加味桂枝茯苓汤对多囊卵巢综合征血清瘦素的影响

Effect of Modified Guizhi Fuling Decoction on Serum Leptin Levels in Patients with Polycystic Ovarian Syndrome

目的:探讨加味桂枝茯苓汤配合常规西药治疗多囊卵巢综合征(PCOS)的疗效及对患者血清瘦素(LP)的影响。方法:94例PCOS患者随机分为观察组49例,对照组45例。对照组采用炔雌醇环丙孕酮片,1片/次,1次/d;盐酸二甲双胍片,0.5 g,3次/d,均于月经第5天开始口服,经期停服。观察组在对照组基础上加服加味桂枝茯苓汤,1剂/d。两组疗程均为3个月经周期。观察体重指数(BMI)、空腹血糖、空腹胰岛素;采用放射免疫法检测内分泌5项;采用酶联免疫吸附试验检测血清LP水平。结果:治疗后两组血清促卵泡生成激素(FSH),促黄体生成激素(LH),雌二醇(E2),睾酮(T)及泌乳素(PRL)水平均较治疗前降低,治疗后观察组LH,E2及T均低于对照组(P<0.05);两组BMI均较治疗前降低,治疗后观察组BMI低于对照组(P<0.05);治疗后观察组血清LP水平为(9.68±2.59)μg·L-1低于对照组的(10.75±2.67)μg·L-1(P<0.05)。结论:加味桂枝茯苓汤能明显下调PCOS患者血LH,E2,T,LP水平,降低BMI,从而改善胰岛素抵抗。

Objective：To investigate the effect of modified Guizhi Fuling decoction combined swith routine western medicine therapy on polycystic ovarian syndrome（PCOS） and leptin（LP） in patients.Method：Ninety-four patients with PCOS were randomly divided into observation group（n=49） and control group（n=45）.Patients in control group orally took ethinylestradiol and cyproterone acetate tablet,1 tablet daily;metformin hydrochloride tablet,0.5 g tid,from the third day of menstruation.There was a discontinuation at menstruation.Observation group was given modified Guizhi Fuling decoction,1 dose daily,on the basis of control group.The treatment course of the two groups lasted 3 menstruation cycles.The patients＇ body mass index（BMI）,fasting glucose and fasting insulin were recorded.Five indexes of endocrine were observed by radioimmunoassay.Serum LP was tested by enzyme linked immunosorbent assay.Result：After treatment,follicle stimulating hormone（FSH）,luteinizing hormone（LH）,estrodiol 2（E2）,testosterone（T） and prolactin（PRL） in the two groups were decreased than those before treatment.LH,E2 and T in observation group were lower than those in the control group（P0.05）;BMI in the two groups were decreased compared with those before treatment,and BMI in observation group were lower than that in control group（P0.05）;Serum LP in observation group was（9.68±2.59） μg·L-1,which was significantly lower than（10.75±2.67） μg·L-1 in control group（P0.05）.Conclusion：Modified Guizhi Fuling decoction can improve insulin resistance by significantly decreasing LH,E2,T and LP and reducing BMI.