中西药联合治疗原发性卵巢功能不全的临床研究

Clinical study of combined therapy of traditional Chinese medicine and western medicine on primary ovarian insufficiency

目的:观察中药及联合西药治疗对原发性卵巢功能不全患者生殖内分泌激素及卵巢体积的影响。方法:采用随机对照研究,将183例原发性卵巢功能不全的患者分为POI(primary ovarian insufficiency,POI)-1(10IU/L≤FSH<40IU/L)及POI-2(FSH≥40IU/L)两大组,每组再分为治疗组和对照组。POI-1治疗组采用单纯中药妇科养荣胶囊治疗,POI-2治疗组采用中西医结合治疗方法,即芬吗通2mg+中药妇科养荣胶囊治疗,对照组POI-1和POI-2均采用芬吗通2mg周期治疗,疗程为3个月。比较两组患者的激素水平、卵巢体积变化、Kupperman评分变化。结果:中药及中西药联合治疗组在改善月经相关症状、卵巢功能围早衰期所致更年期症状Kupperman症状评分及性激素FSH、LH水平升高,优于单纯西药治疗(P<0.01);在改善卵巢体积与西药对照组或中药对照组对比差异无统计学意义。结论:妇科养荣胶囊及联合芬吗通治疗POI疗效显著,优于单纯激素替代疗法。

Objective:To observe the effects of traditional Chinese medicine combined with western medicine on reproductive endocrine hormones and ovarian volume in patients with primary ovarian insufficiency.Methods:In this randomized controlled study,183 patients with primary ovarian insufficiency were divided into two groups:POI-1(10IU/L≤FSH<40IU/L) and POI-2(FSH≥40IU/L).Each group was randomly divided into treatment group and control group.Patients in the POI-1 treatment group were received Gynaecological Yangrong Capsule.Meanwhile,patients in the POI-2 treatment group were received Gynaecological Yangrong Capsule combined with femonston.In the control groups,patients in POI-1 and POI-2 groups were treated with femonston.The course of the treatment was 3 months.The hormone levels in the two groups,the changes of ovarian volume and the Kupperman score were compared.Results:Chinese medicine group and combined Chinese medicine and western medicine treatment group could effectively relieve the clinical symptoms related to menstruation,climacteric symptoms caused by peri premature ovarian failure period,the Kupperman symptom score,the high level of FSH and LH,the low level of E2.The effect was superior to that in simple western medicine treatment group(P<0.01).There was no significant difference between the treatment group and control group in improving the volume of ovary.Conclusion:Gynaecological Yangrong Capsule combined with femonston achieved remarkable curative effect in the treatment of POI,which was better than hormone replacement therapy.