生长激素联合补肾方治疗高龄女性卵巢储备功能减退临床效果

Clinical effect of the growth hormone combined with kidney tonifying prescription for treating advanced patients with reduced ovarian reserve function

目的:观察生长激素(GH)联合补肾方治疗卵巢储备功能减退临床效果。方法:纳入年龄≥35岁卵巢储备功能减退患者90例,随机分组为西药组、中药组和联合治疗组,分别给予常规GH治疗、单纯补肾方治疗、GH联合补肾方治疗,均治疗3个月,记录各组治疗前后临床症状积分变化;检测血清抗苗勒管激素(AMH)、雌二醇(E_(2))、卵泡刺激素(FSH)和黄体生成素(LH)水平,阴道超声检测患者窦卵泡计数(AFC)。结果:治疗3个月后,总有效率西药组(50.0%)、中药组(60.0%)和联合组(73.3%)依次升高(P<0.05)。治疗3个月后,3组中医证候积分均较治疗前降低,月经失血图评分升高,且中药组和联合组中医证候积分低于西药组,月经失血图评分高压西药组(均P<0.05);3组AFC均升高、AMH、E_(2)、FSH和LH水平均降低,且联合组变化幅度均大于西药组(均P<0.05)。3组患者治疗期间均未见明显异常和不良反应,随访治疗后1年成功妊娠率西药组(6.7%)、中药组(13.3%)和联合组(23.3%)依次升高(P<0.05)。结论:补肾方及补肾方联合GH治疗高龄卵巢储备功能减退患者有较好临床疗效益处,且治疗需持续至少3个疗程可体现出较好的临床效果。

Objective:To observe the clinical effect of the growth hormone(GH)combined with kidney tonifying prescription for treating advanced patients with reduced ovarian reserve function.Methods:A total of 90 patients with≥35 years old who met the diagnostic criteria of reduced ovarian reserve function were included and were randomly divided into three groups.The patients in group A were given treatment of GH for 3 months,the patients in group B were given treatment of kidney tonifying prescription for 3 months,and the patients in group C were given treatment of GH combined with kidney tonifying prescription for 3 months.The changes of the clinical symptom scores of the patients before and after treatment in the three groups were recorded.The levels of the serum anti-Mullerian hormone(AMH),estradiol(E_(2)),follicle stimulating hormone(FSH)and luteinizing hormone(LH)of the patients in the three groups were detected,and the antral follicle count(AFC)of the patients in the three groups was examined by the transvaginal ultrasound.Results:After 3 months of treatment,the total effective rate of the patients in group A(50.0%),in group B(60.0%)and in group C(73.3%)had increased gradually(P<0.05).The TCM syndrome scores of the patients in the three groups after 3 months of treatment had decreased significantly,and which of the patients in group B and in group C were significantly lower than those of the patients in group A.The menstrual blood loss chart score of the patients in the three groups after treatment had increased significantly,and which of the patients in group B or in group C was significantly higher than that of the patients in group B(all P<0.05).The AFC of the patients in the three groups after treatment had increased significantly,the AMH,E_(2),FSH and LH levels of the patients in the three groups after treatment had decreased significantly,and the changes of all which of the patients in group C were significantly more than those of the patients in group A(all P<0.05).There was no any patient with obvious abnormality or adverse reaction in the three groups during treatment.The successful pregnancy rate of the patients in group A(6.7%),in group B(13.3%)and in group C(23.3%)had increased gradually within 1 year of follow-up after treatment(P<0.05).Conclusion:GH combined with kidney tonifying prescription for treating the advanced patients with reduced ovarian reserve function has better clinical benefit,and the treatment lasting for at least 3 months may reveal the good clinical effect.