中药天癸方治疗多囊卵巢综合征中高雄激素高胰岛素血症的研究

Study on Treatment of Hyperandrogenism and Hyperinsulinism in Polycystic Ovary Syndrome with Chinese Herbal Formula “Tiangui Fang”

目的 :探讨中药天癸方治疗多囊卵巢综合征 (PCOS)中高雄激素高胰岛素血症的疗效及作用机理。方法 :观察 2 2例克罗米芬治疗无效的PCOS患者应用天癸方 (10例 )和二甲双胍 (12例 )治疗 3个月前后血黄体生成素 (LH)、卵泡刺激素 (FSH)、血睾酮 (T)、雌二醇 (E2 )浓度和口服糖耐量试验 (OGTT)试验中血胰岛素 (Ins)浓度 ,腰臀比值 (WHR)、体重指数 (BMI)的变化。结果 :服用“天癸方”患者血Ins水平、WHR、BMI均有所降低 ,logT/E2 降低明显 ,6例患者恢复规律月经伴双向型基础体温。口服二甲双胍患者血Ins水平降低明显 ,WHR、BMI无明显变化 ,logT/E2 降低明显 ,4例恢复规律月经者 2例伴双向型基础体温。结论 :天癸方促排卵效果优于二甲双胍 ,后者降Ins效果更显著。

To observe the efficacy of Chinese herbal formula “Tiangui Fang” (TGF) in hyperandrogenism and hyperinsulinism patients of polycystic ovarian syndrome (PCOS), and compare with western medicine metformin. Methods: Twenty two anti clomiphen citrite patients were divided into two treatment groups: “Tiangui Fang” (n=10) and metformin (n=12) for three months. Insulin response during oral glucose tolerance test and serum level of LH, FSH, testosterone (T), estradiol (E 2) and waist to hip ratio (WHR), body mass index (BMI) were measured before and after treatment. Results: After treatment for three months with metformin or TGF, fasting and the integrated insulin response to the glucose load decreased. Treated by metformin 4 out of 8 patients had restoration of menstrual cyclicity and 2 of them had double phase bases body temperature (BBT). This was accompanied by lowering in serum logT/E 2 but had no significant difference, the BMI, WHR and serum E 2, LH: FSH ratio were not changed. Treated by TGF for three months, 6 out of 8 patients had restoration of mentrual cyclicity and double phase BBT. This was accompanied by significant lowering in serum T, logT/E 2 and BMI (P<0 05), serum LH: FSH ratio were not changed. Conclusion: Both metformin and TGF can reduce the high concentration of insulin in PCOS patients and induce ovulation, the herbal formula has a better efficacy.