significantly and reached normal, Results suggested that replenishing Kidney-Yin Drugs could provide a good microcircumstance for ovarian follicular growth, and resulted in ovulation and pregnancy. The mechanism is remained to be further explored.