补肾调经膏方对肾虚型卵巢早衰患者内分泌和免疫调节的作用

Effect of Bushen Tiaojing Paste on Endocrine and Immune Regulation of Premature Ovarian Failure Pa-tients with Shen Deficiency

目的观察补肾调经膏方治疗肾虚型卵巢早衰(POF)的临床疗效,并探讨其对患者的内分泌和免疫调节作用。方法将肾虚型POF患者70例,采用随机数字表法分成2组。膏方组给予补肾调经膏方治疗,西药组给予激素替代治疗(HRT),28天为1个疗程,连续治疗3个疗程,治疗结束后随访3个月。另选20名同龄健康体检女性作为健康对照组。观察两组治疗前、后的临床症状、月经改善情况,性激素(E2,FSH,LH)和T细胞亚群(CD3+,CD_4^+ ,CD8+)变化情况。结果两组各有34例患者完成试验。膏方组的总有效率为79.41%(27/34),优于西药组的61.76%(21/34),差异有统计学意义(χ2=6.855,P<0.05)。膏方组改善临床症状优于西药组(P<0.01)。膏方组的月经改善率79.41%(27/34)、月经改善时间(4.09±1.38)个月,优于西药组的61.76%(21/34)和(4.73±1.14)个月(P<0.05);停经复发率11.76%(4/34)低于西药组26.17%(9/34),但差异无统计学意义(P>0.05)。治疗后膏方组血清E2升高,FSH、LH降低幅度优于西药组(P<0.05,P<0.01)。治疗后膏方组血CD_4^+ %升高(P<0.01),CD8+%下降(P<0.01),而西药组CD_4^+ %和CD8+%变化不大,两组差异有统计学意义(P<0.05,P<0.01)。结论补肾调经膏方治疗肾虚型POF的疗效显著,能明显地改善临床症状和恢复正常月经,升高血清E2和降低FSH、LH的水平,并能调节机体的免疫功能。

Objective To observe the clinical effect of Bushen Tiaojing Paste （BTR） in treatment of premature ovarian failure （POF） patients with Shen deficiency （SD）, and to study its effect on patients＇ endocrine and immune regulation function. Methods Totally 70 POF patients with SD were assigned to two groups by random digit table. Patients in the paste group were treated with BTP, while those in the Western medicine group received hormone replacement therapy （HRT）. A total of 28 days consisted of 1 course treatment for 3 consecutive courses, with follow-up of 3 months after treatment. Another 20 age-matched healthy women were selected as the healthy control group. Clinical symptoms and improvement of menstruation, sex hormone （E2, FSH, LH）, and T cell subsets （CD3^＋, CD4^＋, CD8^＋） were observed before and after treatment in the two groups. Results A total of 34 patients in each group completed the study. The total effective rate of the paste group was 79.41% （27/34）, better than that of the Western medicine group （61.76%, 21/34）, with significant difference between the two groups （χ^2 = 6. 855, P 〈0.05）. Improvement of clinical symptoms in the paste group was better than that of the Western medicine group （P 〈0.01 ）. Improvement rate of menstruation and menstrual improvement time in the paste group were 79.41% （27/34） and （4.09 ± 1.38） months, which were better than those of the Western medicine group [61.76% （21/34）, （4.73 ±1.14）months] （P 〈0.05）. And the recurrence rate was 11.76% （4/34） in the paste group, lower than that of the Western medicine group [26.17% （9/34）, P 〉 0.05]. Serum E2 increased, FSH and LH decreased of the paste group, which were superior to those of the western medicine group after treatment （P 〈0.05, P 〈0.01 ）. Serum CD4 ^＋% increased and CD8 ^＋% decreased of the paste group （P 〈0.01 ）, while CD4^＋% and CD8^＋% had no significant changes of the Western medicine group. There was significant difference between two groups （P 〈0.05, P 〈0.01 ）.Conclusions The clinical effect of BTP in the treatment of POF patients with SD was significant. It could significantly improve clinical symptoms and restore normal menstrual blood, increase serum E2. and reduce FSH and LH levels. It also could regulate immune functions of human body. It is worth clinical application.