温经汤不同剂型治疗卵巢储备功能减退的疗效分析

Analysis of therapeutic effect of different dosage forms of Wenjing Decoction on diminislied ovarian reserve

目的分析温经汤膏方、颗粒剂和饮片汤剂对寒凝血瘀型卵巢储备功能减退(DOR)患者的疗效差异。方法选取2021年2月至2022年1月海南省中医院收治的507例寒凝血瘀型DOR患者作为研究对象。随机分为饮片组(采用温经汤汤剂治疗)、颗粒剂组(采用温经汤免煎颗粒治疗)、膏方组(采用温经汤膏方治疗),每组169例。治疗后,比较三组的临床疗效,比较三组治疗前后中医证候评分,采用阴道超声测量并比较三组的卵巢体积(OV)、窦卵泡数(AFC),采用酶联免疫吸附试验法检测并比较三组的血清性激素[雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、抗米勒管激素(AMH)]水平。结果膏方组临床疗效优于饮片组和颗粒剂组,中医证候评分较饮片组、颗粒剂组显著降低,OV、AFC显著增加,血清E2、AMH水平显著升高,LH、FSH水平及FSH/LH比值显著降低,差异具有统计学意义(P<0.05)。颗粒剂组临床疗效优于饮片组,中医证候评分、血清LH、FSH水平显著低于饮片组,OV、AFC及血清E2、AMH水平较饮片组显著提升,差异具有统计学意义(P<0.05)。结论对于寒凝血瘀型DOR,采用温经汤膏方、颗粒剂、饮片汤剂治疗均能有效减轻患者症状,改善性激素水平,其中温经汤膏方的疗效最佳。

Objective To analyze the therapeutic effect of Wenjing Decoction cream formulae,granule and pieces on diminished ovarian reserve(DOR)patients with cold blood stasis syndrome.Methods A total of 507 patients with cold blood stasis syndrome DOR admitted to Hainan Provincial Hospital of Traditional Chinese Medicine from February 2021 to January 2022 were selected as the research subjects.They were randomly divided into decoction pieces group(treated with Wenjing Decoction),granule group(treated with Wenjing Free Decoction Granules),and cream formulae group(treated with Wenjing Cream Formulae),with 169 cases in each group.After treatment,the clinical efficacy of the three groups,the traditional Chinese medicine(TCM)syndrome scores before and after treatment were compared.The ovarian volume(OV)and antral follicle count(AFC)of the three groups were measured and compared by vaginal ultrasound.Enzyme linked immunosorbent assay was used to detect and compare the levels of serum sex hormones[estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),and anti-Müllerian hormone(AMH)]between the three groups.Results The clinical efficacy of the cream formula group was better than that of the decoction pieces group and the granule group,the TCM syndrome score was significantly reduced,OV and AFC were significantly increased,serum E2 and AMH levels are significantly increased,LH,FSH levels,and FSH/LH ratio were significantly reduced compared to the decoction pieces group and the granule group(P<0.05).The clinical efficacy of the granule group was better than that of the decoction pieces group,with significantly lower TCM syndrome scores,serum LH,FSH levels,and significantly higher OV,AFC,and serum E2,AMH levels compared to the decoction pieces group(P<0.05).Conclusions For DOR patients with cold blood stasis syndrome,Wenjing Cream Formula,Granules,and Decoction can effectively alleviate symptoms and improve sexual hormone levels.Among them,Wenjing Cream Formula has the best therapeutic effect.