补肾化浊法对卵巢早衰患者性激素及卵巢动脉血流参数的影响

Effects of therapy for tonifying kidney and resolving turbidity on sex hormones and ovarian artery bloodflow parameters in patients with premature ovarian failure

目的观察补肾化浊法对卵巢早衰患者性激素水平和卵巢动脉血流参数的影响。方法选取2018年5月—2020年5月在石家庄杏林中西医结合门诊部就诊的60例卵巢早衰患者,依据患者的意愿分为2组,对照组30例给予克龄蒙人工周期激素治疗(连服21d,撤退性出血第5天或停药后第7天开始下个疗程治疗),观察组30例在对照组治疗基础上给予补肾化浊方口服,2组均持续治疗3个疗程。比较2组患者治疗前后改良Kuppermann量表评分、血清性激素水平[促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E 2)、抗苗勒管激素(AMH)]、卵巢体积、双侧卵巢窦卵泡数、卵巢动脉血流动力学参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI)]及治疗3个疗程的临床综合疗效。结果与治疗前比较,治疗后2组患者改良Kuppermann量表评分、血清FSH和LH水平、PI和RI均明显降低(P均<0.05),血清E 2、AMH水平及卵巢体积、窦卵泡数均明显增高(P均<0.05),PSV、EDV均明显加快(P均<0.05);治疗后组间比较,观察组以上指标均较对照组改善更明显(P均<0.05)。观察组治疗总有效率明显高于对照组[90.0%(27/30)比73.3%(22/30),P<0.05]。结论补肾化浊法可明显减轻卵巢早衰患者临床症状,调节性激素水平,改善卵巢动脉血流动力学,增加卵巢供血,促进卵巢功能恢复。

Objective It is to observe the effects of therapy for tonifying kidney and resolving turbidity on sex hormone levels and ovarian artery blood flow parameters in patients with premature ovarian failure.Methods Sixty patients with premature ovarian failure treated in Shijiazhuang Xinglin Clinic of Integrated Traditional Chinese and Western Medicine from May 2018 to May 2020 were selected and divided into 2 groups according to the patients’willingness,30 cases in the control group were given Climen artificial cyclic hormone therapy(21 days of continuous treatment,and the next course of therapy started on the 5th day of withdrawal bleeding or on the 7th day of discontinuation of the drug),and 30 cases in the observation group were orally given the decoction for tonifying kidney and resolving turbidity on the basis of the treatment in the control group.Both groups were continuously treated for 3 course of treatment.The modified Kuppermann scale scores,serum levels of sex hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E 2),anti-mullerian hormone(AMH)],ovarian volume,bilateral ovarian sinus follicle number,ovarian arterial hemodynamic parameters[peak systolic flow velocity(PSV),end-diastolic flow velocity(EDV),resistance index(RI),pulsatility index(PI)]of patients in the two groups before and after treatment,and the overall clinical efficacy of 3 courses of treatment were compared between the two groups.Results Compared with those before treatment,the modified Kuppermann scale scores,serum levels of FSH and LH,PI and RI of patients were significantly decreased(all P<0.05),serum levels of E 2 and AMH and ovarian volume and sinus follicle number were significantly increased(all P<0.05),and PSV and EDV were significantly accelerated in the two groups after treatment(all P<0.05),all the above indexes in the observation group improved more significantly than those in the control group(P all<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group[90.0%(27/30)VS.73.3%(22/30),P<0.05].Conclusion Therapy for tonifying kidney and resolving turbidity can significantly reduce the clinical symptoms,regulate the levels of sex hormones,improve the hemodynamics of ovarian artery,increase the blood supply to ovary,and promote the recovery of ovarian function in patients with premature ovarian failure.