启宫丸加味联合二甲双胍片、炔雌醇环丙孕酮片治疗肾虚痰瘀型多囊卵巢综合征疗效观察

Clinical efficacy of modified Qigong Pill combined with metformin tablet and ethinyl estradiol cyproterone tablets for polycystic ovarian syndrome of kidney deficiency and phlegm stasis

目的观察启宫丸加味联合二甲双胍片、炔雌醇环丙孕酮片治疗肾虚痰瘀型多囊卵巢综合征(PCOS)的临床疗效。方法将100例肾虚痰瘀型PCOS患者按照随机数字表法分为2组。对照组50例(后脱落4例)予二甲双胍片、炔雌醇环丙孕酮片治疗,治疗组50例(后脱落2例)在对照组治疗基础上联合启宫丸加味治疗。2组均治疗3个月经周期。2组治疗前后比较中医证候评分、血清性激素卵泡刺激素(FSH)、黄体生成激素(LH)、睾酮(T)、雌二醇(E 2)及炎症因子白细胞介素10(IL-10)、IL-17、肿瘤坏死因子α(TNF-α),并统计2组疗效。结果治疗组总有效率93.75%(45/48),对照组总有效率78.26%(36/46),治疗组疗效优于对照组(P<0.05)。治疗后2组中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗后治疗组月经周期、经量、腰膝痠软、畏寒肢冷、肢体困倦评分及总分均低于对照组(P<0.05)。治疗后2组血清IL-17、TNF-α水平均较本组治疗前降低(P<0.05),IL-10水平均升高(P<0.05),且治疗后治疗组血清IL-17、TNF-α水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。治疗后2组E 2、FSH均较本组治疗前升高(P<0.05),T、LH水平均较本组治疗前降低(P<0.05),且治疗后治疗组E 2、FSH均高于对照组(P<0.05),T、LH均低于对照组(P<0.05)。结论启宫丸加味联合二甲双胍片、炔雌醇环丙孕酮片治疗肾虚痰瘀型PCOS疗效确切,能明显改善患者临床症状,可能与拮抗炎性反应、调节性激素水平等因素有关。

Objective To observe the clinical efficacy of modified Qigong Pill combined with metformin tablet and ethinyl estradiol cyproterone tablets for polycystic ovarian syndrome(PCOS)of kidney deficiency and phlegm stasis.Methods Totally 100 patients with PCOS of kidney deficiency and phlegm stasis were randomly divided into two groups,50 cases(4 cases of shedding)in control group were treated with metformin tablet and ethinyl estradiol cyproterone tablets,and 50 cases(2 cases of shedding)in treatment group were additionally treated with Qigong Pill on the basis of control group.Treated 3 menstrual cycles,aiming to compare traditional Chinese medicine(TCM)syndrome score,serum hormone[follicle stimulating hormone(FSH),luteotropic hormone(LH),testosterone(T),estradiol(E 2)],and inflammation-related indicators[interleukin-10(IL-10),IL-17,tumor necrosis factor-alpha(TNF-α)];and the curative effect was counted.Results The total effective rates in treatment group were better than those in control group[93.75%(45/48)vs 78.26%(36/46),(P<0.05),respectively].Compared with before treatment,TCM syndrome total score in groups was decreased after treatment(P<0.05);Compared with control group,TCM total syndrome(menstrual cycle,menstrual volume,soreness and weakness of waist and knees,chilliness and cold limbs,physical fatigue)in treatment group were decreased(P<0.05);serum IL-17,TNF-αin groups were decreased after treatment(P<0.05),which were lower in treatment group than in control group(P<0.05);while IL-10 in groups was increased(P<0.05),which was higher in treatment group than in control group(P<0.05);serum E 2,FSH in groups were increased after treatment(P<0.05),which were higher in treatment group than in control group(P<0.05);while T,LH in groups was decreased(P<0.05),which was lower in treatment group than in control group(P<0.05).Conclusion For patients with PCOS of kidney deficiency and phlegm stasis,modified Qigong Pill combined with metformin tablet and ethinyl estradiol cyproterone tablets has a definite effect,can significantly improve clinical symptoms,which may be related to antagonizing inflammatory reaction and regulating hormone level.