加味逍遥丸联合炔雌醇环丙孕酮治疗多囊卵巢综合征所致月经不调的疗效观察

Clinical observation on Jiawei Xiaoyao Pills combined with ethinylestradiol and Cyproterone in treatment of irregular menstruation due to polycystic ovary syndrome

目的探讨加味逍遥丸联合炔雌醇环丙孕酮片治疗多囊卵巢综合征所致月经不调的临床疗效。方法选择2020年1月—2021年12月在首都医科大学附属北京康复医院诊治的80例多囊卵巢综合征所致月经不调患者,采用随机数字表法分为对照组和治疗组,每组各40例。对照组口服炔雌醇环丙孕酮片,月经周期第1天开始,1片/次,1次/d,21 d为1个周期,1个疗程为3个周期。在此基础上,治疗组口服加味逍遥丸,6 g/次,2次/d。两组治疗3个周期。观察两组患者临床疗效,比较治疗前后两组患者HPS评分、PBAC评分、CMSS评分和月经症状评分,临床症状改善时间,子宫内膜厚度、子宫动脉收缩期峰值流速(PSV)、阻力指数(RI)和搏动指数(PI),及血清睾酮(T)、卵泡刺激素(FSH)、孕酮(PROG)、催乳素(PRL)和黄体生成素(LH)水平。结果治疗后,对照组总有效率为82.5%,明显低于治疗组(100.0%,P<0.05)。治疗后,两组HPS评分和PBAC评分明显升高,CMSS评分和月经症状评分明显降低(P<0.05),并以治疗组患者改善的最明显(P<0.05)。治疗后,治疗组症状消失时间均明显早于对照组(P<0.05)。治疗后,两组子宫内膜厚度和PSV明显升高,而RI和PI均明显降低(P<0.05),并以治疗组改善的最为明显(P<0.05)。治疗后,两组血清T、FSH、PRL、LH水平均明显降低,而PROG水平明显升高(P<0.05),且治疗组性激素水平明显好于对照组(P<0.05)。结论加味逍遥丸联合炔雌醇环丙孕酮片治疗多囊卵巢综合征所致月经不调能够促进临床症状改善,促进子宫内膜容受功能恢复,调整机体性激素水平。

Objective To explore the clinical effect of Jiawei Xiaoyao Pills combined with ethinylestradiol and Cyproterone in treatment of irregular menstruation due to polycystic ovary syndrome. Methods Patients(80 cases) with irregular menstruation due to polycystic ovary syndrome in Beijing Rehabilitation Hospital Affiliated to Capital Medical University from January 2020 to December 2021 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were po administered with Ethinylestradiol and Cyproterone Acetate Tablets from the first day of the menstrual cycle, 1 tablet/time,once daily, 21 days as a cycle, and one course of treatment as three cycles. Patients in the treatment group were po administered with Jiawei Xiaoyao Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 3 cycles. After treatment, the clinical evaluation was evaluated, the scores of HPS, PBAC, CMSS and menstrual symptoms, improvement time of clinical symptoms, endometrial thickness and endometrial blood flow parameters of PSV, RI and PI, the levels of T, FSH, PRL, LH,and PROG in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 82.5%, which was significantly lower than that of the treatment group(100%, P < 0.05). After treatment, HPS score and PBAC score were significantly increased in two groups, while CMSS score and menstrual symptom score were significantly decreased(P < 0.05), and the improvement in the treatment group was more obvious(P < 0.05). After treatment, the disappearance time of symptoms in the treatment group was significantly earlier than that in the control group(P < 0.05). After treatment, endometrial thickness and PSV were significantly increased, while RI and PI were significantly decreased in two groups(P < 0.05), especially in the treatment group(P < 0.05). After treatment, the levels of serum T, FSH, PRL and LH in two groups were significantly reduced,while the levels of PROG were significantly increased(P < 0.05), and the levels of sex hormones in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Jiawei Xiaoyao Pills combined with ethinylestradiol and Cyproterone in treatment of irregular menstruation due to polycystic ovary syndrome can promote the improvement of clinical symptoms, promote the recovery of endometrial receptive function, and adjust the level of body sex hormones.