补肾活血调周法联合二甲双胍、炔雌醇环丙孕酮片治疗对肾虚血瘀型PCOS患者临床疗效及安全性分析

Clinical Efficacy and Safety of Using Kidney Tonifying and Blood Circulation Activating Method Combined with Metformin and Ethinyl Estradiol and Cyproterone Tablets in the Treatment of Patients with Kidney⁃deficiency and Blood⁃stasis Type PCOS

目的:分析补肾活血调周法联合二甲双胍、炔雌醇环丙孕酮片治疗对肾虚血瘀型PCOS患者临床疗效及安全性。方法:选取本院2018年12月~2020年6月收治的86例肾虚血瘀型PCOS患者作为研究对象,根据不同治疗方式分为对照组(二甲双胍+炔雌醇环丙孕酮片)及研究组(在对照组基础上联合补肾活血调周法)各43例。比较两组患者临床疗效、性激素水平(黄体生成素(Luteinizing hormone,LH)、卵泡刺激素(Follicle stimulating hormone,FSH)、雌二醇(Estrogen,E2)、睾酮(Testosterone,T))、胰岛素抵抗指标(胰岛素分泌指数(Insulin secretion index,HOMA-β)及胰岛素抵抗指数(Insulin resistance index,HOMA-IR))、体质量指数(body mass Index,BMI)、腰臀比(Waist-to-Hip Ratio,WHR)、多毛体征改善情况(采用Ferriman-Gallwey评分)、卵巢体积、妊娠及排卵情况、不良反应。结果(1)研究组总有效率明显高于对照组(95.34%vs 74.41%)两组比较具有统计学意义(P<0.05);(2)治疗后,两组患者LH、FSH、T、HOMA-β、HOMA-IR较治疗前降低,E2升高,以研究组尤甚(P<0.01);(3)治疗后,研究组患者BMI、WHR、多毛评分、卵巢体积指标改善情况显著优于对照组(P<0.05);(4)研究组患者排卵率及妊娠率显著高于对照组(P<0.05);(5)研究组与对照组不良反应总发生率比较未见明显差异(6.97%vs 11.62%)(P>0.05)。结论:肾虚血瘀型PCOS患者采用补肾活血调周法联合二甲双胍、炔雌醇环丙孕酮片治疗临床疗效佳,可有效改善患者临床症状及胰岛素功能,调节患者激素水平,促进排卵及妊娠,安全性高。

Objective: To analyze the clinical efficacy and safety of using kidney tonifying and blood circulation activating method combined with Metformin and Ethinyl Estradiol and Cyproterone Tablets in the treatment of patients with kidney-deficiency and blood-stasis type PCOS. Methods: 86 patients with kidney-deficiency and blood-stasis type PCOS admitted to our hospital from December 2018 to June 2020 were selected as the research objects. According to different treatment methods, they were divided into a controlled group(Metformin+Ethinyl Estradiol and Cyproterone Tablets) and a study group(combined with the method of tonifying kidney and activating blood circulation),with 43 cases in each group. The clinical efficacy, sex hormone levels(Luteinizing hormone(LH),Follicle stimulating hormone(FSH),estradiol(Estrogen, E2),testosterone(T),insulin secretion index(HOMA-β),insulin resistance index(HOMA-IR),body mass index(BMI),Waist-to-Hip Ratio(WHR),improvement of hirsutism signs(using Ferriman-Gallwey score),ovarian volume, pregnancy and ovulation, and adverse reactions between the two groups were compared. Results:(1) The total effective rate of the study group was significantly higher than that of the controlled group(95.34% vs 74.41%). The comparison between the two groups was statistically significant(P<0.05).(2) After treatment, the LH,FSH,T,HOMA-β,and HOMA-IR of the patients in the two groups were lower than those before treatment, and E2 was increased, especially in the study group(P < 0.01).(3) After treatment, the improvement of BMI,WHR,hirsutism score, and ovarian volume in the study group was significantly better than that of the controlled group(P<0.05).(4) The ovulation rate and pregnancy rate of the study group were significantly higher than those of the controlled group(P<0.05).(5) There was no significant difference in the total incidence of adverse reactions between the study group and the controlled group(6.97% vs 11.62%)(P>0.05). Conclusion: The the method of tonifying kidney and activating blood circulation combined with Metformin and Ethinyl Estradiol and Cyproterone Tablets is used in the treatment of patients with kidney-deficiency and blood-stasis type PCOS have a good clinical effect, which can effectively improve the patient’s clinical symptoms and insulin function, regulate the patient’s hormone level, promote ovulation and pregnancy, and has high safety.