许昕调治卵巢功能减退42例临床观察及用药分析

Clinical observation and prescription analysis of 42 cases of hypoovarianism treated by Xu Xin

目的 分析总结许昕调治卵巢功能减退的用药及机理,并进行疗效分析。方法 选取许昕治疗卵巢功能减退的病例42例,根据严重程度,以月经第2天血液激素检测卵泡期的卵泡刺激素(FSH)值,将病例分为2组:卵巢储备功能下降(DOR)组21例和早发性卵巢功能不全及卵巢功能衰竭(POI/POF)组21例。患者仅服用中药汤剂治疗,日1剂,200 mL,分2次服,经期不用药。观察2类患者治疗前后的孕产情况,月经情况、基础体温(BBT)、女性激素、卵巢体积、开始起效时间等,进而分析许昕调治卵巢功能用药及机理。结果 治疗后DOR组有10例患者受孕并全部顺利分娩;POI/POF组有4例患者受孕,其中3例顺利分娩,1例因个人原因终止妊娠。DOR组患者月经均恢复正常;POI/POF组有12例月经复常,占57.14%。DOR组患者BBT均呈双相改变;POI/POF组患者有15例BBT呈双相改变,占75%。2组患者的FSH、促黄体生成素(LH)均有下降,下降程度有明显差异;E2均有一定程度升高,其中,POI/POF组患者的E2升高幅度有统计学意义。治疗后患者的卵巢体积可有一定程度增大,其中POI/POF组患者的右侧卵巢体积在治疗前萎缩最为明显,治疗后体积增加最为明显,差异具有统计学意义(P<0.05)。结论 许昕以中药调治卵巢功能减退,有助于帮助患者孕产,并让月经恢复规律,基础体温和性激素也有一定的恢复。通过补肾、化浊、调畅气血,可以改善卵巢功能减退患者的月经情况、恢复卵巢功能、促进排卵、提高妊娠率和活产率,同时有可能改变血清学与卵巢形态学指标,即下调FSH、LH水平,升高E2水平,可能促使缩小的卵巢体积增加。

Objective To analyze and summarize the prescriptions and mechanism of Dr.Xu Xin in the treatment of hypoovarianism,and make further analysis of clinical efficacy.Methods 42 cases of hypoovarianism treated by Dr.Xu Xin were selected.According to the severity,the FSH value in the follicular phase was measured by the female hormone on the second day of menstruation.The cases were divided into two groups:21 cases in the decreased ovarian reserve(DOR)group and 21 in the premature ovarian insufficiency and ovarian failure(POI/POF)group.The patient was treated with traditional Chinese medicine decoctions only,one dose per day,200 ml,divided into two portions,to be consumed within one day.In addition,no drug was taken during the menstrual period.The pregnancy and childbirth,menstrual status,basal body temperature(BBT),female hormone,ovarian volume,and time onset of action of the two groups were observed,and then the prescriptions and mechanism of Dr.Xu Xin’s treatment were analyzed.Results After the treatment,10 patients in DOR group were pregnant and gave birth successfully;in the POI/POF group,4 were pregnant,of which 3 gave birth successfully,and 1 terminated her pregnancy due to personal reasons.The menstruation of the patients in DOR group returned to normal;in POI/POF group,12 cases(57.14%)had normal menstruation.BBT in DOR group showed biphasic changes;in the POI/POF group,15 patients(75%)showed biphasic changes in BBT.The levels of FSH and LH in the two groups decreased significantly;E2 increased to a certain extent.The increase of E2 in the POI/POF group was statistically significant.After the treatment,the ovarian volume of patients can be increased to a certain extent.The right ovaries of patients in POI/POF group had shrunk most significantly before treatment,and increased in volume most significantly after the treatment,and the statistical data suggested that it was statistically significant.Conclusion Dr.Xu Xin’s gynecological treatment of hypoovarianism is helpful for pregnancy and childbirth,and for restoring the regularity of menstruation.Recovery was also evident in the patients’basic body temperature and female hormone.By tonifying the kidney,removing turbidity,and restoring the free movement of qi and blood,the herbs can improve the menstrual status of the patients,restore ovarian function,promote ovulation,improve pregnancy rate and live birth rate,and may improve the serological and ovarian morphological indicators,by reducing the level of FSH and LH,and increasing the level of E2,increase the size of the shrunken ovaries.