补肾调经汤对多囊卵巢综合征不孕症患者的促排卵作用

Effect of Bushen Tiaojing Decoction in Promoting Ovulation Among Polycystic Ovarian Syndrome Barrenness Patients

目的:探讨补肾调经汤对多囊卵巢综合征不孕(PCOS)促排卵作用及对胰岛素抵抗(IR)和血清瘦素(LP)的影响。方法:将114例患者随机按数字表法分为对照组和观察组各57例。对照组采用炔雌醇环丙孕酮片和枸橼酸氯米芬片治疗。观察组在对照组治疗的基础上加用补肾调经汤。两组疗程均为3个月经周期。观察子宫内膜厚度、子宫内膜类型(A,B,C型)、宫颈黏液评分、排卵数、月经恢复、妊娠;检测胰岛素抵抗指数(HOMA-IR),瘦素(LP),黄体生成素(LH),血清睾酮(T),雌二醇(E2)水平和卵泡刺激素(FSH)的水平。结果:治疗后观察组子宫内膜厚度和宫颈黏液评分优于对照组(P<0.01),治疗后观察组子宫内膜A型比例多于对照组(P<0.05);治疗后观察组月经恢复、排卵、妊娠患者例数多于对照组(P<0.05);治疗后观察组T和LH水平低于对照组(P<0.01);观察组治疗后HOMA-IR和LP低于对照组(P<0.01)。结论:结合西医的治疗,补肾调经汤能改善子宫内膜厚度、改善内膜形态,促进月经恢复,促使排卵,提高妊娠,其作用机制可能与调节内分泌和代谢有关。

Objective： To discuss the efficacy of Bushen Tiaojing decoction in promoting ovulation among patients with polycystic ovarian syndrome（ PCOS） and its effect on insulin resistance（ IR） and serum leptin（ LP）. Method： Totally 114 patients were divided into the control group（ 57 cases） and the observation group（ 57 cases） by the random number table. Patients in the control group received ethinylestradiol and cyproterone acetate tablets and clomiphene citrate. Besides the therapy of the control group therapy,patients in the observation group were also given Bushen Tiaojing decoction. The treatment courses for both groups lasted for 3 menstrual cycles. The endometrial thickness,endometrium types（ A,B,C）,cervical mucus scores,number of eggs ovulated,menstruation recovery,encyesis were observed. The insulin resistance index（ HOMA-IR）,leptin（ LP）,luteinizing hormone（ LH）,serum testosterone（ T）,estradiol（ E2） and follicle stimulating hormone（ FSH） were detected. Result： After the treatment,the endometrial thickness and cervical mucus scores in the observation group were higher than that in the control group（ P〈0. 01）. After the treatment,type A endometrium in the observation group was higher than that in the control group（ P〈0. 05）. The menstruation recovery,number of eggs ovulated,encyesis in the observation group were higher than that in the control group（ P〈0. 05）. T,LH,HOMA-IR and LP levels in the observation group were lower than that in the control group（ P〈0. 01）.Conclusion： Combined with the western therapies,Bushen Tiaojing decoction can improve endometrial thickness and endometrial morphology, promote menstruation recovery, induce ovulation and enhance encyesis. Its mechanism may be correlated with the regulation of endocrine and metabolism.