金匮温经汤联合雌孕激素序贯治疗卵巢早衰对患者卵巢及抑制素B的影响

Effects of Jin'gui wenjing decoction combined with the sequential estrogen and progesterone for treating patients with premature ovarian failure on their ovarian and inhibin B level

目的:金匮温经汤联合雌孕激素序贯治疗卵巢早衰(POF)效果及对患者卵巢最大平面平均卵巢直径(MOD)及抑制素B(INHB)水平的影响。方法:回顾性分析2021年3月-2023年2月本院收治的97例POF肾虚血瘀证患者临床资料,按照治疗方法的不同分成序贯组(n=48,实施雌孕激素序贯治疗)和联合组(n=49,在序贯组基础上联合金匮温经汤治疗)。比较两组疗效、肾虚血瘀证积分、卵巢最大平面MOD、血流情况[收缩期峰值流速(PSV)和阻力指数(RI)]、血清性激素[促卵泡素(FSH)和雌二醇(E_2)]水平及INHB水平。结果:治疗3个周期后,联合组总有效率(93.9%)高于序贯组(79.2%),两组肾虚血瘀证积分、血清FSH水平均低于治疗前且联合组(5.33±1.56分、36.98±5.17 U/L)均低于序贯组(7.60±2.04分、43.45±7.68 U/L),两组卵巢最大平面MOD、卵巢PSV均大于治疗前且联合组(23.54±6.38 mm、18.52±4.26 cm/s)均大于序贯组(19.73±4.26 mm、15.49±3.37 cm/s),两组卵巢RI均小于治疗前且联合组(0.58±0.15)小于序贯组(0.67±0.18),两组血清E_2、INHB水平均高于治疗前且联合组(38.42±7.89 ng/L、64.85±7.64ng/L)均高于序贯组(32.47±6.31 ng/L、56.27±6.91 ng/L)(均P<0.05)。结论:POF肾虚血瘀证患者实施金匮温经汤联合雌孕激素序贯治疗疗效提高,患者卵巢血流、直径及性激素水平得到有效改善,INHB水平显著升高,相关症状明显减轻。

Objective:To investigate the effects of Jin'gui wenjing decoction combined with the sequential estrogen and progesterone for treating patients with premature ovarian failure(POF)on their maximum plane mean of ovarian diameter(MOD)and inhibin B(INHB)level.Methods:A retrospective analysis was conducted on the clinical data of 97 patients with POF caused by kidney deficiency and blood stasis syndrome who had admitted to the hospital from March 2021 to February 2023.According to the different treatment methods,these patients were divided into control group(48 patients with the treatment of the sequential estrogen and progesterone)and study group(49 patients with the treatment of the combined Jin'gui wenjing decoction and the sequential estrogen and progesterone).The therapeutic effect,the score of kidney deficiency and blood stasis syndrome,the maximum plane of MOD,the ovarian blood flow status evaluated by the peak systolic velocity(PSV)and the resistance index(RI)of the ovarian artery,the levels of the serum sex hormones,such as follicle stimulating hormone(FSH)and estradiol(E_(2)),and the INHB level of the patients were compared between two groups.Results:After 3cycles of treatment,the total effective rate(93.9%)of the patients in the study group was significantly higher than that(79.2%)of the patients in the control group.The scores of kidney deficiency and blood stasis syndrome and the serum FSH level of the patients in the two groups had decreased significantly,and which(5.33±1.56 points and 36.98±5.17U/L)of the patients in the study group were significantly lower than those(7.60±2.04 points and 43.45±7.68U/L)of the patients in the control group.The ovarian maximum plane of MOD and the ovarian PSV value of the patients in the two groups had increased significantly,and which(23.54±6.38mm and 18.52±4.26cm/s)of the patients in the study group were significantly higher than those(19.73±4.26mm and 15.49±3.37cm/s)of the patients in the control group.The ovarian RI value of the patients in the two groups had decreased significantly,and which(0.58±0.15)of the patients in the study group was significantly lower than that(0.67±0.18)of the patients in the control group.The levels of serum E_(2) and INHB of the patients in the two groups had increased significantly,and which(38.42±7.89ng/L and 64.85±7.64ng/L)of the patients in the study group were significantly higher than those(32.47±6.31ng/L and 56.27±6.91ng/L)of the patients in the control group(all P<0.05).Conclusion:Jin'gui wenjing decoction combined with the sequential estrogen and progesterone for treating patients with POF caused by kidney deficiency and blood stasis syndrome can increase their therapeutic effect,and which can improve the ovarian blood flow and diameter,increase the sex hormone and INHB levels,and alleviate related symptoms of the patients obviously.