镇肝熄风汤在肾阴虚型早发性卵巢功能不全患者中的疗效分析

Analysis of curative effect of Zhengan Xifeng decoction in patients with early ovarian dysfunction of kidney Yin deficiency

目的评价在肾阴虚型早发性卵巢功能不全患者中应用镇肝熄风汤的效果及对患者卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E_2)等的影响。方法选取2015年1月—2016年12月温州市中医院门诊就诊的肾阴虚型早发性卵巢功能不全患者64例,按随机数字表法分为对照组和实验组,分别给予单纯性激素替代治疗和镇肝熄风汤联合激素替代治疗,比较2组患者治疗前后症状积分临床疗效、不良反应率、相关激素[如FSH、LH、AMH、抑制素B(INHB)和E_2]以及窦卵泡数目等的差异。结果治疗后,实验组患者的潮热出汗、情绪波动、疲乏、头痛、皮肤蚁行感、性生活、经少/闭经等症状积分和总积分均呈明显低于对照组。2组患者治疗后来潮次数、月经周期和行经时间等月经情况差异无统计学意义。对照组和实验组的总有效率分别为93.75%和75.00%,实验组明显高于对照组(P<0.05)。治疗后,2组患者的FSH和LH水平明显降低,E_2、AMH、INHB和AFC明显升高,其中实验组患者的改善程度较对照组更为明显(P<0.05)。对照组和实验组患者治疗相关不良反应发生率间差异无统计学意义(18.75%和9.38%,P>0.05)。结论与单纯激素替代治疗相比,在肾阴虚型早发性卵巢功能不全患者中联合应用镇肝熄风汤具有较高的临床疗效,能够有效调节激素水平,促进卵巢储备功能的恢复。

Objective To observe the efficacy of traditional Chinese medicine decoction （ Zhengan Xifeng Decoction） in patients with kidney-yin deficiency type premature ovarian insufficiency （POI） and its effects on follicle stimulating hor- mone, luteinizing hormone and estradiol. Methods From January, 2015 to December, 2016, 64 patients with kidney- yin deficiency type POF were randomly divided into control group and experimental group （32 cases in each group）. Pa- tients were treated with hormone replacement therapy （HRT） and Tranquilizing Liver-wind decoction combined with HRT. The symptom scores, hormone （such as FSH, LH and E2 ）, antral follicles count （AFC） were comparatively ana- lyzed. Results After treatment, the sweating, mood swings, fatigue, headache, skin ants, sexual life, less/amenorrhea syndrome scores and total score in the experimental group were significantly lower than those in the control group （ P 〈 0.05）. There was no significant difference in menstrual status （ such as the number of busts, menstrual cycle, and pas- sage time） after treatment. The total effective rate of the control group and the experiment were 93.75% and 75.00% re- spectively （P 〈 0.05）. After treatment, FSH and LH levels were significantly decreased in both groups, E2 and AFC were significantly increased, and the improvement of the experimental group was more obvious than the control group （ P 〈 O. 05）. There was no significant difference in the incidence of adverse reactions between the control group and the experimental group （ 18.75 % and 9.38%, P 〉 0.05）. Conclusion Compared with simple hormone replacement thera- py, combined with Zhengan Xifeng decoction in patients with kidney-yin deficiency type premature ovarian failure has a high clinical efficacy, can effectively regulate the hormone levels, and promote the recovery of ovarian reserve function.