益经汤联合雌孕激素序贯疗法治疗肾虚肝郁证卵巢早衰临床研究

Clinical Study on Yijing Decoction Combined with Sequential Therapy of Estrogen and Progesterone for Premature Ovarian Failure with Syndrome of Kidney Deficiency and Liver Depression

目的:观察益经汤联合雌孕激素序贯疗法治疗肾虚肝郁证卵巢早衰(POF)的临床效果。方法:选择96例POF患者为研究对象,按照随机数字表法分为对照组和观察组各48例。对照组予雌孕激素序贯疗法治疗,观察组在对照组的基础上内服益经汤治疗。2组疗程均为6周。比较2组Kupperman评分、肾虚肝郁证证候评分、临床疗效及血清性激素指标[血清促卵泡生成激素(FSH)、促黄体生成激素(LH)、雌二醇(E_(2))、孕酮(P)、睾酮(T)、催乳激素(PRL)]水平变化。结果:观察组总有效率为89.58%,对照组为70.83%,组间比较,差异有统计学意义(P<0.05)。治疗前,2组Kupperman评分比较,差异无统计学意义(P>0.05);治疗后,2组Kupperman评分均较治疗前降低(P<0.05),且观察组Kupperman评分低于对照组(P<0.05)。治疗前,2组腰酸膝软、烘热汗出、精神抑郁、胸闷叹息、烦躁易怒等中医证候评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项证候评分均较治疗前降低(P<0.05),且观察组各项证候评分均低于对照组(P<0.05)。治疗前,2组血清FSH、LH、E_(2)、P、T、PRL水平比较,差异无统计学意义(P>0.05)。治疗后,2组FSH、LH水平均较治疗前降低(P<0.05),E_(2)水平较治疗前升高(P<0.05),且观察组上述3项指标改善较对照组更显著(P<0.05);而2组间P、T、PRL水平治疗前后变化不明显(P>0.05)。结论:益经汤联合雌孕激素序贯疗法治疗肾虚肝郁证POF,能改善患者症状体征及中医证候,有效调节血清性激素水平,疗效优于单纯西药治疗。

Objective:To observe the clinical effect of Yijing Decoction combined with sequential therapy of estrogen and progesterone on premature ovarian failure(POF)with syndrome of kidney deficiency and liver depression.Methods:A total of 96 POF patients were selected as research objects and divided into the control group and the observation group according to random number table method,with48 cases in each group.The control group was treated with sequential therapy of estrogen and progesterone,and the observation group was additionally treated with Yijing Decoction based on the treatment of the control group.The treatment course of the two groups was 6 weeks.The Kupperman scores,syndrome scores of kidney deficiency and liver depression,clinical effects and serum sex hormone indexes,including serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),progesterone(P),testosterone(T)and prolactin(PRL),were compared in the two groups.Results:The total effective rate was 89.58% in the observation group and 70.83% in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference in the Kupperman score between the two groups(P>0.05).After treatment,the Kupperman scores in the two groups were decreased when compared with those before treatment(P<0.05),and the Kupperman score in the observation group was lower than that in the control group(P<0.05).Before treatment,there was no significant difference in traditional Chinese medicine(TCM)syndrome scores between the two groups,such as waist soreness and knee weakness,hot flashes and sweating,mental depression,chest oppression and sighing,vexation and agitation,and irascibility(P>0.05);after treatment,the scores of the above syndromes in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of the above syndromes in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in serum levels of FSH,LH,E_(2),P,T and PRL between the two groups(P>0.05).After treatment,the FSH and LH levels in the two groups were decreased when compared with those before treatment(P<0.05),and the E_(2)levels were increased when compared with those before treatment(P<0.05),and the above three levels in the observation group were improved more significantly than those in the control group(P<0.05).There were no significant changes in the P,T and PRL levels between the two groups before and after treatment(P>0.05).Conclusion:Yijing Decoction combined with sequential therapy of estrogen and progesterone can improve the symptoms and signs of TCM syndromes and effectively regulate the levels of serum sex hormones in POF patients with syndrome of kidney deficiency and liver depression,whose effect is better than that of western medicine alone.