毓麟珠汤加减联合二甲双胍对多囊卵巢综合征Leptin、IGF-1和SHBG水平的影响

Influence of the combined medication of the modified yulinzhu decoction and metformin on the levels of leptin,IGF-1 and SHBG in polycystic ovary syndrome

目的观察毓麟珠汤加减联合二甲双胍对多囊卵巢综合征(PCOS)疗效及其对血清性激素,胰岛素样生长因子-1(IGF-1),瘦素(Leptin)和性激素结合蛋白(SHBG)水平变化的影响。方法选择2015年1月至2016年12月在我院就诊的PCOS患者90例,根据随机数字法分为治疗组和对照组,每组各45例。对照组予以二甲双胍治疗,治疗组在对照组的基础上予以毓麟珠汤加减治疗。比较两组治疗后的疗效、治疗前后中医证候积分、卵巢体积、子宫体积、促卵泡素(FSH)、促黄体(LH)、雌二醇(E2)、睾酮(T)、Leptin、IGF-1和SHBG水平的变化。结果治疗组的总有效率为97. 78%(44/45)明显高于对照组的82. 22%(37/45),治疗组的疗效优于对照组(χ2=4. 444,P <0. 05)。治疗前两组的中医证候积分、卵巢体积、子宫体积、FSH、LH、E2、T、Leptin、IGF-1和SHBG水平差异无统计学意义(P> 0. 05),治疗后两组的中医证候积分、卵巢体积、FSH、LH、E2、T、Leptin和IGF-1较治疗前明显降低(P <0. 01),而子宫体积和SHBG较治疗前明显升高(P <0. 01),治疗组升高和降低水平更为明显(P <0. 01)。结论毓麟珠汤加减联合二甲双胍治疗PCOS的疗效显著,能明显纠正机体的激素紊乱,其机理可能与Leptin,IGF-1和SHBG水平具有明显的相关性。

Objective To observe the changes in the levels of leptin,insulin-like growth factor-1(IGF-1)and sex hormone binding globulin(SHBG) in polycystic ovary syndrome(PCOS) in the treatment with the combined medication of the modified yulinzhu decoction and metformin. Methods From January 2015 to December 2016,90 cases of PCOS were collected from the Hospital and divided into a treatment group and a control group,45 cases in each one according to the random number table. In the control group,metformin was used. In the treatment group,on the base of the treatment as the control group,the modified yulinzhu decoction was supplemented. The therapeutic effects after treatment,the changes in TCM symptom score,ovary volume,uterine volume,follicle stimulating hormone(FSH),lutealizing hormone(LH),estradiol(E2),testosterone(T),leptin,IGF-1 and SHBG before and after treatment were compared in the two groups. Results The total effective rate was 97. 78% in the treatment group,higher obviously than 82. 22% in the control group. The therapeutic effect in the treatment group was better than the control group(χ2= 4. 444,P < 0. 05). Before treatment,there were no differences in TCM symptom score,ovary volume,uterine volume,FSH,LH,E2,T,leptin,IGF-1 and SHBG between the two groups before treatment(P > 0. 05). After treatment,TCM symptom score,ovary volume,FSH,LH,E2,T,leptin,IGF-1 and SHBG were reduced obviously as compared with the levels before treatment(P < 0. 01). The uterine volume and SHBG were increased obviously as compared with those before treatment(P < 0. 01). The increases and decreases in the treatment group were more obvious in comparison(P < 0. 01). Conclusion The combined medication of yulinzhu decoction and metformin achieves the significant effects on PCOS. This treatment obviously rectifies the hormone disturbance in the body,which is probably related to the levels of leptin,IGF-1 and SHBG.