益肾调经汤联合西药治疗肾虚血瘀型卵巢储备功能减退的疗效及对血清E_(2)、FSH的影响

Effect of Yishen Tiaojing Decoction and Western Medicine on Decreased Ovarian Reserve of Renal Deficiency and Blood Stasis Type and Its Effect on Serum E_(2) and FSH

目的探讨益肾调经汤联合西药治疗肾虚血瘀型卵巢储备功能减退(DOR)的疗效及对血清雌二醇(E_(2))、促卵泡激素(FSH)的影响。方法回顾性分析2020年8月至2021年7月在北京中医药大学第三附属医院进行诊治的78例肾虚血瘀型DOR患者的临床资料,按照治疗方法不同分为对照组和观察组,每组39例。所有患者均给予常规生活方式干预,包括饮食、生活作息合理、调节情志等。其中,对照组给予戊酸雌二醇片/雌二醇环丙孕酮片复合包装治疗,按照先11片白片,后10片粉红色片的顺序口服,每日1片,无间断的服用21 d;观察组在对照组的基础上给予益肾调经汤治疗,两组均进行3个月经周期的治疗。对两组患者的临床疗效、中医证候(月经错后、经期少腹痛及颜色暗或紫等)积分、性激素(E_(2)、FSH)、抗缪勒管激素(AMH)水平等进行比较。结果观察组的总有效率高于对照组[97.44%(38/39)比74.36%(29/39)](P<0.05)。治疗后,两组的月经错后、经期少腹痛及经色暗或紫等中医证候评分均低于治疗前(P<0.05),且观察组低于对照组(P<0.01)。治疗后,两组的E_(2)水平高于治疗前,FSH低于治疗前(P<0.05);且观察组的E_(2)水平高于对照组,FSH水平低于对照组(P<0.01)。治疗后,两组的AMH水平高于治疗前(P<0.05),且观察组高于对照组(P<0.01)。观察组的总不良反应发生率低于对照组[2.56%(1/39)比15.83%(6/39)](P<0.05)。结论益肾调经汤联合西药使用对DOR患者疗效确切,可以对患者临床症状起到缓解作用,能有效改善性激素水平,是一种治疗DOR比较理想的手段。

Objective To explore the efficacy of Yishen Tongjing decoction combined with western medicine in the treatment of decreased ovarian reserve(DOR)of renal deficiency and blood stasis type and its effects on serum estradiol(E_(2))and follicle stimulating hormone(FSH).Methods A retrospective collection included 78 cases of DOR of renal deficiency and blood stasis type who came to Beijing University of Chinese Medicine Third Affiliated Hospital from Aug.2020 to Jul.2021,and divided them into a control group and an observation group according to different treatment methods,39 cases in each group.Routine interventions were given to all the patients,including reasonable diet,reasonable living schedule,and emotional conditioning,etc.The control group was given estradiol valerate tablets/estradiol cyproterone tablets combined packaging treatment,oral administration in the order of 11 white tablets first,then 10 pink tablets,1 tablet per day,21 d without interruption;the observation group was given theYishen Tiaojing decoction treatment on the basis of the control group,and both groups were treated for 3 menstrual cycles.The clinical efficacy,integral of traditional Chinese medicine(TCM)syndromes(delayed menstruation,menstrual hypogastric pain,dark or purple menstrual blood,etc.),sex hormones(E_(2),FSH),and anti-Müllerian hormone(AMH)levels of the two groups were compared.Results The total effective rate in the observation group was higher than that in the control group[97.44%(38/39)vs 74.36%(29/39)](P<0.05).After treatment,the scores of TCM syndromes such as delayed menstruation,menstrual hypogastric pain and dark or purple menstrual blood were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.01).After treatment,the E_(2) levels in both groups were higher than those before treatment,and the FSH levels were lower than those before treatment(P<0.05);and the observation group had higher E_(2) level and lower FSH level than the control group(P<0.01).After treatment,the AMH levels were elevated in both groups compared with before treatment(P<0.05),and the observation group was higher than the control group(P<0.01).The overall incidence of adverse reactions in the observation group was lower than that in the control group[2.56%(1/39)vs 15.83%(6/39)](P<0.05).Conclusion The combined use of Yishen Tiaojing decoction and western medicine in DOR patients has definite effect,and can relieve the clinical symptoms and effectively improve the level of sex hormones,thus is an ideal treatment for DOR.