加味五苓散联合二甲双胍治疗肾虚痰瘀型多囊卵巢综合征

Modified Wuling Powder Combined with Metformin in the Treatment of Polycystic Ovary Syndrome with Kidney Deficiency and Phlegm Stasis Type

目的:观察加味五苓散联合二甲双胍治疗肾虚痰瘀型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)的临床疗效。方法:126例肾虚痰瘀型PCOS患者按随机数字表法分为中药组42例,西药组40例,联合组44例。3组均给予常规治疗,西药组在常规治疗基础上给予二甲双胍口服,中药组在常规治疗基础上给予加味五苓散煎服,联合组在常规治疗基础上给予加味五苓散联合二甲双胍。3组疗程均为6个月。比较3组患者治疗前后中医证候积分、胰岛素抵抗情况、子宫内膜容受性及临床疗效。结果:治疗后,联合组中医证候积分下降,且低于中药组、西药组(P<0.05);联合组空腹血糖(fasting blood-glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homa insulin-resistance,HOMA-IR)水平均下降,且低于中药组、西药组(P<0.05);联合组子宫动脉阻力指数(resistance index,RI)、子宫内膜螺旋动脉搏动指数(pulsatility index,PI)下降,且低于中药组、西药组(P<0.05);联合组子宫内膜厚度增加,且高于中药组、西药组(P<0.05);联合组有效率为90.91%,高于中药组的80.95%、西药组的77.50%(P<0.05);中药组与西药组中医证候积分、FPG、FINS、HOMA-IR水平、RI、PI、子宫内膜厚度以及有效率比较,差异均无统计学意义(P>0.05)。结论:加味五苓散联合二甲双胍治疗肾虚痰瘀型PCOS疗效显著,可有效改善患者临床症状,并可改善患者胰岛素抵抗及子宫内膜容受性。

Objective:To observe the clinical effect of modified Wuling Powder combined with metformin in the treatment of polycystic ovarian syndrome(PCOS).Methods:126 cases of PCOS with kidney deficiency and phlegm stasis type were divided into Chinese medicine group(42 cases),western medicine group(40 cases)and combined group(44 cases).All three groups were given conventional treatment,western medicine group was given metformin orally on the basis of conventional treatment,Chinese medicine group was given modified Wuling Powder Decoction on the basis of conventional treatment,combined group was given modified Wuling Powder combined with metformin on the basis of conventional treatment.The course of treatment was 6 months.After treatment,TCM syndrome score,insulin resistance,endometrial receptivity and clinical effect were compared among the three groups.Results:After treatment,the TCM syndrome score of the combined group decreased,which was lower than that of the Chinese medicine group and the western medicine group(P<0.05);the fasting blood-glucose(FPG),fasting insulin(FINS),homa insulin-resistance(HOMA-IR)of the combined group decreased,which was lower than that of the Chinese medicine group and the western medicine group(P<0.05);in the combined group,resistance index(RI)and pulsatility index(PI)decreased,which were lower than those in the Chinese medicine group and the western medicine group(P<0.05);the thickness of endometrium in the combined group increased,which was higher than those in the Chinese medicine group and the western medicine group(P<0.05);the effective rate of the combined group was 90.91%,higher than 80.95%of the Chinese medicine group and 77.50%of the western medicine group(P<0.05).There was no significant difference in TCM syndrome score,FPG,FINS,HOMA-IR level,RI,PI,endometrial thickness and effective rate between the Chinese medicine group and the western medicine group(P>0.05).Conclusion:Modified Wuling Powder combined with metformin is effective in treating PCOS of kidney deficiency and phlegm stasis type,which can effectively improve the clinical symptoms,insulin resistance and endometrial receptivity.