中西医治疗多囊卵巢综合征患者无排卵性功血

Treatment of anovulatory dysfunctional bleeding of patients with polycystic ovary syndrome with combinatwn of TCM and western medicine

目的探讨中西医结合治疗多囊卵巢综合征伴无排卵性功能失调性子宫出血证属肾虚血瘀型的临床疗效。方法对24例因多囊卵巢综合征出现无排卵性功血证属肾虚血瘀型患者中药采用补肾化瘀止血汤及补肾活血调经汤治疗,西药采用黄体酮及氯米芬治疗。治疗前后测定血清黄体生成素、促卵泡激素、睾酮、胰岛素、雌二醇水平,比较治疗前后各激素水平变化,并观察治疗前后基础体温的变化。结果治疗因多囊卵巢综合征出现无排卵性功血证属肾虚血瘀型的总有效率为87.5%,排卵率为66.67%,妊娠率为54.55%。治疗后,黄体生成素从16.21±5.07m IU/mL降低为10.39±3.59m IU/mL(P<0.01),促卵泡激素从5.81±3.55m IU/mL升高为7.86±2.99m IU/mL(P<0.05),黄体生成素/促卵泡激素从3.46±0.86降低为1.74±0.63(P<0.01),睾酮从101.9±26.56ng/dL降低为68.8±21.55ng/dL(P<0.01),胰岛素从21.19±8.72m IU/L降低为11.83±5.70m IU/L(P<0.05),雌二醇从73.88±32.79pg/mL升高为86.23±30.58pg/mL(P>0.05)。结论中西医结合治疗多囊卵巢综合征患者的内分泌及代谢紊乱症状,恢复其生殖功能,取得较好疗效。

Objective To investigate the therapeutic effect of combination of TCM and western medicine （WM） for anovulatory dysfunctional bleeding of patients with PCOS and TCM diagnosis of kidney deficiency and blood stasis syndrome. Methods 24 patients were treated with TCM drugs Bushenhuayuzhi-xue Decoction （decoction for tonifying kidney and hemostasis by removing blood stasis） and Bushenhuoxuetiaojing Decoction （decoction for tonifying kidney and promoting blood circulation to restore menstruation） combined with western drugs （progesterone, clomiphene citrate）. Before and after treatment, the changes in serum hormone （ LH, FSH, E2 , T, INS） levels and basic body temperature（BBT） were examined and compared. Results The total effective rate was 87.5%, the ovulation rate was 66.67% , and the pregnancy rate was 54.55%. After treatment, LH lowered from 16.21 ± 5.07 mIU/mL to 10.39 ± 3.59 mIU/mL（P 〈 0.01 ）, FSH raised from 5.81 ± 3.55 mIU/mL to 7.86 ± 2.99 mIU/mL（ P 〈 0.05 ）, LH/FSH lowered from 3.46 ± 0.86 to 1.74 ± 0.63 （ P 〈 0.01 ） ,T lowered from 101.9 ± 26.56 ng/dL to 68.8 ± 21.55 ng/dL（P 〈 0.01 ） ,INS lowered from 21.19 ± 8.72 mIU/L to 11.83 ± 5. 70 mIU/L（P 〈0.05） ,E2 raised from 73.88 ±32.79 pg/mL to 86.23 ±30.58 pg/mL（ P 〉0.05）. Conclusion The TCM and western drugs can regulate the imbalanced metabolisms of LH, FSH, T, INS so as to induce ovulation and resume the balance.