中医治疗肾虚血瘀型月经不规律伴胰岛素抵抗的临床研究

Clinical Study of Applying Traditional Chinese Medicine in the Treatment of Kidney Deficiency and Blood Stasis Type of Irregular Menstruation Combined with Insulin Resistance

目的：测定自拟补肾活血汤治疗肾虚血瘀型月经不规律伴胰岛素抵抗相关观察指标,并对自拟补肾活血汤的临床疗效进行评价。方法：选取76例肾虚血瘀型月经不规律伴胰岛素抵抗患者随机分为两组,对照组和治疗组各38例,对照组患者给予口服二甲双胍0.25g,每日2次,疗程为6个月;治疗组采用院内自拟补肾活血汤治疗,每日1剂,水煎分2~3次服用,疗程为6个月,测量两组患者治疗前后空腹血糖（FPG）、餐后2小时FPG、空腹胰岛素（FINS）、餐后2小时INS、胰岛素抵抗指数（HOMA-IR）、促卵泡成熟激素（FSH）、促黄体生成素（LH）、睾酮（T）及LH/FSH,同时比较两组治疗的效果。结果：治疗后两组患者的FPG、2h FPG,FINS、2h INS、HOMA-IR、FSH及LH水平均显著降低（P〈0.05）,治疗组的T及LH/FSH水平在治疗后显著低于治疗前（P〈0.05）,而对照组的T及LH/FSH水平较治疗前无显著变化（P〉0.05）,并且治疗后治疗组以上所有检测指标均显著低于对照组（P〈0.05）;对照组治疗总有效率为78.9%,治疗组治疗总有效率为92.1%,两组比较差异具有统计学意义（P〈0.05）。结论：自拟补肾活血汤可以通过补肾益脾、活血散瘀来改善月经不规律,同时又可改善性激素水平及胰岛素抵抗。

Objective： Determining the effect of Bushen Huoxue Decoction in the treatment of kidney deficiency and blood stasis type irregular menstruation related outcome measures with insulin resistance,and the clinical effect of Bushen Huoxue Decoction was evaluated. Methods： 76 cases of kidney deficiency and blood stasis type menstruation irregular with insulin resistance were randomly divided into two groups,the controlled group and the treatment group,each group had 38 cases,the controlled group was treated with oral administration of metformin 0. 25 g,twice a day. The course of treatment was 6months. The treatment group used in hospital with Bushen Huoxue Decoction,daily 1agent,water frying points 2 ~ 3times to take. The course of treatment for 6months,the measurement of the two groups of patients before and after treatment,fasting plasma glucose（ FPG）,postprandial 2h fasting plasma glucose（ FPG）,fasting insulin（ fins）,postprandial 2h INS,insulin resistance index（ HOMAIR）,follicle stimulating hormone（ FSH）,and luteinizing hormone（ LH）,testosterone（ T） and LH / FSH were compared between the two groups. Results： After the treatment of the two groups of patients with FPG,2h FPG,fins,2h INS,HOMA-IR,FSH and LH levels were significantly lower（ P 0. 05）,the treatment group T and LH / FSH levels after treatment was significantly lower than the treatment（ P〈0. 05）,while the controlled group of T and LH / FSH levels had no significant change compared with those before treatment（ P〉0. 05）,and after treatment the treatment group above all indexes were significantly lower than the controlled group（ P〈0. 05）,the total efficiency of the controlled group was 78. 9%,the total effective rate of the treatment group was 92. 1%,difference of the two groups had statistical significance（ P〈0. 05）. Conclusion： Bushen Huoxue Decoction can tonify kidney and strengthen spleen to promote blood circulation and dissipate blood stasis to improve irregular menstruation,and can improve sex hormone level and insulin resistance.