柴胡疏肝汤加减治疗肝郁肾虚型排卵障碍性不孕症的临床研究

Clinical Study on Modified Chaihu Shugan Decoction in Treating Anovulatory Infertility with Liver Depression and Kidney Deficiency

目的:观察柴胡疏肝汤加减治疗肝郁肾虚型排卵障碍性不孕症的疗效,并探讨其作用机制。方法:选取2015年3月至2017年2月河南省中医药研究院附属医院妇科门诊就诊的肝郁肾虚型排卵障碍性不孕症患者100例,按就诊顺序随机分为对照组和观察组,每组50例。对照组口服枸橼酸氯米芬片,观察组在对照组治疗基础上给予柴胡疏肝汤加减。观察2组治疗前后临床症状及体征,检测月经第3天及卵泡成熟时血清促卵泡成熟激素(FSH)、黄体生成激素(LH)和雌二醇(E2)的变化;比较2组总妊娠率与不良发应发生率。结果:对照组脱落7例,观察组脱落4例。观察组总妊娠率58.7%,明显高于对照组的30.2%(P<0.05);观察组临床症状和体征,较对照组改善更为明显(P<0.05);观察组不良反应的发生率10.9%(5/46)低于对照组的18.6%(8/43)(P<0.05)。结论:柴胡疏肝汤加减联合枸橼酸氯米芬片可有效改善肝郁肾虚型排卵障碍性不孕症的临床症状及体征、FSH、LH和E2,且可降低枸橼酸氯米芬片的不良反应。

Objective： To observe the clinical efficacy of Modified Chaihu Shugan Decoction in treating anovulatory infertility with liver depression and kidney deficiency, and explore its effect mechanism. Methods： A total of 100 anovulatory infertility patients with liver depression and kidney deficiency treated in Department of Gynecology of Henan Traditional Chinese Medicine Institute Affiliated Hospital from March 2015 to February 2017 were selected and randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with clomifene citrate tablets. Based on the same treatment, the Modified Chaihu Shugan Decoction was adopted in observation group. The clinical symptoms and signs, the changes in serum follicular maturation hormone （FSH）, luteal production hormone （LH） and estradiol （E 2） were detected at the 3rd day of menstruation and at the day of follicles matured. The efficiency and incidence of adverse reactions in the two the groups were compared. Results： There were 7 cases lost in control group and 4 cases lost in observation group. The pregnancy rate of the observation group was 58.7%, which was significantly higher than 30.2% of control group （ P 〈0.05）. Compared with the control group, the clinical symptoms and signs in the observation group improved more significantly （ P 〈0.05）. The adverse reactions rate of the observation group （10.9%, 5/46） was lower than that of the observation group （18.6%, 8/43） （ P 〈0.05）. Conclusion： Modified Chaihu Shugan Decoction in the treatment of the anovulatory infertility with liver depression and kidney deficiency is effective to improve the clinical symptoms and signs, FSH, LH and E 2, and it can reduce the adverse reactions caused by clomifene Citrate Tablets