健脾益气化湿方联合枸橼酸氯米芬治疗脾肾阳虚型多囊卵巢综合征所致不孕症临床研究

Clinical Study on Jianpi Yiqi Huashi Prescription Combined with Clomiphene Citrate for Infertility Caused by Polycystic Ovary Syndrome of Spleen-Kidney Yang Deficiency Type

目的:观察健脾益气化湿方联合枸橼酸氯米芬治疗脾肾阳虚型多囊卵巢综合征(PCOS)所致不孕症的临床疗效。方法:选取146例脾肾阳虚型PCOS所致不孕症患者,采用随机数字表法分为观察组和对照组各73例。2组均给予枸橼酸氯米芬片治疗,观察组在此基础上给予健脾益气化湿方治疗,1个月经周期为1个疗程,2组均治疗3个疗程。比较2组临床疗效、排卵率及妊娠率;比较2组治疗前后中医证候积分及血清性激素水平。结果:观察组总有效率为93.15%,高于对照组的82.19%(P<0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),观察组中医证候积分低于对照组(P<0.05)。观察组排卵率为62.94%,对照组排卵率为47.25%;观察组妊娠率为20.55%,对照组妊娠率为8.22%,观察组排卵率和妊娠率均高于对照组(P<0.05)。治疗后,2组血清睾酮(T)、黄体生成素(LH)、雌二醇(E2)水平均较治疗前降低(P<0.05),观察组血清T、LH及E2水平均低于对照组(P<0.05)。结论:健脾益气化湿方联合枸橼酸氯米芬治疗脾肾阳虚型PCOS所致不孕症可有效减轻患者的临床症状,调节血清性激素水平,促进排卵和妊娠,疗效优于单纯使用枸橼酸氯米芬治疗。

Objectives:To observe the clinical effect of Jianpi Yiqi Huashi prescription combined with clomiphene citrate for infertility caused by polycystic ovary syndrome(PCOS)of spleen-kidney yang deficiency type.Methods:A total of146 cases of patients with infertility caused by PCOS of spleen-kidney yang deficiency type were divided into the observation group and the control group according to the random number table method,with 73 cases in each group.Both groups were treated with clomiphene citrate tablets,and the observation group was additionally treated with Jianpi Yiqi Huashi prescription.Both groups were treated for three courses,each menstrual cycle being a course.The clinical effect and the rates of ovulation and pregnancy in the two groups were compared.Before and after treatment,the Chinese medicine syndrome scores and the levels of sex hormone in serum in the two groups were compared.Results:The total effective rate was 93.15%in the observation group,higher than that of 82.19%in the control group(P<0.05).After treatment,the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the Chinese medicine syndrome score in the observation group was lower than that in the control group(P<0.05).The ovulation rate was 62.94%in the observation group and 47.25%in the control group;the pregnancy rate was 20.55%in the observation group,and 8.22%in the control group;the rates of ovulation and pregnancy in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of testosterone(T),luteinizing hormone(LH)and estradiol(E2)in serum in the two groups were decreased when compared with those before treatment(P<0.05).The levels of T,LH and E2 in serum in the observation group were lower than those in the control group(P<0.05).Conclusion:Jianpi Yiqi Huashi prescription combined with clomiphene citrate for infertility caused by PCOS of spleen-kidney yang deficiency type can effectively alleviate the clinical symptoms of patients,regulate the levels of sex hormone in serum,and promote ovulation and pregnancy,whose curative effect is better than that of simple clomiphene citrate.