益肾疏肝汤治疗卵巢储备功能下降所致月经过少病

Yishen Shugan Decoction in Treatment of Oligodynia Caused by Decreased Ovarian Reserve Function

目的:观察益肾疏肝汤治疗卵巢储备功能下降(diminished ovarian reserve, DOR)月经过少病患者的临床疗效。方法:将60例患者随机分为试验组、对照组,各30例。试验组口服益肾疏肝汤颗粒剂,对照组口服安慰剂治疗,共3个月经周期。记录两组患者治疗前后月经量、中医症状积分、血清激素水平、子宫内膜厚度、内膜下血流阻力指数,比较两组临床疗效及安全性。结果:54例患者完成研究,其中试验组28例,对照组26例。试验组治疗后月经量较治疗前及对照组明显增加(P<0.05);试验组治疗后中医症状总积分、各单项评分较治疗前及对照组明显降低(P<0.05);试验组血清卵泡刺激素(follicle stimulating hormone, FSH)水平较治疗前及对照组明显降低(P<0.05),抗缪勒管激素(anti-Müllerian hormone, AMH)较治疗前及对照组明显升高(P<0.05),窦卵泡数较治疗前及对照组明显增多(P<0.05)。子宫内膜厚度较治疗前及对照组显著增加(P<0.05),内膜下血流阻力指数(resistance index, RI)较治疗前及对照组均显著降低(P<0.05)。试验组和对照组有效率分别为75%(21/28)和26.9%(7/26),两组比较差异有统计学意义(P<0.05)。两组患者观察期间均未见不良反应。结论:益肾疏肝汤治疗肾虚肝郁型DOR,不仅能增加月经量,改善患者临床症状,还能改善激素水平,增加子宫内膜厚度及改善内膜下血流情况。

Objective: To observe the clinical effect of Yishen Shugan Decoction on patients of diminishes DOR.Methods: 60 patients were randomly divided into experimental group and control group, with 30 cases in each group.The experimental group was treated with Yishen Shugan Decoction granules, while the control group was treated with placebo.Menstrual volume, TCM symptom score, serum hormone level, endometrial thickness and sub-endometrial blood flow resistance index were recorded before and after treatment in the two groups, and the clinical efficacy and safety of the two groups were compared.Results: 54 patients completed the study, including 28 patients in experimental group and 26 patients in control group.The menstrual volume of experimental group after treatment was significantly increased compared with that before treatment and control group(P<0.05).The total score and individual scores of TCM symptoms of experimental group after treatment were significantly lower than those before treatment and control group(P<0.05);Patients serum levels of follicle-stimulating hormone(FSH) before the treatment and the control group significantly decreased(P<0.05),anti mullerian hormone(AMH) before the treatment and control group increased significantly(P<0.05),The number of sinus follicles was significantly increased compared with that before treatment and control group(P<0.05).The endometrial thickness was significantly increased compared with before treatment and control group(P<0.05),and the sub-endometrial blood flow resistance index(RI) was significantly decreased compared with before treatment and control group(P<0.05).The effective rate of the experimental group and the control group was 75%(21/28) and 26.9%(7/26),respectively, and the difference between the two groups was statistically significant(P<0.05).No adverse reactions were observed in both groups during observation.Conclusion: Yishen Shugan Decoction can not only increase menstrual volume and improve clinical symptoms, but also improve hormone levels, endometrial thickness and sub-endometrial blood flow in the treatment of kidney deficiency and liver depression type DOR.