化浊解毒方联合优思明治疗肥胖型多囊卵巢综合征的临床研究

Clinical study of Huazhuo jiedu prescription combined with Yasmin in the treatment of obese polycystic ovary syndrome

目的 分析化浊解毒方联合优思明治疗肥胖型多囊卵巢综合征(polycystic ovary syndrome, PCOS)的临床疗效。方法 将2021年2月至2023年3月在5所医院接受治疗的96例肥胖型PCOS患者按照随机数字表法分为观察组和对照组各48例,对照组给予优思明治疗,观察组在对照组的基础上给予化浊解毒方治疗,持续治疗3个月经周期。比较两组患者脂代谢指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、糖代谢指标[糖化血红蛋白(GHb)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)]、肥胖程度[体重指数(BMI)、腰臀比(WHR)]、临床症状[多毛、痤疮、月经稀少]、性腺激素[黄体生成素(LH)、促黄体生成素/促卵泡生成素(LH/FSH)、睾酮(T)],并统计两组患者药物不良反应发生率。结果 治疗前两组患者TC、TG、HDL-C、LDL-C、FINS、FPG、HOMA-IR、BMI、WHR、多毛、痤疮、月经稀少发生率、LH、LH/FSH、T比较,差异均无统计学意义(P>0.05),治疗后观察组TC、TG、LDL-C、FINS、FPG、HOMA-IR、BMI、WHR、LH、LH/FSH、T低于对照组,多毛、痤疮、月经稀发治疗有效率高于对照组,差异有统计学意义(P<0.05),两组HDL-C比较差异无统计学意义(P>0.05);观察组1例呕吐,对照组1例呕吐、1例恶心,调整至餐后服药缓解,两组患者均未发生需要处理的严重药物不良反应,血常规、尿常规、肝肾功能检查均未见异常。结论 化浊解毒方联合优思明治疗肥胖型PCOS,其临床疗效优于单用优思明,在改善糖脂代谢、性激素水平、体重及临床症状方面疗效较好。

Objective To analyze the clinical efficacy of Huazhuo jiedu prescription combined with Yasmin in the treatment of obese polycystic ovary syndrome(PCOS).Methods A total of 96 obese PCOS patients from five hospitals from February 2021 to March 2023 were divided into observation group and control group according to random number table method,48 cases in each group.The control group was treated with Yasmin,and the observation group was treated with Huazhuo jiedu prescription on the basis of the control group.The treatment lasted for 3 menstrual cycles.Lipid metabolism indexes[total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],glucose metabolism indexes[glycated hemoglobin(GHb),fasting blood glucose(FPG),insulin resistance index(HOMA-IR)],obesity degree[body mass index(BMI),waist-to-hip ratio(WHR)],clinical symptoms[hypertrichosis,acne,menstrual deficiency],gonadal hormones[luteinizing hormone(LH),luteinizing hormone/follicle-stimulating hormone(LH/FSH),testosterone(T)]were compared between the two groups,and the incidence of adverse drug reactions in the two groups were analyzed.Results Before treatment,there were no significant differences in TC,TG,HDL-C,LDL-C,FINS,FPG,HOMA-IR,BMI,WHR,hairy,acne,incidence of menstrual dysphoria,LH,LH/FSH and T between the two groups(P>0.05).After treatment,TC,TG,LDL-C,FINS,FPG,HOMA-IR,BMI,WHR,LH,LH/FSH and T in the observation group were lower than those in the control group,and the effective rate of treatment for hypertrichosis,acne and oligmenorrhea was higher than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in HDL-C between the two groups(P>0.05).The observation group had 1 case of vomiting,while the control group had 1 case of vomiting and 1 case of nausea,which were relieved by medication after meals.No serious adverse drug reactions requiring treatment occurred in both groups,and no abnormalities were found in routine menstrual blood,routine urine and liver and kidney function tests.Conclusion Huazhuo jiedu prescription combined with Yasmin in the treatment of obese PCOS has better clinical efficacy than Yasmin alone,and has better efficacy in improving glucose and lipid metabolism,sex hormone levels,body weight and clinical symptoms.