健脾益肾祛瘀方治疗脾肾阳虚型多囊卵巢综合征患者的效果

Effect of Jianpi Yishen Quyu Formula in the Treatment of Patients with Polycystic Ovarian Syndrome of Spleen-kidney Yang-deficiency

目的:观察健脾益肾祛瘀方治疗脾肾阳虚型多囊卵巢综合征(PCOS)患者的临床效果。方法:选择本院2017年2月-2019年8月治疗的74例脾肾阳虚型PCOS患者,按照数字表法随机分为两组,每组37例。对照组给予炔雌醇环丙孕酮片治疗,观察组在对照组治疗基础上予以自拟健脾益肾祛瘀方治疗。比较两组治疗前后中医症状积分,检测两组治疗前后性激素、糖代谢指标及体质量指数(body mass index,BMI),同时记录两组随访期间妊娠情况。结果:两组治疗前中医症状积分比较差异无统计学意义(P>0.05),治疗后两组中医症状积分较治疗前均降低,差异有统计学意义(P<0.05),且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗前性激素相关指标比较差异无统计学意义(P>0.05),治疗后两组性激素相关指标较治疗前均降低,差异有统计学意义(P<0.05),且观察组促黄体生成激素(luteotropic hormone,LH)、雌二醇(estradiol,E2)、睾酮(testosterone,T)较对照组低,差异有统计学意义(P<0.05);两组治疗前糖代谢指标及BMI比较差异无统计学意义(P>0.05),治疗后两组空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(HOMA-IR)及BMI较治疗前均降低,差异有统计学意义(P<0.05),且观察组FINS、HOMA-IR及BMI较对照组低,差异有统计学意义(P<0.05),而FBG未出现明显改变,差异无统计学意义(P>0.05);观察组治疗后月经恢复正常、排卵、妊娠情况均优于对照组,差异有统计学意义(P<0.05)。结论:健脾益肾祛瘀方可明显减轻脾肾阳虚型PCOS患者临床症状,纠正性激素、糖代谢严重紊乱状态,从而改善患者妊娠情况。

Objective:To observe the clinical effect of Jianpi Yishen Quyu Formula in the treatment of patients with polycystic ovarian syndrome(PCOS)of spleen-kidney yang-deficiency.Method:A total of 74 PCOS patients with spleen-kidney yang-deficiency treated in our hospital from February 2017 to August 2019 were randomly divided into two groups according to number table method,37 cases in each group.The control group was treated with Ethinyl Estradiol Cyproterone Tablets,and the observation group was given self-designed Jianpi Yishen Quyu Formula on the basis of the control group.The scores of TCM symptoms before and after treatment were compared between the two groups,and the indexes of sex hormones,glucose metabolism and body mass index(BMI)were detected before and after treatment.Meanwhile,the pregnancy status of the two groups during follow-up was recorded.Result:There were no statistically significant differences in the scores of TCM symptoms between the two groups before treatment(P>0.05),but the scores of TCM symptoms in the two groups after treatment were lower than those before treatment,the difference was statistically significant(P<0.05),and the observation group was lower than the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the sex hormone related indexes between the two groups before treatment(P>0.05),but the sex hormone related indexes between the two groups after treatment were lower than those before treatment,the differences were statistically significant(P<0.05).The levels of luteotropic hormone(LH),estradiol(E;)and testosterone(T)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in glucose metabolism indexes and BMI between the two groups before treatment(P>0.05),but after treatment,fasting insulin(FINS),HOMA-IR and BMI in the two groups were decreased compared with before treatment,the differences were statistically significant(P<0.05).FINS,HOMA-IR and BMI in observation group were lower than those in control group,the differences were statistically significant(P<0.05),while FBG was not significantly changed,the difference was not statistically significant(P>0.05).After treatment,menstruation returned to normal,ovulation,pregnancy in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:The Jianpi Yishen Quyu Formula can significantly reduce the clinical symptoms of patients with PCOS of spleen-kidney yang-deficiency,correct the serious disorder of sex hormone,glucose metabolism,and thus improve the pregnancy status of patients.