朱氏调经方对肾虚血瘀型POI患者卵巢血供的改善作用

Ameliorative effect of Zhu’s Tiaojing Recipe on ovarian blood supply in POI patients with type of kidney deficiency and blood stasis

目的观察朱氏调经方治疗肾虚血瘀型早发性卵巢功能不全(POI)患者的临床疗效及对患者卵巢血供的改善作用。方法纳入122例肾虚血瘀型POI患者,随机分为中药组60例和西药组62例。中药组患者给予朱氏调经方口服,西药组患者给予雌二醇片/雌二醇地屈孕酮片口服,两组均连续治疗6个月经周期。治疗前后,检测所有患者的卵巢动脉血流收缩期峰值流速(PSV)、阻力指数(RI)及血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、抗米勒管激素(AMH)水平,比较两组患者的中医证候评分,评估中医证候疗效。结果①治疗后,中药组患者的卵巢动脉血流RI较治疗前明显降低(P<0.01)、PSV较治疗前明显升高(P<0.01),西药组患者的卵巢动脉血流PSV较治疗前亦明显升高(P<0.01),且中药组患者的卵巢动脉血流RI下降幅度明显大于西药组(P<0.05)。②治疗后,两组患者的中医证候评分较治疗前均明显降低(P<0.01),且中药组患者的中医证候评分降低幅度大于西药组(P<0.01)。③治疗后,中药组患者的中医证候疗效总有效率为88.33%,西药组为69.35%,中药组的疗效优于西药组(P<0.05)。④治疗后,两组患者的FSH水平较治疗前均明显降低(P<0.01),E_(2)、AMH水平较治疗前均明显升高(P<0.01,P<0.05),但组间各激素水平比较,差异均无统计学意义(P>0.05)。结论朱氏调经方可有效改善肾虚血瘀型POI患者的临床证候和血清性激素水平,加快卵巢动脉血流PSV、降低RI,从而改善卵巢基质血供,为卵泡发育提供营养支持。

Objective To observe the clinical efficacy of Zhu’s Tiaojing Recipe in treating premature ovarian insufficiency(POI)patients with type of kidney deficiency and blood stasis and its ameliorative effect on ovarian blood supply.Methods One hundred and twenty-two POI patients with type of kidney deficiency and blood stasis were enrolled and randomly divided into the Chinese medicine group(60 cases)and the western medicine group(62 cases).The patients in the Chinese medicine group were orally treated with Zhu’s Tiaojing Recipe,and the patients in the western medicine group were orally treated with estradiol tablets/estradiol and dydrogesterone tablets.The patients in both groups were continuously treated for 6 menstrual cycles.Before and after treatment,the peak systolic velocity(PSV)and resistance index(RI)of ovarian artery blood flow and the levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))and anti-Müllerian hormone(AMH)were detected,the scores of Chinese medical syndrome in both groups were compared,and the efficacy of Chinese medical syndrome was evaluated.Results①After treatment,the RI of ovarian artery blood flow in the Chinese medicine group was significantly decreased compared with that before treatment(P<0.01),and the PSV was significantly increased compared with that before treatment(P<0.01);the PSV of ovarian artery blood flow in the western medicine group was also increased compared with that before treatment(P<0.01);and the decrease range of ovarian artery blood flow RI in the Chinese medicine group was significantly greater than that in the western medicine group(P<0.05).②After treatment,the scores of Chinese medical syndrome in both groups were significantly decreased compared with those before treatment(P<0.01),and the decrease range of Chinese medical syndrome score in the Chinese medicine group was higher than that in the western medicine group(P<0.01).③After treatment,the total effective rates on Chinese medical syndrome of the Chinese medicine group and the western medicine group were 88.33%and 69.35%respectively,and the therapeutic effect of the Chinese medicine group was better than that of the western medicine group(P<0.05).④After treatment,the levels of FSH in the two groups were significantly decreased compared with those before treatment(P<0.01),and the levels of E_(2) and AMH were significantly increased compared with those before treatment(P<0.01,P<0.05),but there were no statistically significant differences in the hormone levels between the two groups(P>0.05).Conclusion Zhu’s Tiaojing Recipe can effectively improve the clinical syndromes and serum sex hormone levels in POI patients with type of kidney deficiency and blood stasis,accelerate the PSV of ovarian artery blood flow and decrease the RI,thus improve the ovarian blood supply and provide the nutritional support for follicular growth.