益肾调经汤治疗肾虚血瘀型月经过少的疗效及对中医证候积分、血清性激素水平和子宫螺旋动脉血流参数的影响

Efficacy of Yishen Tiaojing decoction in the treatment of oligomenorrhea of kidney deficiency and blood stasis syndrome and its effects on scores of TCM syndromes,levels of serum sex hormones,and uterine spiral artery blood flow parameters.

目的探讨益肾调经汤治疗肾虚血瘀型月经过少的疗效及对患者中医证候积分、血清性激素水平和子宫螺旋动脉血流参数的影响。方法选取2019年6月至2021年3月陕西中医药大学第二附属医院收治的110例肾虚血瘀型月经过少患者作为研究对象,按随机数表法分为对照组和观察组各55例。对照组患者给予常规西药治疗,观察组患者在对照组治疗的基础上给予益肾调经汤治疗,疗程为3个月经周期。比较两组患者的临床治疗效果,以及治疗前后的中医证候积分、血清性激素水平和子宫螺旋动脉血流参数。结果治疗3个月后,观察组患者的临床总有效率为96.36%,明显高于对照组的83.64%,差异有统计学意义(P<0.05);观察组患者治疗后月经量少、经色暗淡、经期腹痛、腰膝酸软症状的中医证候积分分别为(2.59±0.36)分、(2.70±0.31)分、(2.68±0.25)分、(2.32±0.41)分,明显低于对照组的(3.29±0.51)分、(3.67±0.49)分、(3.79±0.34)分、(3.49±0.67)分,差异均有统计学意义(均P<0.05);观察组患者治疗后的血清卵泡刺激素(FSH)水平为(3.34±0.82)IU/L,明显低于对照组的(5.26±1.39)IU/L;雌二醇(E2)、黄体生成素(LH)及孕酮(P)水平分别为(136.88±12.46)pmol/L、(7.34±1.28)IU/L、(7.49±1.38)nmol/L,明显高于对照组的(122.71±11.39)pmol/L、(8.26±1.39)IU/L、(5.81±1.46)nmol/L,差异均有统计学意义(P<0.05);治疗后,观察组患者的子宫螺旋动脉搏动指数(PI)、血管阻力指数(RI)分别为1.59±0.13、0.62±0.08,明显低于对照组的1.73±0.26、0.71±0.16,收缩期与舒张期流速比(S/D)为3.59±0.32,明显高于对照组的3.10±0.49,差异均有统计学意义(P<0.05)。结论益肾调经汤能够有效缓解肾虚血瘀型月经过少患者临床不适症状,改善其性激素水平和子宫螺旋动脉血流参数,提高临床疗效。

Objective To explore the efficacy of Yishen Tiaojing decoction in the treatment of oligomenorrhea of kidney deficiency and blood stasis syndrome and its effects on scores of TCM syndromes,levels of serum sex hormones,and uterine spiral artery blood flow parameters.Methods A total of 110 patients with oligomenorrhea of kidney deficiency and blood stasis syndrome treated in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine between June 2019 and March 2021 were selected as the research subjects.According to the random number table method,the patients were divided into a control group and an observation group,with 55 cases in each group.The patients in the control group were treated with conventional western medicine,and the patients in the observation group were given Yishen Tiaojing decoction on the basis of treatment in the control group,for 3 menstrual cycles.The clinical therapeutic effect,and scores of TCM syndromes,levels of serum sex hormones,and uterine spiral artery blood flow parameters before and after treatment were compared between the two groups.Results After 3 months of treatment,the total clinical effective rate in the observation group was 96.36%,which was significantly higher than 83.64%in the control group(P<0.05).After treatment,the scores of TCM syndromes such as oligomenorrhea,dim menstrual color,menstrual abdominal pain,and soreness and weakness of waist and knees were(2.59±0.36)points,(2.70±0.31)points,(2.68±0.25)points,and(2.32±0.41)points in the observation group,which were significantly lower than(3.29±0.51)points,(3.67±0.49)points,(3.79±0.34)points,and(3.49±0.67)points in the control group(all P<0.05).After treatment,the level of serum follicle stimulating hormone(FSH)in the observation group was(3.34±0.82)IU/L,which was significantly lower than(5.26±1.39)IU/L in the control group;while the levels of estradiol(E2),luteinizing hormone(LH),and progesterone(P)were(136.88±12.46)pmol/L,(7.34±1.28)IU/L,and(7.49±1.38)nmol/L,which were significantly higher than(122.71±11.39)pmol/L,(8.26±1.39)IU/L,and(5.81±1.46)nmol/L in the control group(P<0.05).After treatment,the uterine spiral artery pulsatility index(PI)and vascular resistance index(RI)in the observation group were 1.59±0.13 and 0.62±0.08,which were significantly lower than 1.73±0.26 and 0.71±0.16 in the control group,while the systolic to diastolic velocity ratio(S/D)was 3.59±0.32,significantly higher than 3.10±0.49 in the control group(P<0.05).Conclusion Yishen Tiaojing decoction can effectively relieve the clinical discomfort symptoms,improve the levels of sex hormones,and uterine spiral artery blood flow parameters and enhance the clinical efficacy in patients with oligomenorrhea of kidney deficiency and blood stasis syndrome.