补肾调经方配合激素替代疗法治疗卵巢早衰患者的临床观察

Treatment of Premature Ovarian Failure Patients by Bushen Tiaojing Recipe Combined Hormone Replacement Therapy: a Clinical Observation

目的观察补肾调经方配合激素替代疗法(HRT)治疗卵巢早衰(POF)的临床疗效。方法将72例POF患者采取随机数字表法分成3组,中药组(24例)给予补肾调经方治疗,西药组(24例)给予激素替代治疗,中西药组(24例)给予补肾调经方配合HRT治疗,治疗3个疗程,治疗结束后随访3个月。比较3组治疗前、治疗结束时、停药3个月的疗效、临床症状积分和血清性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)]。结果 (1)中西药组总有效率优于中药组、西药组(P<0.05);(2)治疗结束时3组症状积分较治疗前降低(P<0.05或P<0.01);停药3个月西药组症状积分高于治疗结束时(P<0.05),中药组、中西药组症状积分变化差异无统计学意义(P>0.05);(3)治疗结束时3组血清E2升高(P<0.01),FSH、LH下降(P<0.01),以中西药组、西药组改善更显著(P<0.05,P<0.01);停药3个月后西药组血清E2下降,FSH、LH升高,与中药组、中西药组比较,差异有统计学意义(P<0.05,P<0.01),而中药组与中西药组比较,血E2、FSH、LH变化差异无统计学意义(P>0.05)。结论补肾调经方配合HRT治疗POF能明显地改善患者的临床症状、月经情况及血清性激素水平,且复发率低,不良反应少。

Objective To observe the clinical effect on treatment of premature ovarian failure （POF） patients by Bushen Tiaojing Recipe （BTR） and hormone replacement therapy （HRT）. Methods Totally 72 POF patients were randomly assigned to three groups by random digit table, i.e., the Chinese medicine group, the Western medicine group, and the integrative medicine group, 24 in each group. Those in the Chinese medicine group took BTR. Those in the Western medicine group were treated by HRT. Those in the integrative medicine group were treated by BTR ＋ HRT. All were treated for three courses and followed-up for 3 months after treatment. The clinical efficacy, integrals of clinical symptoms, and serum sex hormones levels E follicular stimulating hormone （FSH）, estradiol （E2）, luteinizing hormone （LH）j were compared among the three groups before treatment, at the end of treatment, and 3 months after withdrawal. Results （1） The total effective rate was better in the integrative medicine group than in the Chinese medicine group and the Western medicine group （P 〈0.05）. （2） At the end of treatment, the integrals of clinical symptoms decreased in the 3 groups when compared with before treat- ment in the same group （P 〈0.05, P 〈0.01 ）. The integrals of clinical symptoms were higher at 3 months after withdrawal than at the end of treatment in the Western medicine group （P 〈0.05）. But there was no statistical difference in changes of integrals between the Chinese medicine group and the integrative medicine group （P〉0.05）. （3） By the end of treatment serum E2 increased （P〈0.01）, FSH and LH decreased （P 〈 0.01 ） in the three groups, more significantly in the integrative medicine group and the Western medicine group （P 〈0.05, P 〈0.01 ）. At 3 months after withdrawal serum E2 decreased, FSH and LH increased in the Western medicine group, showing statistical difference when compared with the other two groups （P 〈0.05, P 〈0.01 ）. There was no statistical difference in changes of serum E2, FSH, or LH between the Chinese medicine group and the integrative medicine group （P 〉0.05）. Conclusions BTR combined HRT had significant effect on treatment of POF, could significantly improve patients＇ clini- cal symptoms, menstrual states, and serum sex hormones levels. It had lower recurrence rate. Patients suffered from less adverse reactions.