自拟滋补肝肾组方对女性更年期综合征患者血管舒缩功能失调及单胺类神经递质的影响

Effect of self-made prescription of nourishing liver and kidney on vasomotor dysfunction and monoamine neurotransmitter in female patients with menopausal syndrome

目的探讨自拟滋补肝肾组方对更年期综合征(MPS)患者血管舒缩功能失调及单胺类神经递质的影响,为临床治疗MPS提供参考依据。方法选取2014年7月-2016年9月在济宁市兖州人民医院就诊的126例MPS患者为研究对象,采用随机数字表法将其分为观察组和对照组,每组63例。其中对照组患者采用单纯激素替代治疗,观察组患者采用自拟滋补肝肾组方治疗,评价并比较两组患者的治疗疗效,同时检测并比较两组患者治疗前后性激素水平、血管舒缩症状改善及脑内5-羟色胺(5-HT)、去甲肾上腺素(NE)、促性腺激素释放激素(GnRH)水平变化及不良反应发生情况。结果观察组患者治疗总有效率明显高于对照组患者,差异有统计学意义(93. 65%vs. 76. 19%,χ~2=7. 499,P<0. 05)。治疗后两组患者的血清FSH均明显低于治疗前,血清E_2明显高于治疗前,且观察组患者治疗后血清FSH明显低于对照组患者,E2明显高于对照组,差异均具有统计学意义(均P<0. 05)。治疗后两组患者潮热次数均明显减少,观察组患者夜汗症状明显改善,对照组患者改善不明显,观察组患者治疗后的潮热次数和夜汗症状改善均明显优于对照组患者,差异均有统计学意义(均P<0. 05),此外,治疗后观察组患者的更年期生存质量量表(MENQOL)中血管舒缩症状和Greene更年期量表(GCS)中血管舒缩症候群得分均明显降低,对照组患者无明显变化,观察组患者治疗后与对照组患者相比差异均具有统计学意义(均P<0. 05)。治疗后观察组患者脑内5-HT、GnRH和NE均明显降低,且治疗后观察组患者明显低于对照组,差异均有统计学意义(均P<0. 05)。两组患者不良反应发生率比较差异无统计学意义(7. 94%vs. 7. 94%,χ~2=0. 000,P>0. 05)。结论自拟滋补肝肾组方治疗MPS疗效显著,可纠正患者的各项性激素指标,明显改善患者的血管舒缩症状,可能是通过对单胺类神经递质的调节来发挥作用的,同时其不良反应轻微,安全性高。

Objective To explore the effect of self-made prescription of nourishing liver and kidney on vasomotor dysfunction and monoamine neurotransmitter in female patients with menopausal syndrome( MPS),provide a reference basis for clinical treatment of MPS.Methods A total of 126 patients with MPS treated in People’s Hospital of Yanzhou District from July 2014 to September 2016 were selected and divided into observation group and control group according to random number table,63 patients in each group. The patients in control group were treated by hormone replacement therapy,and the patients in observation group were treated by self-made prescription of nourishing liver and kidney. The curative effects in the two groups were evaluated and compared. The levels of sex hormones before and after treatment,improvements of vasomotor symptoms,changes of brain 5-hydroxytryptamine( 5-HT),noradrenaline( NE),gonadotrophin releasing hormone( GnRH),and incidence rates of adverse reactions in the two groups were detected and compared. Results The total effective rate in observation group was 93. 65%,which was statistically significantly higher than that in control group( 76. 19%)( χ2= 7. 499,P<0. 05).After treatment,the levels of serum FSH in the two groups were statistically significantly lower than those before treatment( P<0. 05),while the levels of serum E2 in the two groups were statistically significantly higher than those before treatment( P<0. 05),serum FSH level after treatment in observation group was statistically significantly lower than that in control group,while serum E2 level after treatment in observation group was statistically significantly higher than that in control group( P<0. 05). The numbers of hot flashes after treatment in the two groups decreased significantly,night sweat symptom in observation group was improved significantly,which was unobvious in control group.The improvements of number of hot flashes and night sweat symptom after treatment in observation group were superior to control group( P<0. 05). After treatment,vasomotor symptom scores of MENQOL and GCS in observation group decreased significantly,which were not obvious in control group,there were statistically significant differences between the two groups( P<0. 05). After treatment,the levels of brain5-HT,GnRH,and NE in observation group decreased significantly. The levels of brain 5-HT,GnRH,and NE after treatment in observation group were statistically significantly lower than those in control group( P<0. 05). There was no statistically significant difference in incidence rate of adverse reactions between the two groups( 7. 94% vs. 7. 94%,χ2= 0. 000,P>0. 05). Conclusion The curative effect of self-made prescription of nourishing liver and kidney in treatment of MPS is significant,self-made prescription of nourishing liver and kidney can correct sex hormones,significantly improve vasomotor symptom,it may play a role by regulation of monoamine neurotransmitters,the adverse reactions are mild,and the safety is high.