温肾健脾化痰法对痰湿型多囊卵巢综合征患者胰岛素抵抗及血清性激素水平的影响

Effect of Wenshen Jianpi decoction on insulin resistance and hormone levels in patients with polycystic ovary syndrome of phlegm-damp syndrome

目的观察温肾健脾化痰方剂对痰湿型多囊卵巢综合征患者的临床疗效。方法选取2017年5月至2019年5月浙江中医药大学附属广兴医院妇产科诊治的80例痰湿型多囊卵巢综合征患者作为研究对象。随机分为两组,治疗组及对照组各40例。对照组口服炔雌醇环丙孕酮及二甲双胍片,治疗组在此基础上联合应用自拟温肾健脾化痰方剂。疗程结束后,比较两组患者临床症状、身体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、血清性激素水平、卵泡发育、妊娠率、流产率等指标的变化。结果①治疗组总有效率达90.0%,临床疗效高于对照组,差异具有统计学意义(P<0.05)。②2组患者在月经周期、多毛、痤疮、溢脂、黑棘皮等临床症状方面均明显改善;且治疗组优于对照组。③疗程结束后,2组患者空腹血糖(FBG)、空腹胰岛素水平(FINS)、胰岛素抵抗指数水平等均明显降低,且治疗组低于对照组,差异具有统计学意义(P<0.05)。④治疗后,2组患者卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平降低,雌二醇(E2)水平升高。⑤治疗后,2组患者的卵巢体积及卵泡个数均下降。结论温肾健脾化痰方剂结合西药治疗痰湿型PCOS,能有效改善症状,优化相关指标,提高妊娠率,值得临床推广。

Objective To observe the clinical efficacy of Wenshen Jianpi decoction for patients with polycystic ovary syndrome(PCOS) of phlegm-damp syndrome. Methods 80 patients with PCOS of phlegm-damp syndrome diagnosed and treated in our hospital from May 2017 to May 2019 were selected and divided into the treatment group and the control group randomly, with 45 cases in each group. The control group adopted estradiol cyclopropanone tablets and metformin, and the treatment group adopted the Wenshen Jianpi decoction on the basis of the control group. After 3 months of treatment, the changes in clinical symptoms, body mass index(BMI), insulin resistance index(HOMA-IR), serum hormone level, follicle development, pregnancy rate, and abortion rate of the two groups were compared. Results ① The total effective rate in treatment group was 90.0%, better than that in control group, with statistically significant difference between the two groups(P<0.05).② All patients in the two groups showed significant improvement in the menstrual cycle, polychaete, acne, sebum, black echinoderm and other clinical symptoms, more signifant in the treatment group than that in the control group.③ After completing the course of treatment, the levels of fasting blood sugar(FBG), fasting insulin(FINS), and insulin resistance index were significantly reduced in the 2 groups, and the levels in the treatment group were lower than those in the control group(P<0.05).④ After treatment, the levels of FSH, LH, and T decreased in two groups and the E2 level increased.⑤After treatment, the ovarian volume and the number of follicles in the two groups decreased. Conclusions Wenshen Jianpi decoction combined with western medicine can effectively improve symptoms, optimize related indicators, improve pregnancy rate when treating PCOS patients, which is worthy of clinical promotion.