加减滋水清肝饮治疗肾虚肝郁型DOR的临床观察

目的观察加减滋水清肝饮对卵巢储备功能减退(DOR)肾虚肝郁型的治疗效果。方法按随机数字表法将76例肾虚肝郁型DOR患者分成两组。中药组38例采用加减滋水清肝饮治疗;西药组38例采用补佳乐+地屈孕酮片序贯治疗,3个月经周期后比较两组治疗前后的中医证候积分、血清基础FSH、FSH/LH值、AMH、窦卵泡计数的变化。结果两组治疗后血清基础FSH、FSH/LH值、中医证候积分均较治疗前下降(P<0.05),AMH、窦卵泡计数均较治疗前提高(P<0.05)。治疗后两组FSH、FSH/LH值、AMH、窦卵泡计数、中医主症积分差异无统计学意义(P>0.05),而中药组次症积分低于西药组(P<0.05)。中药组总有效率为91%,西药组为92%,两组比较差异无统计学意义(P>0.05)。结论针对肾虚肝郁型DOR患者,加减滋水清肝饮能有效改善临床症状和卵巢功能,获得了与人工周期疗法相当的疗效,值得进一步研究、推广。

Objective To observe the clinical effect of the addition and reduction of modified Zishui Qinggan Decoction on Diminished Ovarian Reserve(DOR)of kidney deficiency and liver stagnation.Methods Use a table of random numbers,76 patients with DOR of kidney deficiency and liver stagnation were divided into two groups.38 cases in TCM group taking Zishui Qinggan Decoction.In the western medicine group,38 patients received sequential treatment of Bujiale 2mg QD+Dctrogesterone tablet lOmg Bid.After 3 menstrual cycles,the TCM syndrome score,serum basal FSH,FSH/LH,AMH and sinus follicle count were contrasted before and after treatment.Results After treatment,serum basal FSH,FSH/LH,TCM main symptom and TCM secondary symptom scores were decreased in both groups,while AMH and sinus follicle count were increased,with statistical significance(P<0.05).There were no statistical differences in FSH,FSH/LH,AMH,sinus follicle count and TCM main symptom score between the two groups after treatment(P>0.05).After treatment,TCM minor symptom score in TCM group was lower than that in western medicine group(P<0.05).The total effective rate of TCM group is 91%,and the rate of the western medicine group is 92%(P>0.05).Conclusion The addition and reduction of modified Zishui Qinggan Decoction can effectively improve the symptoms and ovarian function of DOR patients with kidney liver depression,which is equivalent to artificial cycle therapy,safe and effective,and have application value.