加味左归丸联合雌孕激素序贯治疗对早发性卵巢功能不全患者子宫动脉血流动力学、氧化应激和免疫因子的影响

Effects of Jiawei Zuogui Pill Combined with Estrogen and Progesterone Sequential Treatment on the Hemodynamics, Oxidative Stress and Immune Factors of Uterine Artery in Patients with Premature Ovarian Insufficiency

目的:探讨加味左归丸联合雌孕激素序贯治疗对早发性卵巢功能不全(POI)患者子宫动脉血流动力学、氧化应激和免疫因子的影响。方法:纳入我院2019年10月-2021年10月期间收治的100例POI患者,按照随机数字表法分为对照组(雌孕激素序贯治疗,50例)和研究组(加味左归丸联合雌孕激素序贯治疗,50例)。对比两组中医证候积分、子宫动脉血流动力学、氧化应激指标、性激素指标和免疫因子指标。结果:两组治疗后月经周期、月经量、腰膝酸软、潮热盗汗、头晕耳鸣、阴道干涩、失眠多梦、五心烦热、性欲降低评分均下降,且研究组低于对照组(P<0.05)。两组治疗后子宫动脉收缩期峰值流速(Vmax)升高,搏动指数(PI)、阻力指数(RI)下降,且研究组的变化程度大于对照组(P<0.05)。两组治疗后血清丙二醛(MDA)下降,谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)升高,且研究组的变化程度大于对照组(P<0.05)。两组治疗后雌二醇(E2)升高,促黄体生成素(LH)、促卵泡生成激素(FSH)下降,且研究组的变化程度大于对照组(P<0.05)。两组治疗后NK细胞、CD8^(+)下降,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高,且研究组的变化程度大于对照组(P<0.05)。结论:加味左归丸联合雌孕激素序贯治疗POI患者,可有效改善子宫动脉血流动力学、性激素、氧化应激和免疫功能,促进患者恢复。

Objective: To investigate the effects of Jiawei Zuogui pill combined with estrogen and progesterone sequential treatment on the hemodynamics, oxidative stress and immune factors of uterine artery in patients with premature ovarian insufficiency(POI).Methods: 100 patients with POI who were admitted to our hospital from October 2019 to October 2021 were included, they were and divided into control group(estrogen and progesterone sequential treatment, 50 cases) and study group(Jiawei Zuogui pill combined with estrogen and progesterone sequential treatment, 50 cases) according to random number table method. The traditional Chinese medical syndrome score, uterine arterial blood flow mechanics, oxidative stress indexes, sex hormone indexes and immune factor indexes were compared in the two groups. Results: After treatment, the scores of menstrual cycle, menstrual volume, soreness of waist and knees, hot flashes and night sweats, dizziness and tinnitus, vaginal dryness, insomnia and dreaminess, five heart upset fever, and decreased sexual desire in two groups decreased, and the study group was lower than the control group(P<0.05). After treatment, the uterine artery peak systolic velocity(Vmax) in the two groups increased, while the pulsation index(PI) and resistance index(RI) decreased, the change degree in the study group was greater than that in the control group(P<0.05). After treatment, serum malondialdehyde(MDA) in the two groups decreased, glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD) increased, and the change degree in the study group was greater than that in the control group(P<0.05). After treatment, estradiol(E2) in the two groups increased, luteinizing hormone(LH)and follicle stimulating hormone(FSH) decreased, and the change degree in the study group was greater than that in the control group(P<0.05). NK cells and CD8^(+)in the two groups after treatment decreased, and CD3^(+), CD4^(+), CD4^(+)/CD8^(+)increased, and the change degree in the study group was greater than that in the control group(P<0.05). Conclusion: The Jiawei Zuogui pill combined with estrogen and progesterone sequential treatment of patients with POI can effectively improve uterine artery hemodynamics, sex hormones, oxidative stress and immune function, and promote patient recovery.