益肾调肝和血法联合穴位贴敷治疗卵巢储备功能下降临床研究

Clinical study of Yishen-Tiaogan-Hexue method combined with acupoint application in the treatment of decreased ovarian reserve function

目的观察益肾调肝和血法联合穴位贴敷治疗卵巢储备功能下降(DOR)的临床疗效。方法将60例DOR患者按照随机数字表法分为2组。对照组30例采用戊酸雌二醇片加黄体酮注射液治疗,治疗组30例采用益肾调肝和血法联合穴位贴敷治疗。2组均治疗3个月经周期。比较2组治疗前后及随访时中医证候评分、血清性激素[卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E 2)及FSH/LH比值]的变化,并统计疗效。停药3个月后随访,统计妊娠及复发情况。结果2组显效率及总有效率比较差异无统计学意义(P>0.05)。治疗后2组FSH、LH水平及FSH/LH比值均较本组治疗前降低(P<0.05),E 2水平均升高(P<0.05),治疗后2组组间FSH、LH、E 2水平及FSH/LH比值比较差异无统计学意义(P>0.05)。治疗后2组各中医证候评分及总分均较本组治疗前降低(P<0.05),治疗后治疗组头晕耳鸣、心悸、失眠、潮热汗出、神疲乏力评分及总分均低于对照组(P<0.05)。随访时治疗组复发率低于对照组(P<0.05);2组妊娠率比较差异无统计学意义(P>0.05)。2组治疗有效且未妊娠的患者随访时,治疗组FSH、LH水平均较本组治疗后降低(P<0.05),E 2水平升高(P<0.05),对照组FSH、LH水平升高(P<0.05),E 2水平降低(P<0.05),且治疗组FSH、LH水平均低于对照组(P<0.05),E 2水平高于对照组(P<0.05)。2组治疗有效且未妊娠的患者中,治疗后2组间仅失眠、潮热汗出评分比较差异有统计学意义(P<0.05),随访时治疗组头晕耳鸣、心悸、失眠、潮热汗出、情绪急躁评分及总分均低于对照组(P<0.05)。结论益肾调肝和血法联合穴位贴敷治疗DOR,疗效良好且停药后远期获益显著。

Objective To observe the effect of Yishen-Tiaogan-Hexue method combined with acupoint application in the treatment of decreased ovarian reserve(DOR)function.Methods 60 patients with DOR were randomly divided into two groups according to the random number table method.30 cases in the control group were treated by estradiol valerate tablets and progesterone injection.30 cases in the treatment group were treated by Yishen-Tiaogan-Hexue method combined with acupoint application.Both groups were treated for 3 menstrual cycles.The changes of TCM syndrome scores,serum sex hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)and FSH/LH ratio]before and after treatment and during follow-up were compared between the two groups.And the curative effect was counted.Three months after the drug withdrawal,the pregnancy and recurrence were recorded.Results There was no significant difference in the total effective rate between the two groups(P>0.05).After treatment,FSH,LH and FSH/LH in the two groups were lower than those in the group before treatment(P<0.05),and E2 was increased(P<0.05),and there was no significant difference between the two groups(P>0.05).After treatment,the TCM syndrome scores and total scores of the two groups were lower than those in the group before treatment(P<0.05).After treatment,dizziness and tinnitus,palpitation,insomnia,hot flashes and sweating,fatigue in the treatment group were lower than those in the control group(P<0.05).The recurrence rate of the treatment group was lower than that of the control group during the follow-up(P<0.05).There was no significant difference in pregnancy rate between the two groups(P>0.05).The two groups of patients with effective treatment and no pregnancy were followed up,FSH and LH in the treatment group were lower than those after treatment in this group(P<0.05),and E 2 was increased(P<0.05),while in the control group,FSH and LH were increased(P<0.05),and E 2 was decreased(P<0.05),and FSH and LH in the treatment group were lower than those in the control group(P<0.05),and E 2 was higher than that in the control group(P<0.05).The two groups of patients with effective treatment and no pregnancy were followed up,only insomnia and hot flashes and sweating syndrome scores between the two groups were statistically significant(P<0.05).During the follow-up,the scores of dizziness and tinnitus,palpitation,insomnia,hot flashes and sweating,and irritability in the treatment group were lower than those in the control group(P<0.05).Conclusion Yishen-Tiaogan-Hexue method combined with acupoint application in the treatment of DOR has good curative effect and significant long-term benefits after drug withdrawal.