补肾活血汤治疗心理精神因素所致卵巢储备功能减退的临床观察

Clinical observation of Kidney-supplementing and blood-quickening decoction on the treatment of ovarian dysfunction caused by psychological factors

目的观察补肾活血汤对心理精神因素所致卵巢储备功能减退(DOR)患者的疗效。方法将60例心理精神因素所致DOR患者随机分为2组,治疗组30例予补肾活血汤口服,对照组30例予激素替代疗法,2组均治疗3个月。观察2组治疗前后临床症状改善情况,治疗前后卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E_2)及窦卵泡数(AFC)、卵巢直径(OVD)、卵巢基质血流阻力指数(RI)的变化;观察比较2组治疗后中医证候疗效及综合疗效,统计不良反应发生情况。结果 2组治疗后各项中医症状积分均较治疗前降低(P<0.05),治疗组治疗后腰膝痠软症状积分低于对照组(P<0.05)。2组治疗后FSH均降低(P<0.01),E_2均升高(P<0.05),治疗组治疗后LH下降(P<0.01),2组治疗后FSH、LH比较差异有统计学意义(P<0.05)。2组治疗后AFC均增加、RI均降低(P<0.01),2组治疗后AFC、RI比较差异有统计学意义(P<0.05);2组治疗前后OVD比较差异无统计学意义(P>0.05)。2组治疗后中医证候疗效及综合疗效比较差异无统计学意义(P>0.05)。2组治疗期间未见明显不良反应。结论补肾活血汤具有改善心理精神因素所致DOR患者临床症状及调经的作用;能降低FSH、LH水平,升高E_2水平,促进卵泡发育,改善卵巢血供,从而使卵巢功能得到改善。

ObjectiveTo observe the effects of Kidney-supplementing and blood-quickening decoction on treatment of the decreased ovarian reserve（DOR）caused by psychological factors.Methods60 DOR patients caused by psychologicd factors were randomly divided into two groups.The treatment group（n=30）was treated by oral Kidney-supplementing and blood-quickening decoction.The control group（n=30）was treated by hormone replacement therapy（HRT）.The treatment course in two groups was 3 months.The changes of clinical symptoms,follicle stimulating hormone（FSH）,corpus luteum hormone（LH）,estradiol（E2）,the number of antral follicles（AFC）,ovarian diameter（OVD）,ovarian stromal blood flow resistance index（RI）were observed before and after treatment in two groups.The effects of traditional Chinese medicine（TCM）syndromes and comprehensive curative effect after treatment were compared between two groups,and the occurrence of adverse reactions was evaluated.ResultsEach TCM symptoms scores after treatment were decreased in two groups（P〈0.05）,and the score of soreness and weakness of waist and knees after treatment in treatment group was lower than that in control group（P〈0.05）.The FSH after treatment was decreased in two groups（P〈0.05）,the E2was increased（P〈0.05）,the LH was decreased only in treatment group（P〈0.01）,and there were statistical differences on FSH and LH after treatment between two groups（P〈0.05）.After treatment,the AFC was increased and RI was decreased in two groups,and there were statistical differences between two groups（P〈0.05）.There was no statistical differences on OVD between before and after treatment in two groups（P〈0.05）.There was no statistical differences on the effects of TCM symptoms and comprehensive curative（P〈0.05）.There were no serious adverse reactions occurred in two groups during treatment.ConclusionThe kidney-supplementing and blood-quickening decoction has curative effects of improving the clinical symptoms and regulating the menstrual on stress-induced DOR,can reduce FSH and LH,increase E2,and promote follicular development,improve blood supply of ovarian,thereby improving ovarian function.