滋肾清肝法治疗非月经后期的卵巢储备功能下降51例疗效观察

Clinical observation on the treatment of 51 patients with non-menstrual late decreasing ovarian reserve by using nourishing kidney and clearing liver therapy

目的:观察中医滋肾清肝法治疗非月经后期的卵巢储备功能下降(DOR)的临床疗效。方法:符合纳入标准的51例病例给予滋肾清肝方中药颗粒剂,每日1剂,连续3个月。服药前后取月经周期第2天空腹血清,测定卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2),记录中医症状,比较治疗前后指标变化。结果:治疗后中医症状积分减少,与治疗前比较,差异显著(P<0.01);血清FSH治疗后与治疗前比较,差异显著(P<0.01),FSH/LH治疗后与治疗前比较,差异显著(P<0.01);血清E2治疗后与治疗前比较有下降趋势但无统计学差异。纳入病例中因不孕症和胎停育就诊的患者有30例,治疗后3个月内妊娠者12例,随访至孕12周均无胎停育发生,妊娠率40%。结论:滋肾清肝法治疗非月经后期的DOR具有良好的疗效,治疗后中医症状得到显著改善,FSH、FSH/LH显著下降;运用滋肾清肝法治疗DOR,对生育功能也有一定的改善和促进作用。

Objective： To observe the clinical effect on the treatment of non-menstrual late decreasing ovarian reserve （DOR） by using nourishing kidney and clearing liver therapy. Methods： Fifty-one patients in according with the inclusion criteria were given the treatment of nourishing kidney and clearing liver granules once a day for 3 months. Serum was collected on the 2nd day of menstrual cycle to test the level of FSH, LH and E2, traditional Chinese medicine symptoms were recorded, and index changes before and after the treatment were compared. Results： The traditional Chinese medicine symptom scores were decreased significantly after treatment compared with treatment before （P〈0.01）. The differences in FSH level of serum and FSH/LH between before and after treatment were significant （P〈0.01）. Compared with treatment before, E2 level of serum was decreased after treatment but the difference was not significant. There were 30 patients to see a doctor because of infertility and embryo damage in the included patients. Twelve patients were gestation after 3 months of treatment, and there were no embryo damage followed up to 12 weeks. The pregnancy rate was 40%. Conclusion： The curative effect of nourishing kidney and clearing liver therapy used in treating with non-menstrual late decreasing ovarian reserve is good. The TCM symptoms are improved, and FSH level and FSH/LH are decreased significantly. Nourishing kidney and clearing liver therapy could use to treat DOR, and it also could improve and promote the fertility function.