清心滋肾汤治疗绝经综合征心肾不交证的临床研究

Clinical Study on Heart-clearing Kidney-nourishing Decoction in Treating Menopausal Syndrome of Heart-kidney Imbalance Pattern

目的:探讨清心滋肾汤治疗绝经综合征(menopausal syndrome,MPS)心肾不交证的临床疗效及对神经-内分泌的影响。方法:选取MPS患者104例,按随机数字表法分为对照组和观察组,每组52例。对照组给予中药安慰剂,观察组给予清心滋肾汤治疗。比较两组临床疗效,症状评分,Kupperman指数(Kupperman index,KI),生存质量量表(menopause-specific quality of life,MENQOL)评分,外周血中肿瘤转移抑制基因亲吻素1(kisspeptins-1,Kiss-1)、内源性受体G蛋白偶联受体54(G protein-coupled receptor 54,GPR54)、神经激肽B(neurokinin B,NKB)、强啡肽(dynorphin,DYN)mRNA水平,血清促性腺激素释放激素(gonadotropin releasing hormone,GnRH)、雌二醇(estradiol,E2)、卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)水平。结果:治疗后,观察组临床疗效总有效率[98.08%(51/52)]高于对照组[84.62%(44/52)](P<0.01)。观察组症状评分,KI、MENQOL总分均低于对照组(P<0.01)。观察组外周血中Kiss-1、GPR54、NKB、DYN mRNA及血清GnRH、FSH、LH水平低于对照组,E2高于对照组,差异有统计学意义(P<0.01)。结论:清心滋肾汤治疗MPS心肾不交证可改善患者临床症状和生活质量,提高疗效,调节神经-内分泌的作用可能是其疗效途径之一。

Objective:To investigate curative efficacy of heart-clearing kidney-nourishing decoction in the treatment of MPS of heart-kidney imbalance pattern and its regulatory effect on neuro-endocrine.Methods:A total of 104 MPS cases were selected and divided into the control group and the observation group with 52 cases in each group in light of random number method.The control group was given herbal placebo and the observation group was treated with heart-clearing kidney-nourishing decoction.To compare curative effects,symptom scales,KI,MENQOL scores,the levels of Kiss-1,GPR54,NKB,DYN mRNA in peripheral blood,the levels of GnRH,E2,FSH and LH between both groups.Results:After treating,total effective rate of the observation group was 98.08%(51/52),higher than 84.62%(44/52)of the control group(P<0.01).The observation group was lower than the control group in symptom scales,KI and MENQOL scores(P<0.01).The levels of Kiss-1,GPR54,NKB and DYNmRNA in peripheral blood,the levels of serum GnRH,FSH and LH of the observation group were lower than these of the control group,the levels of E2 higher than these of the control group,and the difference was statistically significant(P<0.01).Conclusion:Heart-clearing kidney-nourishing decoction in the treatment of MPS of heart-kidney imbalance pattern could help improve the symptoms and quality of life,raise clinical effects,and the effects of regulating neuro-endocrine might be one of therapeutic approaches.