滋阴补阳方序贯法与西药联合治疗多囊卵巢综合征高雄激素血症临床研究

Clinical Study on Sequential Method of Yin-nourishing and Yang-tonifying Prescription Combined with Western Medicine for Patients with Hyperandrogenism in PCOS

目的:观察滋阴补阳方序贯法与西药联合治疗,对多囊卵巢综合征(PCOS)高雄激素血症患者血清硫酸脱氢表雄酮(DHEAS)及性激素结合球蛋白(SHBG)的影响,评价滋阴补阳方序贯法与西药联合治疗PCOS高雄激素血症的临床疗效。方法:将65例PCOS患者随机分为2组。对照组32例患者于月经周期第5天起口服达英-35及地塞米松;观察组33例在对照组治疗方案的基础上于卵泡期服用滋阴方,经前期服用补阳方,共3个月经周期。观察2组治疗前后血清的促黄体生成素(LH)、雄激素(T)、DHEAS、SHBG和临床症状评分情况。结果:与本组治疗前比较,2组LH、T、DHEAS水平及症状评分均降低(P<0.01),SHBG升高(P<0.01);与对照组比较,治疗后观察组LH、T、DHEAS水平及症状评分均低于对照组(P<0.01),SHBG差异无统计学意义(P>0.05);治疗后观察组总有效率优于对照组(P<0.01)。结论:滋阴补阳方序贯法与西药联合能降低PCOS高雄激素血症患者血清LH、T、DHEAS水平,升高SHBG,改善临床症状,疗效优于单用西药治疗。

Objective:To evaluate the clinical effect of sequential method of yin-nourishing and yang-tonifying prescription combined with western medicine for hyperandrogenism in polycystic ovary syndrome(PCOS), and observe its effect on dehydroepiandrosterone(DHEAS) and sex hormone-binding globulin(SHBG). Methods : Divided 65 cases of patients with PCOS into two groups randomly, 32 cases in the control group and 33 cases in the observation group. The control group received the oral administration of diane-35 and dexamethasone from the 5 thday of the menstrual cycle, while the observation group additionally received the oral administration of yin-nourishing prescription in follicular phase and yangtonifying prescription in premenstrual period for three menstrual cycles in total. Observed the levels of serum luteinizing hormone(LH), testosterone(T), DHEAS and SHBG and scores of clinical symptoms in both groups before and after treatment. Results:After treatment,the levels of LH,T and DHEAS and symptom scores in both groups were lower than those before treatment(P<0.01),and the level of SHBG was higher than those before treatment(P<0.01);the levels of LH,T and DHEAS and symptom scores in the observation group were respectively lower than those in the control group(P<0.01),and there was no significant difference being found when comparing the level of SHBG in-between the two groups(P >0.05). After treatment, the total effective rate in the observation group was better than that in the control group(P<0.01).Conclusion:The application of sequential method of yin-nourishing and yang-tonifying prescription combined with western medicine can improve clinical symptoms,decrease the levels of LH,T and DHEAS and increase the level of SHBG in serum of patients with hyperandrogenism in PCOS. It has better therapeutic effect than simple western medicine.