左归丸加减结合温针灸治疗早发性卵巢功能不全临床研究

Clinical Effect of Modified Zuogui Pill(左归丸加减)Combined with Warm Acupuncture and Moxibustion in Treatment of Premature Ovarian Insufficiency

目的观察左归丸加减结合温针灸治疗早发性卵巢功能不全临床疗效。方法研究纳入2020年1月—2022年7月收治的81例早发性卵巢功能不全患者进行分组研究,以随机数字表法分为观察组(41例)与对照组(40例),对照组患者采取雌孕激素序贯疗法治疗,观察组患者采取雌孕激素序贯疗法治疗+左归丸加减结合温针灸治疗,各组数据对比:临床疗效、治疗前后中医证候(五心烦热、腰膝酸软、闭经、头晕及潮热盗汗等)积分变化及卵泡刺激素(Follicle-stimulating hormone,FSH)、黄体生成素(Luteinizing hormone,LH)以及雌二醇(Estradial,E_(2))等水平变化、窦卵泡数以及卵巢面积、卵巢平均直径等指标变化、血清免疫球蛋白A/G/M(Immuno globulins A,Immuno globulins G,Immuno globulins M,IgA、IgG、IgM)指标变化、不良反应。结果对照组患者治疗总有效率(80.00%,32/40)比观察组患者(95.12%,39/41)低,P<0.05;各组患者治疗前中医证候(五心烦热、腰膝酸软、闭经、头晕及潮热盗汗等)积分、FSH、LH、E_(2)、窦卵泡数以及卵巢面积、卵巢平均直径、IgA、IgG、IgM等指标比较,P>0.05,各组患者治疗后中医证候(五心烦热、腰膝酸软、闭经、头晕及潮热盗汗等)积分、FSH、LH、E_(2)、窦卵泡数以及卵巢面积、卵巢平均直径、IgA、IgG、IgM等指标均明显改善,观察组患者治疗后中医证候(五心烦热、腰膝酸软、闭经、头晕及潮热盗汗等)积分、FSH、LH、E_(2)、窦卵泡数以及卵巢面积、卵巢平均直径、IgA、IgG、IgM等指标均显著优于对照组,P<0.05;对照组1例腹泻,1例恶心,1例呕吐,不良反应率为7.50%(3/40),观察组患者2例恶心(4.88%,2/41),两组不良反应均较为轻微,不良反应率较低,P>0.05。结论左归丸加减结合温针灸治疗早发性卵巢功能不全临床疗效显著,患者治疗后病症明显减轻,且患者卵巢功能恢复较好,免疫功能提升,不良反应轻微且较少,安全可靠,值得临床应用。

Objective To observe the clinical effect of Modified Zuogui Pill(左归丸加减)combined with warm acupuncture and moxibustion in the treatment of premature ovarian insufficiency.Methods Eighty-one patients with early-onset ovarian insufficiency(admitted from January 2020 to July 2022)were included in the study.They were randomly divided into the observation group(41 cases)and the control group(40 cases).The patients in the control group were treated with estrogen and progesterone sequential therapy,and those in the observation group were treated with estrogen and progesterone sequential therapy+Modified Zuogui Pill combined with warming acupuncture and moxibustion.The clinical efficacy before and after treatment,the integral changes of traditional Chinese medicine syndromes(such as restless heat,soreness and weakness of the waist and knees,amenorrhea,dizziness,and hot flashes and night sweats),the changes in levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2),the changes in the number of sinus follicles,ovarian area,the average ovarian diameter changes,the serum levels of immunoglobulin A/G/M[ImmunoGlobulinsA(IgA),ImmunoGlobulinsG(IgG),ImmunoGlobulins M(IgM)]and adverse reactions of the two groups were compared.Results The total effective rate of the control group(80.00%,32/40)was lower than that(95.12%,39/41)of the observation group(P<0.05).The integral changes of traditional Chinese medicine syndromes(such as restless heat,soreness and weakness of the waist and knees,amenorrhea,dizziness,and hot flashes and night sweats),the changes in levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2),the changes in the number of sinus follicles,ovarian area,the average ovarian diameter changes,the serum levels of IgA,IgG and IgM and other indicators between the two groups before treatment had no significance(P>0.05).After treatment,integral changes of traditional Chinese medicine syndromes(such as restless heat,soreness and weakness of the waist and knees,amenorrhea,dizziness,and hot flashes and night sweats),the changes in levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2),the changes in the number of sinus follicles,ovarian area,the average ovarian diameter changes,the serum levels of IgA,IgG and IgM and other indicators were significantly improved in two groups.And those in the observation group were significantly better than those in the control group(P<0.05).There was 1 case of diarrhea,1 case of nausea and 1 case of vomiting in the control group,and the adverse reaction rate was 7.50%(3/40),and 2 cases of nausea in the observation group(4.88%,2/41).The adverse reactions in the two groups were mild and the adverse reaction rate was low(P>0.05).Conclusion Modified Zuogui Pill combined with warm acupuncture and moxibution has a significant clinical effect on early-onset ovarian insufficiency.After treatment,the symptoms can be significantly alleviated,and the ovarian function of the patients is well recovered,the immune function is improved,and the adverse reactions are mild and few.It is safe and reliable,which is worthy of clinical application.