加减温经汤对脾肾阳虚型卵巢早衰相关激素水平及预后的影响

Effects of Modified Wenjing Decoction( 加减温经汤) on Hormone Levels and Prognosis of Premature Ovarian Failure with Yang Deficiency of Spleen and Kidney

目的 探讨加减温经汤对脾肾阳虚型卵巢早衰患者血清内分泌激素水平以及预后的影响。方法 选择我院2017年1月-2021年1月收治的93例脾肾阳虚型卵巢早衰(Premature ovarian failure, POF)患者进行研究,采用随机数表通过简单随机方法将其分为研究组46例与对照组47例,对照组接受雌二醇地屈孕酮片(芬吗通)治疗,研究组在对照组的基础上,采用温经汤加减治疗,治疗周期均为3个月,比较两组治疗前后血清黄体生成素(Luteinizing hormone, LH)、雌二醇(Estradiol, E2)、孕酮(Progesterone, P)、催乳素(Prolactin, PRL)、睾酮(Testosterone, T)及卵泡生成素(Follicle stimulating hormone, FSH)、抗缪勒管激素(Antimullerian hormone, AMH)的水平,通过激素水平与中医证候指数综合评价治疗疗效,比较两组卵巢功能恢复情况以及不良反应发生情况。结果 治疗后两组FSH、LH、PRL、T水平均明显下降(P<0.05),E2、P、AMH水平均升高(P<0.05),研究组治疗后各激素水平与对照组比较,差异有统计学意义(P<0.05),研究组与对照组的总有效率分别为93.48%(43/46)和78.72%(37/47)(P<0.05),研究组治疗后卵巢体积(Ovarian volume, OV)、子宫内膜厚度、卵泡数量(Number of follicles, FN)以及卵巢血流收缩期峰值流速(Peak systolic velocity, PSV)均高于对照组(P<0.05),研究组与对照组不良反应分别为19.57%(9/46)和42.55%(20/47)(P<0.05)。结论 加减温经汤对脾肾阳虚型卵巢早衰具有明显的疗效,可显著改善雌激素水平,促进卵巢功能恢复,安全性高,适合在临床推广应用。

Objective To investigate the effect of Modified Wenjing Decoction(加减温经汤)on serum endocrine hormone levels and prognosis in patients with premature ovarian failure due to Yang deficiency of spleen and kidney.Methods A total of 93 patients with premature ovarian failure(POF)in the hospital from January 2017 to January 2021 were selected for research,and they were divided into study group(46 cases)and the control group(47 cases).The control group received estradiol-dydrogesterone tablets(Fenmoston)treatment.The study group was treated with Wenjing Decoction on the basis of the control group,and the treatment cycle was 3 months,and the serum levels of luteinizing hormone(LH),estradiol(E2),progesterone(P),prolactin(PRL),testosterone(T),follicle-stimulating hormone(FSH)and anti-mullerian hormone(AMH)were compared between the two groups before and after treatment.The therapeutic efficacy was evaluated through hormone levels and TCM syndrome index,and the recovery of ovarian function and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of FSH,LH,PRL and T in the two groups were significantly decreased(P<0.05),while the levels of E2,P and AMH were increased(P<0.05).After treatment,there was a statistically significant difference in hormone levels between the study group and the control group.The total effective rates of the study group and the control group were 93.48%(43/46)and 78.72%(37/47),respectively(P<0.05),and the ovarian volume(0V),endometrial thickness,fibronectin(FN)and peak saccadic velocity(PSV)of the study group were higher than those of the control group after treatment group(P<0.05).The incidences of adverse reactions in the study group and control group were 19.57%(9/46)and 42.55%(20/47),respectively(P<0.05).Conclusion Modified Wenjing Decoction has obvious curative effect on POF of Yang deficiency of spleen and kidney type,and can significantly improve the E2 level and promote the recovery of ovarian function.It is safe and suitable for clinical application.