自拟抗早衰汤联合针刺治疗肝郁肾虚型早发性卵巢功能不全患者的临床效果

Clinical effect of self-prepared Kangzaoshuai Decoction combined with acupuncture for treating patients with premature ovarian insufficiency in type of liver qi stagnation and kidney deficiency

目的探讨自拟抗早衰汤联合针刺治疗肝郁肾虚型早发性卵巢功能不全(POI)的临床效果。方法选取70例肝郁肾虚型POI患者作为研究对象,将其随机分对照组和观察组,每组35例。给予对照组雌孕激素序贯治疗,给予观察组自拟抗早衰汤联合针刺治疗。比较两组患者治疗前后的中医证候积分、卵巢功能(卵巢体积、窦卵泡数、排卵周期)、子宫内膜厚度,以及血清性激素[促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇]、抗苗勒管激素(AMH)、炎症因子[肿瘤坏死因子α(TNF-α)、γ干扰素]水平。治疗结束后比较两组的临床疗效,并记录两组患者在治疗期间的不良反应发生情况。结果治疗后,两组患者的中医证候积分较治疗前降低,卵巢体积、窦卵泡数和子宫内膜厚度较治疗前增加,排卵周期较治疗前缩短,血清FSH、LH、TNF-α、γ干扰素水平较治疗前降低,血清雌二醇、AMH水平较治疗前升高,且观察组上述指标优于对照组(P<0.05)。观察组的总有效率高于对照组(P<0.05)。两组患者治疗期间不良反应发生率差异无统计学意义(P>0.05)。结论自拟抗早衰汤联合针刺治疗肝郁肾虚型POI患者疗效确切,能改善临床症状,增加子宫内膜厚度,提高卵巢功能,调节性激素水平,抑制炎症反应,效果优于雌孕激素序贯治疗,且安全性良好。

Objective To explore the clinical effect of self-prepared Kangzaoshuai Decoction combined with acupuncture for treating patients with premature ovarian insufficiency(POI)in type of liver qi stagnation and kidney deficiency.Methods A total of 70 patients with POI in type of liver qi stagnation and kidney deficiency were selected as the research subjects,and they were randomly divided into control group or observation group,with 35 cases in each group.The control group received estradiol and progesterone hormones sequential therapy,while the observation group was treated with self-prepared Kangzaoshuai Decoction combined with acupuncture.The pre-and post-treatment Traditional Chinese Medicine syndrome score,ovarian function(ovarian volume,number of antral follicles,ovulation cycle),and endometrial thickness,as well as the levels of serum sex hormones(follicle stimulating hormone[FSH],luteinizing hormone[LH],estradiol),anti-Müllerian hormone(AMH),and inflammatory factors(tumor necrosis factorα[TNF-α],γ-interferon)were compared between patients of the two groups.The clinical efficacy after the end of treatment was compared between the two groups,and the occurrence of adverse reactions during treatment were recorded in both groups.Results After treatment,the Traditional Chinese Medicine syndrome score was decreased as compared with before treatment,ovarian volume,number of antral follicles,and endometrial thickness of the two groups were elevated as compared with before treatment,ovulation cycle of the two groups was shorter than that before treatment,levels of serum FSH,LH,TNF-α and γ-interferon in the two groups were decreased as compared with before treatment,while serum estradiol and AMH levels in the two groups were elevated as compared with before treatment,and the observation group exhibited superior indices as above as compared with the control group(P<0.05).The observation group yielded a higher total effective rate as compared with the control group(P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions during treatment between the two groups(P>0.05).Conclusion Self-prepared Kangzaoshuai Decoction combined with acupuncture exerts a definite efficacy for the treatment of POI patients in type of liver qi stagnation and kidney deficiency,which can ameliorate clinical symptoms,increase endometrial thickness,improve ovarian function,regulate the levels of sex hormones,inhibit inflammatory responses,and the effect is superior to estradiol and progesterone hormones sequential therapy,exerting a favorable safety.