滋肾安坤颗粒治疗肾虚精亏型卵巢功能减退类疾病临床观察

Clinical efficacy of ZishenAnkun granule in treating ovarian dysfunction diseases of kidney essence deficiency type

目的观察滋肾安坤颗粒治疗肾虚精亏型卵巢功能减退类疾病临床疗效。方法应用滋肾安坤颗粒治疗卵巢储备功能减退(DOR)、早发性卵巢功能不全(POI)共计70例,治疗6个月,分别于治疗3、6个月评价月经周期、月经量及中医证候疗效,观察中医证候评分、性激素、抗苗勒管激素(AMH)、窦卵泡数(AFC)变化。结果治疗3、6个月月经周期改善疗效总有效率分别为58.33%(35/60)、75.86%(44/58),治疗3、6个月月经量改善疗效总有效率分别为62.50%(30/48)、80.43%(37/46),治疗3、6个月中医证候疗效总有效率分别为60.00%(42/70)、80.88%(55/68)。本组DOR患者治疗3个月月经周期、月经量、月经色质、腰膝酸软、面色无华、失眠健忘、大便干燥评分均较本组治疗前降低(P<0.05),治疗6个月月经周期、月经量、月经色质、潮热汗出、腰膝酸软、面色无华、失眠健忘、大便干燥评分均较本组治疗前降低(P<0.05),治疗6个月月经周期、月经量、月经色质、潮热汗出、失眠健忘评分较治疗3个月降低(P<0.05)。本组POI患者治疗3个月月经周期、月经量、月经色质、腰膝酸软、面色无华、大便干燥评分较治疗前降低(P<0.05),治疗6个月月经周期、月经量、月经色质、潮热汗出、腰膝酸软、面色无华、失眠健忘、大便干燥评分均较本组治疗前降低(P<0.05),治疗6个月月经周期、月经色质、潮热汗出、面色无华评分均较治疗3个月降低(P<0.05)。本组DOR患者,治疗3、6个月卵泡刺激素(FSH)均较治疗前降低(P<0.05),雌二醇(E_(2))较治疗前升高(P<0.05);治疗6个月黄体生成激素(LH)较治疗前降低(P<0.05)。治疗6个月FSH、LH均较治疗3个月降低(P<0.05),治疗6个月E_(2)较治疗3个月升高(P<0.05)。本组POI患者治疗3、6个月FSH均较治疗前降低(P<0.05),治疗6个月LH较治疗前降低(P<0.05),E_(2)较治疗前升高(P<0.05);治疗6个月FSH较治疗3个月降低(P<0.05),E_(2)较治疗3个月升高(P<0.05)。本组DOR患者治疗6个月血清AMH水平高于治疗前(P<0.01);本组POI患者治疗前与治疗6个月血清AMH水平比较差异无统计学意义(P>0.05)。25例DOR患者治疗6个月AFC较治疗前升高(P<0.01)。结论滋肾安坤颗粒治疗肾虚精亏型DOR、POI,可调节月经周期及月经量,改善血清性激素水平和卵巢储备功能,减轻临床症状。

Objective To observe the clinical efficacy of ZishenAnkun granule in the treatment of ovarian dysfunction diseases of kidney essence deficiency type.Methods Seventy patients diagnosed with diminished ovarian reserve(DOR)or premature ovarian insufficiency(POI)were treated by ZishenAnkun granules for 6 months.The 3-month and 6-month effects,traditional Chinese medicine(TCM)symptoms,sex hormones,as well as antral follicle count(AFC)were included as comparisons.Results To compare the efficacy of 3-month versus 6-month,the total improve rate of menstrual cycle was 58.33%(35/60)vs 75.86%(44/58),the total improvement rate of menstrual volume was 62.50%(30/48)vs 80.43%(37/46),and the total effective rate of TCM syndrome was 60.00%(42/70)vs 80.88%(55/68).The 3-month TCM symptom scores(menstrual cycle,menstrual volume,menstrual color,lumbar and knee weakness,colorless face,insomnia and forgetfulness,dry stool)of DOR patients were lower than those before treatment(P<0.05).The 6-month TCM symptom scores(menstrual cycle,menstrual volume,menstrual color,hot flashes and sweating,lumbar and knee weakness,Colorless face,insomnia and forgetfulness,dry stool)of DOR patients were lower than those before treatment(P<0.05).TCM symptom scores(menstrual cycle,menstrual volume,menstrual color,hot flashes and sweating,insomnia and forgetfulness)of DOR patients were lower in 6-month versus 3-month.The 3-month TCM symptom scores(menstrual cycle,menstrual volume,menstrual color,lumbar and knee weakness,colorless face,dry stool)of POI patients were lower than those before treatment(P<0.05).The 6-month TCM symptom scores(menstrual cycle,menstrual volume,menstrual color,hot flashes and sweating,lumbar and knee weakness,colorless face,insomnia and forgetfulness,dry stool)of POI patients were lower than those before treatment(P<0.05).TCM symptom scores(menstrual cycle,menstrual color,hot flashes and sweating,Colorless face)of POI patients were lower in 6-month versus 3-month.The 3-month and 6-month follicle stimulating hormone(FSH)of DOR patients and POI patients was lower than those before treatment(P<0.05).The 6-month luteinizing hormone(LH)was lower(P<0.05),6-month estradiol(E_(2))was higher(P<0.05),Decreased FSH and LH and increased E_(2) were found in DOR patients and POI patients in 6-month versus 3-month(P<0.05).The 6-month serum anti-Mullerian hormone(AMH)level of DOR patients was higher than that before treatment(P<0.01).There was no significant difference in AMH level of POI patients between before treatment and 6 months after treatment(P>0.05).The 6-month AFC level of 25 patients with DOR was higher than that of them before treatment(P<0.01).Conclusion For patients with DOR and POI of kidney essence deficiency type,ZishenAnkun granule can effectively regulate menstrual cycle and menstrual volume,improve serum sex hormone level and ovarian reserve function,and relieve clinical symptoms.