温经汤对寒凝血瘀型卵巢储备功能减退中医证候及卵巢功能的影响

Effect of Wenjing Decoction(温经汤)on Traditional Chinese Medicine Symptoms and Ovarian Function of Patients with Decreased Ovarian Reserve Function of Cold-Coagulation and Blood-Stasis Type

目的探讨温经汤对寒凝血瘀型卵巢储备功能减退(Decreased ovarian reserve,DOR)患者中医证候及卵巢功能的影响。方法选取200例寒凝血瘀型卵巢储备功能减退患者,随机分为对照组与观察组,每组100例,对照组给予戊酸雌二醇片、地屈孕酮片口服治疗,观察组给予温经汤口服治疗,疗程3个月,观察治疗前后中医证候积分及卵巢功能变化。结果两组患者治疗前中医证候积分比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组积分低于对照组(P<0.05);两组患者治疗前促卵泡生成素(follicle-stimulating hormone,FSH)、促黄体生成素(Luteinizing hor⁃mone,LH)、雌二醇(Estradiol,E2)、抗苗勒管激素(Anti Mullerian hormone,AMH)水平比较差异无统计学意义(P>0.05),治疗后FSH、LH下降(P<0.05),且观察组低于对照组(P<0.05),治疗后E2、AMH升高(P<0.05),且观察组高于对照组(P<0.05);两组患者治疗前卵巢体积(Ovarian volume,OV)、窦卵泡数(Antral Follicle Counting,AFC)比较差异无统计学意义(P>0.05),治疗后增加(P<0.05),且观察组大于对照组(P<0.05);两组患者治疗前卵巢动脉收缩期峰值流速(peak systolic velocity,PSV)、阻力指数(Resistance index,RI)、搏动指数(Pulsatility index,PI)水平比较差异无统计学意义(P>0.05),治疗后RI、PI下降,且观察组低于对照组(P<0.05),治疗后PSV升高(P<0.05),观察组高于对照组(P<0.05);观察组治疗疗效整体优于对照组(P<0.05),治疗总有效率为91.00%(91/100)高于对照组80.00%(80/100)(P<0.05)。结论温经汤可有效改善寒凝血瘀型卵巢储备功能减退患者中医证候,改善卵巢功能,疗效显著。

Objective To investigate the effect of Wenjing Decoction(温经汤)on traditional Chinese medicine(TCM)symp⁃toms and ovarian function of patients with decreased ovarian reserve function of cold-coagulation and blood-stasis type.Meth⁃ods A total of 200 cases of decreased ovarian reserve function of cold-coagulation and blood-stasis type were collected and ran⁃domly divided into control group and observation group,100 cases in each group.The control group was given estradiol valerate tablets and dydrogesterone tablets and the observation group was given Wenjing Decoction.The course of treatment was 3 months,and the changes of TCM symptom score and ovarian function were observed before and after treatment.Results There was no significant difference in scores of TCM symptoms between the two groups before treatment(P>0.05)and the scores of the two groups decreased after treatment(P<0.05).The score of the observation group was lower than that of the control group(P<0.05).There was no significant difference in follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)or anti-mullerian hormone(AMH)between the two groups before treatment(P>0.05).The levels of FSH and LH of two groups decreased after treatment(P<0.05)and the levels of FSH and LH of observation group were lower than those of the control group(P<0.05).The levvels of E2 and AMH of two groups increased after treatment(P<0.05),and levels of the observation group were higher than those of the control group(P<0.05).There was no significant difference in ovarian volume(OV)or bas⁃al antral follicle count(AFC)between the two groups before treatment(P>0.05).The values of OV and AFC of two groups in⁃creased after treatment(P<0.05)and those of the observation group were higher than those of the control group(P<0.05).There was no significant difference in systolic peak flow rate(PSV),resistance index(RI)or pulsatile index(PI)of arteriae ovar⁃ica between the two groups before treatment(P>0.05).The values of RI and PI of two groups decreased after treatment(P<0.05)and those of the observation group were lower than those of the control group(P<0.05).PSV increased after treatment compared with that before treatment of the two groups(P<0.05)and that of the observation group was higher than that of the control group(P<0.05).The therapeutic effect of the observation group was better than that of the control group(P<0.05),and the total effective rate was 91.00%(91/100)in the observation group,higher than that 80.00%(80/100)of the control group(P<0.05).Conclusion Wenjing Decoction can effectively improve TCM symptoms and ovarian function and the effect is remarkable.