补肾固冲汤加减治疗黄体功能不足性月经失调疗效及对患者血浆cAMP/cGMP的影响

Efficacy of Bushen Guchong decoction in the treatment of dysfunctional menstruation due to luteal phase defect and influence on plasma cAMP/cGMP

目的:研究补肾固冲汤加减治疗黄体功能不足(LPD)性月经失调疗效及对患者血浆环磷酸腺苷(cAMP)/环磷酸鸟苷(cGMP)的影响。方法:将88例黄体功能不足性月经失调患者分为两组,每组44例。对照组给予西医治疗,观察组在对照组基础上加用补肾固冲汤加减治疗。观察两组治疗前后临床证候、基础体温(BBT)、高相评分(HPS)、性激素水平变化,测定血浆cAMP/cGMP水平。结果:观察组总有效率为93.18%高于对照组的81.82%,组间差异有统计学意义(P<0.05)。治疗后,观察组的中医证候积分、月经症状评分低于治疗前及对照组;HPS评分及BBT高温时间高于治疗前及对照组(均P<0.05)。治疗后,观察组的血清E_2、P、LH高于治疗前及对照组,PRL低于治疗前和对照组,差异有统计学意义(均P<0.05)。治疗后,观察组的血浆cAMP及cAMP/cGMP比值低于治疗前及对照组,cGMP水平高于治疗前及对照组(均P<0.05)。两组间不良反应率比较,差异无统计学意义(P>0.05)。结论:补肾固冲汤加减治疗LPD性月经失调疗效较好,能够有效改善临床症状并调节性激素水平,其机制可能与调节血浆cAMP/cGMP平衡有关。

Objective:To investigate the effect of Bushen Guchong decoction in the treatment of dysfunctional menstruation due to luteal phase defect(LPD)and its influence on plasma cyclic adenosine monophosphate(cAMP)/cyclic guanosine monophosphate(cGMP).Methods:88 patients with dysfunctional menstruation due to LPD were randomly divided into two groups,with 44 cases in each group.The control group was given standardized western medicine treatment,the observation group was treated with Bushen Guchong decoction on the basis of control group,the course was 3 menstrual cycles.The clinical syndromes,basal body temperature(BBT)high phase score(HPS),changes of sex hormone levels were compared before and after treatment,the plasma cAMP and cGMP was measured.Results:The total effective rate of the observation group was 93.18%significantly higher than 81.82%of the control group(P<0.05).After treatment,the scores of traditional Chinese medical syndromes and menstrual symptoms of the observation group were significantly lower than those before treatment and the control group,the HPS scores and BBT high temperature time were significantly higher than those before treatment and the control group(all P<0.05).After treatment,serum levels of E 2,P,LH of the observation group were higher than those before treatment and control group,and PRL was lower than that before treatment and the control group(all P<0.05).After treatment,the plasma cAMP and cAMP/cGMP ratio of the observation group were significantly lower than those before treatment and the control group.The cGMP level was higher than that before treatment and the control group(all P<0.05).There was no significant difference in the adverse reaction rate between the two groups(P>0.05).Conclusion:Bushen Guchong decoction has significant effect in the treatment of dysfunctional menstruation due to LPD,which can effectively improve the clinical symptoms and regulate the level of sex hormones.The mechanism may be related to the regulation of plasma cAMP/cGMP balance.