王氏养卵汤联合来曲唑治疗多囊卵巢综合征伴不孕症疗效观察

Clinical Observation on Wang's Egg-fostering Decoction Combined with Letrozole in the Treatment of Polycystic Ovarian Syndrome and Infertility

目的:观察王氏养卵汤联合来曲唑治疗多囊卵巢综合征(polycystic ovarian syndrome,PCOS)伴不孕症的临床疗效。方法:将PCOS伴不孕症患者60例按随机数字表法分为对照组和观察组各30例。对照组予来曲唑治疗,观察组在对照组基础上联合王氏养卵汤治疗。比较两组患者性激素水平[促黄体生成素(luteinizing hormone,LH)、促卵泡激素(follicle stimulating hormone,FSH)、雌二醇(estradiol,E_(2))、泌乳素(prolactin,PRL)、睾酮(testosterone,T)]、血清空腹胰岛素(fasting insulin,FINS)、肿瘤坏死因子α(tumor necrosis factor α,TNF-α)表达水平及排卵率、妊娠率、中医证候疗效与临床总有效率。结果:治疗后,两组患者血清LH、PRL、T表达水平均低于治疗前(P<0.05),FSH、E_(2)表达水平高于治疗前(P<0.05),观察组LH、PRL、T表达水平低于对照组(P<0.05),E_(2)表达水平高于对照组(P<0.05);两组患者血清FINS、TNF-α表达水平均低于治疗前(P<0.05),观察组低于对照组(P<0.05)观察组排卵率为83.3%(25/30),高于对照组的50.0%(15/30)(P<0.05);观察组妊娠率为63.3%(19/30),高于对照组的36.7%(11/30)(P<0.05);观察组中医证候总有效率为93.33%(28/30),高于对照组的60.0%(18/30)(P<0.05);观察组临床总有效率为83.3%(25/30),高于对照组的63.3%(19/30)(P<0.05)。结论:王氏养卵汤联合来曲唑能够调节血痧肾虚型PC0S伴不孕症患者体内性激素水平,改善患者慢性炎症及胰岛素抵抗状态,进一步提高排卵率,从而提高妊娠率,降低流产率。

Objective:To observe clinical effects of Wang's egg-fostering decoction(Wangshi Yangluan Tang)and letrozole in the treatment of polycystic ovarian syndrome(PCOS)and infertility.Methods:Sixty patients suffering PCOS and infertility were divided into the control group and the observation group using random number table method with 30 cases in each group.The control group was treated with letrozole,and the observation group took Wang's egg-fostering decoction on the foundation of Western medicine.To compare the levels of sex hormone such as LH,FSH,E_(2),PRL and T,serum FINS,the expressions of TNF-α,ovulation rate,pregnancy rate,clinical effects of TCM syndrome and clinical total effective rates between both groups.Results:After the treatment,the expressions of LH,PRL and T were lower than these before the treatment in the two groups(P<0.05),the levels of FSH and E_(2)higher than these before the treatment(P<0.05),the levels of LH,PRL and T of the observation group were lower than these of the control group(P<0.05),the expressions of E_(2)were higher than these of the control group(P<0.05);the levels of FINS and TNF-αin the serum were lower than before the treatment in the two groups(P<0.05),the observation group was lower than the control group(P<0.05);the ovulation rate of the observation group was 83.3%(25/30),higher than 50.0%(15/30)of the control group(P<0.05);the pregnancy rate of the observation group was 63.3%(19/30),higher than 36.7%(11/30)of the control group(P<0.05);total effective rate of TCM syndrome of the observation group was 93.3%(28/30),higher than 60.00%(18/30)of the control group(P<0.05);clinical total effective rate of the observation group was 83.3%(25/30),higher than 63.3%(19/30)of the control group(P<0.05).Conclusion:Wang's egg-fostering decoction and letrozole could regulate the levels of sex hormone in the treatment of blood stasis and kidney deficiency type of PCOS and infertility,improve chronic inflammation and insulin resistance,further raise the ovulation rate,thus raising the pregnancy rate and reducing the abortion rate.