疏肝补肾结合调经促孕针刺治疗卵巢早衰临床观察

Clinical Effect of Soothing Liver and Tonifying Kidney Method Combined with Acupuncture for Regulating Menstruation and Promoting Pregnancy on Premature Ovarian Failure

目的观察疏肝补肾结合调经促孕针刺治疗卵巢早衰的临床疗效。方法纳入医院收治的65例卵巢早衰患者(2022年1月—2022年8月收治)进行随机分组研究,将患者以随机数字表法分为对照组(32例)与治疗组(33例),对照组患者口服坤泰胶囊治疗,治疗组患者口服坤泰胶囊治疗,并结合疏肝补肾法+调经促孕针刺法治疗,两组数据观察:治疗效果、治疗前后患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)变化、卵巢体积与子宫体积、子宫内膜厚度变化、性激素水平变化、免疫功能指标变化、抑郁自评量表评分(SDS)变化、不良反应。结果治疗组患者治疗总有效率(93.94%,31/33)显著高于对照组患者(75.00%,24/32),P<0.05;治疗前,各组患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、促黄体生成素(luteinizing hormone,LH)以及促卵泡生成素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_(2))等性激素水平、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分等比较,P>0.05,治疗后各组患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、LH及FSH、E_(2)、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分均改善,治疗组患者治疗后中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、LH及FSH、E_(2)、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分均优于对照组,P<0.05;各组均未见严重不良反应,P>0.05。结论疏肝补肾法结合调经促孕针刺法治疗卵巢早衰临床疗效显著,患者症状及卵巢功能、免疫功能及心理状态均改善,无不良反应,安全可靠。

Objective To observe the clinical effect of soothing liver and tonifying kidney method combined with acupuncture for regulating menstruation and promoting pregnancy in the treatment of premature ovarian failure.Methods A total of 65 patients with premature ovarian failure admitted to the hospital from January 2022 to August 2022 were randomly divided into the control group(32 cases)and the treatment group(33 cases)according to the random number table method.The patients in the control group were treated with Kuntai Capsule(坤泰胶囊)orally,while those in the treatment group were treated with Kuntai Capsule and soothing liver and tonifying kidney method combined with acupuncture for regulating menstruation and promoting pregnancy.The treatment effect,the changes in various points of traditional Chinese medicine(TCM)syndrome scores(amenorrhea or men-strual disorders,vaginal dryness,irritability,decreased libido,etc.)before and after treatment,the changes in ovarian volume and uterine volume,the changes in endometrial thickness,the changes in sex hormone levels,the changes in immune function indica-tors,the changes in Self Rating Depression Scale(SDS)scores and adverse reactions were observed.Results The total effective rate of the treatment group(93.94%,31/33)was significantly higher than that of the control group(75.00%,24/32)(P<0.05).Before treatment,traditional Chinese medicine syndrome scores(amenorrhea or menstrual disorders,vaginal dryness,irri-tability,decreased libido,etc.),ovary volume and uterus volume,endometrial thickness,luteinizing hormone(LH)and follicle-stimulating hormone(FSH),estradiol(E 2)and sex hormone levels and immune function index(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))and SDS score had no significance(P>0.05).After treatment,the scores of TCM syndromes(amenorrhea or menstrual disorders,va-ginal dryness,irritability,decreased libido,etc.),ovarian volume and uterine volume,endometrial thickness,LH and FSH,E_(2),im-mune function indexes(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))and SDS scores were improved in both groups.And those of the treatment group were better than those of the control group(P<0.05).There were no serious adverse reactions in both groups(P>0.05).Con-clusion The method of soothing liver and tonifying kidney combined with acupuncture for regulating menstruation and promoting pregnancy in the treatment of premature ovarian failure has significant clinical effect.The symptoms,ovarian function,immune function and psychological state of the patients are improved without adverse reactions,which is safe and reliable.