补肾活血化痰方治疗肾虚血瘀痰阻证多囊卵巢综合征的临床疗效观察

Clinical Efficacy of Bushen Huoxue Huatan Decoction in the Treatment of Polycystic Ovary Syndrome with Kidney Deficiency,Blood Stasis,and Phlegm Stagnation Syndrome

目的:观察补肾活血化痰方(BHHD)治疗肾虚血瘀痰阻证多囊卵巢综合征(PCOS)的临床疗效。方法:选取2019年1月至2020年12月海军军医大学第一附属医院中医妇科收治的肾虚血瘀痰阻证患者225例作为研究对象,按照随机数字表法及受试患者入组的先后顺序分为对照组(n=112)和观察组(n=113)。分别给予BHHD和达英-35药物治疗,连续3个月,并于治疗后随访3个月。统计2组患者的排卵率;观察2组患者治疗后各项人体测量学指标、临床症状、中医证候、血清性激素、代谢相关指标的变化情况;分析2组患者子宫内膜、卵巢体积、窦卵泡个数及基质血流的变化情况。结果:与达英-35药物比较,BHHD可明显改善患者月经不调、经行腹痛、经色紫黯、腰膝酸软、头晕耳鸣、胸闷泛恶中医证候;可显著升高患者血清雌二醇、促卵泡素水平,降低患者血清胰岛素水平以及胰岛素曲线下面积;可明显增加患者子宫内膜厚度以及子宫动脉最大流速、卵巢动脉流速;可显著提升患者的周期排卵率,其临床总有效率为80.53%,显著高于达英35组(P<0.05)。结论:BHHD可有效改善肾虚血瘀痰阻证PCOS患者的临床症状、纠正其紊乱的内分泌水平,重塑子宫卵巢内环境,其疗效确切,安全性好。

Objective:To observe the clinical efficacy of the Bushen Huoxue Huatan Decoction(BHHD)in the treatment of polycystic ovary syndrome(PCOS)with kidney deficiency,blood stasis,and phlegm stagnation syndrome.Methods:A total of 225 PCOS patients with kidney deficiency,blood stasis,and phlegm stagnation syndrome treated at the Department of Traditional Chinese Medicine(TCM)Gynecology of the First Affiliated Hospital of Naval Medical University from January 2019 to December 2020 were enrolled and divided into a control group(n=112)and an observation group(n=113)according to a random number table and the order of patient enrollment.The control group was treated with Diane-35 medication,and the observation group was treated with BHHD for three consecutive months,followed by a three-month follow-up period.Ovulation rates were recorded in both groups.Changes in anthropometric measurements,clinical symptoms,TCM syndrome,serum hormones,and metabolism-related indicators were observed after treatment in both groups.Changes in endometrial thickness,ovarian volume,the number of antral follicles,and uterine artery blood flow were also analyzed.Results:Compared with Diane-35 medication,BHHD significantly improved menstrual irregularities,menstrual abdominal pain,dark menstrual blood,soreness and weakness of waist and knees,dizziness,tinnitus,and chest tightness with nausea in patients,increased serum estradiol and follicle-stimulating hormone levels,reduced serum insulin levels and the insulin area under the curve,increased endometrial thickness,uterine artery maximum flow velocity,and ovarian artery flow velocity,and markedly improved the ovulation rate in patients,with a clinical overall effective rate of 80.53%,which was significantly higher than that in the Diane-35 group(P<0.05).Conclusion:BHHD can effectively improve clinical symptoms in PCOS patients with kidney deficiency,blood stasis,and phlegm stagnation syndrome,correct their disrupted endocrine levels,and reshape the uterine and ovarian internal environment,demonstrating precise efficacy and good safety.