温肾化痰方治疗肾虚痰湿型多囊卵巢综合征不孕症的临床效果

Efficacy of warming kidney and resolving phlegm prescription on kidney deficiency and phlegm wet type of polycystic ovary syndrome with infertility

目的探究温肾化痰方治疗肾虚痰湿型多囊卵巢综合征(PCOS)不孕症的临床效果。方法选取2019年12月至2020年12月就诊于河南省中医院的122例肾虚痰湿型PCOS不孕症患者,采用随机数字表法分为观察组(62例)和对照组(60例)。对照组口服炔雌醇环丙孕酮片治疗3个月经周期,观察组在对照组基础上口服中药温肾化痰方治疗,2组均于第4个月经周期开始口服来曲唑促排卵治疗3个月。比较2组治疗前及治疗3个月经周期后中医证候积分、血清性激素、抗米勒管激素(AMH)、白细胞介素6(IL-6)水平。记录患者排卵率、妊娠率及临床疗效。结果治疗3个月经周期后,2组中医证候积分均较治疗前降低,且观察组低于对照组(均P<0.001);2组血清黄体生成素(LH)、睾酮、AMH、IL-6水平及LH/卵泡刺激素(FSH)比值均较治疗前明显降低,且观察组血清LH、睾酮、AMH、IL-6水平及LH/FSH比值均低于对照组[(4.7±1.4)IU/L比(8.6±1.1)IU/L、(0.43±0.12)μg/L比(0.51±0.10)μg/L、(2.9±0.5)μg/L比(8.5±1.0)μg/L、(6.8±1.4)μg/L比(9.7±1.3)μg/L、(0.96±0.18)比(1.70±0.38)](均P<0.05)。观察组排卵率、妊娠率及总有效率均高于对照组(均P<0.05)。结论温肾化痰方治疗肾虚痰湿型PCOS不孕症患者,能够改善生殖内分泌激素水平,有效促卵泡发育及排卵,提高妊娠率。

Objective To investigate the effect of warming kidney and resolving phlegm prescription on kidney deficiency and phlegm wet type of polycystic ovary syndrome(PCOS)with infertility.Methods Totally 122 patients with kidney deficiency and phlegm wet type of PCOS and infertility admitted to Henan Provincial Hospital of Traditional Chinese Medicine were enrolled from December 2019 to December 2020.They were randomly divided into observation group(62 cases)and control group(60 cases).The control group was treated with ethinylestradiol and cyproterone acetate tablets orally for 3 menstrual cycles,the observation group was treated with warming kidney and resolving phlegm prescription based on the control group,and both groups were treated with letrozole orally to induct ovulation for 3 nomths from the forth menstrual cycle.The traditional Chinese medicine syndrome score,serum levels of sex hormone,anti-Müllerian tubular hormone(AMH)and interleukin-6(IL-6)were compared between the two groups.The ovulation rate,pregnancy rate and clinical efficacy were recorded.Results Three menstrual cycles after treatment,traditional Chinese medicine syndrome scores of both groups were lower than those before treatment,and the score in the observation group was lower than that in the control group(all P<0.001);serum levels of luteinizing hormone(LH),testosterone,AMH,IL-6,and LH/follicle stimulating hormone(FSH)ratio in both groups were decreased,and serum levels of LH,testosterone,AMH,IL-6,and LH/FSH ratio in the observation group were lower than those in the control group[(4.7±1.4)IU/L vs(8.6±1.1)IU/L,(0.43±0.12)μg/L vs(0.51±0.10)μg/L,(2.9±0.5)μg/L vs(8.5±1.0)μg/L,(6.8±1.4)μg/L vs(9.7±1.3)μg/L,(0.96±0.18)vs(1.70±0.38)](all P<0.05).The ovulation rate,pregnancy rate and totally effective rate in the observation group were higher than those in the control group(all P<0.05).Conclusions The warming kidney and resolving phlegm prescription can improve the level of reproductive endocrine hormone,promote follicular development and ovulation,and improve the pregnancy rate in the treatment of patients with kidney deficiency and phlegm wet type of PCOS and infertility.