益经汤治疗肝郁肾虚型早发性卵巢功能不全30例临床观察

Clinical observation on 30 cases of premature ovarian insufficiency with liver depression and kidney deficiency type treated by Yijing Tang( 益经汤)

目的观察益经汤治疗肝郁肾虚型早发性卵巢功能不全的临床疗效。方法将60例肝郁肾虚型早发性卵巢功能不全患者采用随机数字表法分为治疗组和对照组,各30例。治疗组于月经干净后第1天开始服用益经汤(经期停服),对照组于月经周期第1天开始口服芬吗通,3个月经周期为1个疗程,1个疗程后比较2组的临床疗效以及治疗前后的中医证候积分,血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗苗勒管激素(AMH)水平,卵巢窦卵泡数。结果对照组总有效率为73.33%(22/30),治疗组为93.33%(28/30),2组比较差异有统计学意义(P<0.05);治疗后2组中医证候积分及血清FSH、LH水平均明显降低,血清E2、AMH水平及卵巢窦卵泡数均明显升高,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组对各项指标的改善作用更明显,与对照组治疗后比较差异均有统计学意义(P<0.05或P<0.01)。结论益经汤治疗肝郁肾虚型早发性卵巢功能不全临床疗效显著,可明显改善患者临床症状,有效调节激素水平,促进排卵,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of Yijing Tang( 益经汤) in the treatment of premature ovarian insufficiency( POI) with liver depression and kidney deficiency type. Methods Sixty cases of POI with liver depression and kidney deficiency type were divided into treatment group and control group according to random number table method,with 30 cases in each. The treatment group took Yijing Tang on the first day after menstruation( discontinuance in intermenstrual period),while the control group took femoston on the first day of menstrual cycle,3 menstrual cycles constitued 1 course of treatment. After 1 course of treatment,the clinical efficacy,TCM symptom score,serum levels of follicule-stimulating hormone( FSH),luteinizing hormone( LH),estradiol( E2),antimullerian hormone( AMH) and antral follicle count( AFC) before and after treatment of the 2 groups were compared.Results The total effective rate of the control group was 73.33%( 22/30),that of the treatment group was 93.33%( 28/30),and the difference between the 2 groups was statistically significant( P < 0.05). After treatment,TCM symptom score and serum levels of FSH and LH all significantly decreased,while serum levels of E2,AMH and AFC all significantly increased in the 2 groups,and the difference was statistically significant compared with the same group before treatment( P<0.01),moreover,the improvement effect of the treatment group on each index was more significant,and the difference was statistically significant compared with the control group after treatment( P<0.05 or P<0.01).Conclusion It has significant clinical efficacy,markedly improve the clinical symptoms of the patients,effectively regulate hormone level and promote ovulation without marked adverse reactions to use Yijing Tang in the treatment of POI with liver depression and kidney deficiency type,which deserves clinical promotion and application.