女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探

Primary investigation on clinical of Nuzhen decoction on diminished ovarian reserve in type of internal heat due to yin deficiency

目的探讨女禛汤治疗阴虚内热型卵巢储备功能下降(diminished ovarian reserve,DOR)的临床疗效。方法70例DOR患者,用EXCEL软件生成随机序列数,按照1∶1的比例,分为女禛汤治疗组和坤泰胶囊对照组。两组均从月经第5天开始服药,至下次月经来潮第一天停药。3个月为一个疗程。随访6个月。治疗前后监测中医证候评分及血清内分泌指标[血清卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E 2)、抗苗勒管激素(anti-Mullerian hormone,AMH)和抑制素B(inhibin B,INHB)浓度]、窦卵泡计数(antral follicle count,AFC)等。结果两组均可有效改善阴虚内热型卵巢储备功能下降患者的中医证候,降低中医证候评分,降低月经第2~4 d血清FSH、FSH/LH浓度,提高血清AMH浓度和AFC数量,女禛汤治疗组优于坤泰胶囊对照组。结论女禛汤可以通过提高卵巢反应性,从而改善卵巢储备功能。

Objective To observe the clinical effect of Nuzhen decoction on diminished ovarian reserve(DOR)belonged to the type of internal heat due to yin deficiency.Methods Totally 70 patients of DOR were randomly divided into two groups using EXCEL software.The treatment group was given Nuzhen decoction and the control group was treated with Kuntai capsule.Both groups started taking medicine on the fifth day of menstruation and stopped taking medicine on the first day of the next menstruation.The treatment lasted for three months for a course.The follow-up period was 6 months.All patients were evaluated at traditional Chinese medicine(TCM)syndrome evaluation,serum endocrine index follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E 2),anti-Mullerian hormone(AMH),inhibin B(INHB),antral follicle count(AFC).Results For both groups the TCM syndromes were effectively improved and the scores of TCM syndromes were reduced.The levels of FSH and FSH/LH in serum on the 2 nd to 4 th day of menstruation were reduced and the levels of AMH in serum and AFC were increased.These changes in the treatment group were superior to that in the control group.Conclusion Nuzhen decoction can improve ovarian reserve function by improving ovarian responsiveness.