肥瘦分型治疗多囊卵巢综合征不孕症疗效观察

Curative Effect Observation on Polycystic Ovary Syndrome Infertility Treated with Fat and Lean Typing

目的 观察肥瘦分型中药治疗多囊卵巢综合征(polycystic ovary syndrome, PCOS)不孕症疗效。方法 选择PCOS不孕症患者96例,采用随机数字表法将患者分为对照组和观察组,各48例。两组患者均给予中药调周法治疗,观察组在此基础将患者分为肥瘦两型进行治疗,体质量指数(Body Mass Index, BMI)≥24的超重和肥胖PCOS患者归为肥型,BMI<24的PCOS患者归为瘦型。肥型者多为脾虚湿蕴,治疗以健脾温阳、化痰利湿为法,瘦型者多为肝郁肾虚,治疗以疏肝理气、补肾温阳为法。两组均治疗3个月,每天晨起监测舌下基础体温,比较两组治疗前后促黄体生成素(luteinizing hormone, LH)、促卵泡生成素(Follicle stimulating hormone, FSH)、睾酮(testosterone, T)的变化,排卵及妊娠情况。结果 治疗后两组患者T水平无显著性差异,观察组LH水平及LH/FSH低于对照组(P<0.05),有显著性差异。对照组出现双相体温42例,共完成76个周期,妊娠10例,观察组出现双相体温46例,共完成101个周期,妊娠25例,观察组妊娠率高于对照组(P<0.05),有显著性差异。对照组治愈10例,有效32例,无效6例,总有效率87.5%;观察组治愈15例,有效31例,无效2例,总有效率95.8%。观察组总有效率高于对照组,但差异无统计学意义(P>0.05)。结论 肥、瘦分型治疗PCOS患者,更有利于调节内分泌紊乱,提高妊娠率。

Objective To observe the curative effect of TCM treatment of fat and lean typing on infertility of polycystic ovary syndrome(PCOS).Methods Ninety-six patients with PCOS infertility were randomly divided into control group and observation group, with 48 cases in each group.The patients in both groups were treated with regulating menstruation method with Chinese medicine.On this basis, the patients in the observation group were divided into fat and lean types.Overweight and obese PCOS patients whose body mass index(BMI)≥24 kg/mwere classified as fat type, and PCOS patients whose BMI<24 kg/mwere classified as lean type.The patients in fat type group were mostly spleen deficiency and dampness accumulation, who were treated by strengthening spleen and warming Yang, resolving phlegm and eliminating dampness.The patients in fat type group were mostly liver depression and kidney deficiency, who were treated by soothing liver and regulating Qi, tonifying kidney and warming Yang.Both groups were treated for 3 months.The sublingual basal body temperature was monitored every morning and the changes of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),ovulation and pregnancy were compared between the two groups before and after treatment.Results There was no significant difference in T level between the two groups after treatment(P>0.05).The levels of LH and LH/FSH in the observation group were lower than those in the control group(P<0.05).Forty-two cases appeared biphasic body temperature in the control group, completed 76 cycles and 10 cases got pregnant.Forty-six cases appeared biphasic body temperature in the observation group, completed 101 cycles and 25 cases got pregnant.The pregnancy rate in the observation group was higher than that in the control group(P<0.05).In the control group, 10 cases were cured, 32 cases were effective and 6 cases were ineffective, and the total effective rate was 87.5%.In the observation group, 15 cases were cured, 31 cases were effective and 2 cases were ineffective, and the total effective rate was 95.8%.The total effective rate of the observation group was higher than that of the control group, but there was no significant difference.Conclusion lTCM treatment of fat and ean typing is more conducive to regulating endocrine disorder and improving pregnancy rate in patients with PCOS.