调经2号加减方联合西药治疗肾虚痰瘀型多囊卵巢综合征临床研究

Clinical Study on the Treatment of Polycystic Ovary Syndrome of Kidney Deficiency and Phlegm Stasis Type with Modified Tiaojing No.2 Recipe Combined with Western Medicine

目的观察调经2号加减方联合西药治疗肾虚痰瘀型多囊卵巢综合征伴胰岛素抵抗(polycystic ovary syndrome with insulin resistance,PCOS-IR)的临床疗效。方法将90例肾虚痰瘀型PCOS-IR患者随机分为3组,每组30例。治疗组予调经2号加减方联合炔雌醇环丙孕酮片与二甲双胍片治疗,对照组1予炔雌醇环丙孕酮片与二甲双胍片治疗,对照组2予调经2号加减方治疗,3组均治疗3个月后进行疗效评估。比较3组中医证候疗效,中医证候评分,痤疮评分,促黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle-stimulating hormone,FSH)、睾酮(testosterone,T)、LH/FSH比值等性激素水平,以及空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(HOMA insulin resistance,HOMA-IR)和血脂指标等的变化,并比较3组双侧卵巢体积和窦卵泡数目的变化。结果治疗后,治疗组总有效率为93.33%,显著高于对照组1(66.67%)和对照组2(63.33%),组间比较,差异具有统计学意义(P均<0.05);与对照组1和对照组2比较,治疗组中医证候评分、痤疮评分、LH、T、LH/FSH比值等明显降低(P均<0.05),FSH明显升高(P均<0.05);治疗组FBG、FINS、HOMA-IR和血脂指标等的改善程度明显优于对照组1和对照组2(P均<0.05)。结论调经2号加减方联合炔雌醇环丙孕酮片与二甲双胍片治疗肾虚痰瘀型PCOS-IR效果显著,能有效降低患者的中医证候评分、痤疮评分及胰岛素抵抗,改善性激素及糖脂代谢水平,提高临床疗效。

Objective To observe the clinical efficacy of modified Tiaojing No.2 recipe combined with western medicine in the treatment of polycystic ovary syndrome with insulin resistance(PCOS-IR)of kidney deficiency and phlegm stasis type.Methods Ninety PCOS-IR patients with kidney deficiency and phlegm stasis were randomly divided into 3 groups,with 30 cases in each group.The treatment group was treated with modified Tiaojing No.2 recipe combined with ethinylestradiol cyproterone tablets and metformin tablets,while the control group 1 was treated with ethinylestradiol cyproterone tablets and metformin tablets,and the control group 2 was treated with modified Tiaojing No.2 recipe.The clinical efficacy of the three groups were evaluated after three months of treatment.The efficacy of TCM syndrome,TCM syndrome scores,acne scores,levels of sex hormone such as luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),LH/FSH ratio,and fasting blood glucose(FBG),fasting insulin(FINS),HOMA insulin resistance(HOMA-IR)and blood lipid indicators were compared among the three groups.Besides,the changes in bilateral ovarian volume and numbers of antral follicles were compared among the three groups.Results After treatment,the total effective rate of the treatment group was 93.33%,which was significantly higher than that of control group 1(66.67%)and control group 2(63.33%)(all P<0.05).Compared with control group 1 and control group 2,the TCM syndrome scores,acne scores,levels of LH and T,and LH/FSH ratio in the treatment group were significantly decreased(all P<0.05),while FSH was significantly increased(all P<0.05).The improvement of FBG,FINS,HOMA-IR,and blood lipid indicators in the treatment group were significantly better than those in control group 1 and control group 2(all P<0.05).Conclusion The combination of modified Tiaojing No.2 recipe and ethinylestradiol cycloproterenone tablets and metformin tablets had a significant effect on the treatment of PCOS-IR of kidney deficiency and phlegm stasis type.It can effectively reduce the TCM syndrome scores,acne scores,and insulin resistance of patients,ameliorate sexual hormone and glucose lipid metabolism,and improve clinical efficacy.