Clinical observation of Kuntai capsule combined with Fenmotong in treatment of decline of ovarian reserve function

BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruation,amenorrhea,infertility,de-creased libido,and autonomic nervous dysfunction.Fenmatong(FMT)is a com-pound mixture of estradiol tablets and estradiol didroxyprogesterone tablets,which can improve ovarian reserve function by supplementation of exogenous estrogen.However,this treatment has also been shown to cause breast pain,gastrointestinal discomfort,irregular vaginal bleeding,and changes in sexual desire.In severe cases,FMT can promote the development of breast cancer,endometrial cancer,and venous embolic disease.AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve func-tion.METHODS Patients(130)with decreased ovarian reserve function,who were treated in our hospital from May 2018 to May 2020,were divided into two groups:The FMT group,in which patients were treated with FMT,and the observation group,in which patients were treated with Kuntai capsules.Chinese medicine symptom scores,uterine artery blood flow parameters,ovarian ultrasound test indexes,pictorial blood loss assessment chart(PBAC)scores,and hormone levels were recorded,and total effective rates were calculated for both groups.RESULTS The total effective rate in the observation group was higher than that in the FMT group(P<0.05).After treatment,primary symptoms,including low menstrual volume,delayed menstruation,red color and thick consistency of menses,di-zziness,palpitation,weakness at the waist and knee,insomnia and excessive dreaming,irritability,and dryness and astringency of the pudendal canal in the observation group decreased,and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group(P<0.05).The systolic peak flow rate(PSV),end-diastolic flow rate(EDV),ovarian diameter,sinus follicle count,and resistance index(RI)of the uterine arteries in the observation group and FMT group increased after treatment.Notably,the PSV,EDV,ovarian diameter,and antral follicle count in the observation group were higher than those in the FMT group,whereas the RI in the observation group was lower than that in the FMT group(P<0.05).The PBAC scores in the observation and FMT groups increased after treatment,with that in the ob-servation group becoming significantly higher than that in the FMT group(P<0.05).After treatment,estradiol(E2)and anti-Mullerian hormone(AMH)levels increased,whereas follicle-stimulating hormone(FSH)levels decreased in the observation group and FMT group;E2 and AMH levels became significantly higher and FSH levels became significantly lower in the observation group than in the FMT group(P<0.05).CONCLUSION Compared with FMT,Kuntai capsules promoted uterine artery blood circulation,improved menstruation,relieved symptoms,regulated endocrine function,and improved curative effects.

Meta-analysis of Kuntai Capsules combined with Diane-35 in treatment of PCOS

Objective:To systematically evaluate the clinical efficacy of Kuntai Capsules combined with Diane-35 in the treatment of polycystic ovarian syndrome(PCOS).Methods:The randomized controlled trials(RCTs)of Kuntai Capsules combined with Diane-35 in the treatment of PCOS from databases establishment to April 2020 were searched in Chinese and English databases,and then meta-analysis was performed using RecMan 5.3 software.Results:A total of 132 articles were collected and 14 studies were included.The total sample size was 1254 cases,including 627 cases in the experimental group and 627 cases in the control group.Meta-analysis showed that the combined group was significantly superior to the single group in terms of overall response rate(OR=5.53,95%CI[3.25,9.41],P<0.01),ovulation rate(OR=3.54,95%CI[2.13,5.88],P<0.01),and pregnancy rate(OR=3.21,95%CI[2.00,5.14],P<0.01).In terms of serum sex hormone levels,the combined group was significantly better than the singer group for the regulation of follicle-stimulating hormone(FSH)(MD=-2.09,95%CI[-2.16,-2.01],P<0.01),luteinizing hormone(LH)(MD=-2.15,95%CI[-2.35,-1.95],P<0.01),estrogen(E2)(MD=36.47,95%CI[34.97,37.96],P<0.01),and testosterone(T)(MD=-1.95,95%CI[-2.77,-1.14],P<0.01).In addition,the combined group also showed some advantages over the single group in improving the level of insulin resistance(HOMA-IR)and pancreatic beta cells function(HOMA-β).Conclusion:Kuntai Capsules combined with Diane-35 had certain efficacy advantage in the treatment of PCOS compared with control group.However,the data indicate that the methodological quality of the studies are low,there was potential publication bias,no define conclusion could be drawn,and more high-quality RCTs studies are needed for further validation.

Protective Effect and Mechanism of Kuntai Capsule on Angiotensin II-Induced Hypertension in Ovariectomized Rats

Objective To explore the protective effect and mechanism of Kuntai(KT)Capsule on angiotensin II(Ang II)-induced hypertension in ovariectomized(OVX)rats.Methods Fifty-four rats were randomly divided into 6 groups according to a random number table,9 in each group:control,OVX sham+Ang II,OVX,OVX+Ang II,OVX+Ang II+E2,and OVX+Ang II+KT.OVX rats model was constructed by retroperitoneal bilateral ovariectomy.After 4 weeks of pretreatment with KT Capsule[0.8 g/(kg·d)and 17-β-estradiol(E2,1.2 mg/(kg·d)]respectively,Ang II was injected into a micro-osmotic pump with a syringe to establish a hypertensive rat model.Blood pressure of rat tail artery was measured in a wake state of rats using a non-invasive sphygmomanometer.Blood pressure changes were compared between the intervention groups(OVX+Ang II+KT,OVX+Ang II+E2)and the negative control group(OVX+Ang II).Serum malondialdehyde(MDA)level and superoxide dismutase(SOD)activity were detected respectively.The expressions of oxidative stress-related protein superoxide dismutase2(SOD2)and anti-thioredoxin(TRX),autophagy marker protein[beclin1,light chain(LC)3 II/I ratio and autophagy canonical pathway protein phosphatidylinositol 3-kinase(PI3K)/serine/threonine kinase(AKT)-mammalian target of rapamycin(mTOR)]were evaluated by Western blotting.Results Compared with the OVX+Ang II group,the systolic blood pressure of OVX+Ang II+KT group was significantly lowered(P<0.05)but not the diastolic blood pressure.Besides,SOD2 and TRX protein levels in mycardial tissues were significantly reduced in the OVX+Ang II+KT group compared with the OVX+Ang II group(P<0.05).Oxidative stress serum markers MDA and SOD were down-and up-regulated in the OVX+Ang II+KT group,respectively(P<0.05).Compared with OVX+Ang II group,the levels of cardiac proteins beclin-1 and LC3II/LC3 I in OVX+Ang II+KT group were also up-regulated(P<0.05),and the expression levels of p-PI3K,p-AKT and mTOR protein were down-regulated(P<0.05).Conclusion KT could protect blood pressure of Ang II-induced OVX rats by inhibiting oxidative stress and up-regulating protective autophagy.

坤泰胶囊结合电针周期疗法治疗卵巢储备功能低下效果观察

目的观察坤泰胶囊结合电针周期疗法治疗卵巢储备功能低下的效果。方法将医院2019年2月—2021年6月收治的109例卵巢储备功能低下患者以随机数字表法分为观察组(55例)与对照组(54例),对照组患者均予以激素周期疗法治疗,观察组患者采取激素周期疗法及坤泰胶囊结合电针周期疗法治疗。各组数据观察:临床疗效、治疗前后中医证候(月经推后或月经量少、闭经、性欲减退、神疲乏力等)积分变化、雌二醇(Estradiol,E2)及卵泡雌激素(Follicle-Stimulating Hormone,FSH)、黄体生成素(luteinizing Hormone,LH)等血清激素水平变化、卵巢间质血流动力学指标变化、卵泡发育情况以及不良反应、治疗后1年受孕率。结果对照组与观察组患者治疗总有效率比较(81.48%vs94.55%)(P<0.05);治疗前,各组患者中医证候(月经推后或月经量少、闭经、性欲减退、神疲乏力等)积分、E2、FSH及LH等血清激素水平、阻力指数(Regular Insulin,RI)及搏动指数(Pulsatility Index,PI)、收缩期最大血流速度(Peak Systolic Veloci⁃ty,PSV)、动脉血流收缩期峰值流速/舒张末期流速(systolic phase diastolic phase,S/D)等卵巢间质血流动力学指标、排卵日子宫内膜厚度、非排卵日子宫内膜厚度及初级卵泡数、优势卵泡数等卵泡发育情况指标比较,P>0.05,经治疗后各组患者中医证候(月经推后或月经量少、闭经、性欲减退、神疲乏力等)积分、E2、FSH及LH等血清激素水平、RI及PI、PSV、S/D等卵巢间质血流动力学指标、排卵日子宫内膜厚度、非排卵日子宫内膜厚度及初级卵泡数、优势卵泡数等卵泡发育情况指标均改善,观察组患者治疗后中医证候(月经推后或月经量少、闭经、性欲减退、神疲乏力等)积分、E2、FSH及LH等血清激素水平、RI及PI、PSV、S/D等卵巢间质血流动力学指标、排卵日子宫内膜厚度、非排卵日子宫内膜厚度及初级卵泡数、优势卵泡数等卵泡发育情况指标均优于对照组(P<0.05);观察组治疗不良反应率与对照组不良反应率均较低(P>0.05);观察组治疗1年后受孕率(47.27%,26/55)高于对照组患者(25.93%,14/54)(P<0.05)。结论坤泰胶囊结合电针周期疗法治疗卵巢储备功能低下的效果较为显著,患者症状恢复较好,且卵巢功能恢复好,患者未来1年受孕率高,且不良反应较少,安全可靠,值得进行应用。

坤泰胶囊联合地屈孕酮治疗围绝经期综合征的临床效果

目的:探讨坤泰胶囊联合地屈孕酮治疗围绝经期综合征(PMS)的临床效果.方法:选取2022年7月—2023年6月沈阳维康医院收治的PMS患者78例为研究对象,依据随机数字表法分为对照组和观察组,各39例.对照组采用地屈孕酮治疗,观察组在对照组基础上联合坤泰胶囊治疗.比较两组治疗效果、女性雌激素指标水平、康复相关指标.结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.042);治疗后,两组促卵泡生成素、促黄体生成素水平均低于治疗前,雌二醇水平高于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05);治疗后,两组窦卵泡数量、卵巢体积、子宫内膜厚度水平均高于治疗前,观察组窦卵泡数量、子宫内膜厚度优于对照组,差异有统计学意义(P<0.05),两组卵巢体积比较,差异无统计学意义(P>0.05).结论:坤泰胶囊联合地屈孕酮治疗PMS的临床效果显著,可促进患者的卵巢功能恢复,调节女性激素水平.

Efficacy and Safety Investigation of Kuntai Capsule for the Add-back Therapy of Gonadotropin Releasing Hormone Agonist Administration to Endometriosis Patients： A Randomized,Double-blind, Blank-and Tibolone-controlled Study

Background：As a Chinese Traditional Medicine product,Kuntai capsule could improve the peri-menopausal symptoms in postmenopausal women.But it is still not clear whether Kuntai capsule has a good effect on alleviating peri-menopausal symptoms induced by gonadotropin releasing hormone agonist （GnRH-a） treatment.The purpose of this study was to investigate the clinical effectiveness and safety of Kuntai capsule,on peri-menopausal symptoms in endometriosis （EMS） patients,with postoperative GnRH-a treatment.Methods：Ninety EMS ovarian cyst women with postoperative GnRH-a administration were enrolled in the study,and were randomly divided into Kuntai group,Tibolone group,or blank Control group.The therapeutic strategy in Kuntai group was 4 Kuntai capsules tid,po for 12 weeks after the first GnRH-a injection,while Tibolone 2.5 mg qd,po for 12 weeks in Tibolone group.There was no drug addition in Control group.Climacteric complaints were evaluated by Kupperman menopausal index （KMI） and hot flash/sweating score.Liver and renal functions,lipid profile,serum sex hormone levels and endometrial thickness were measured,and the frequency of adverse events in Kuntai and Tibolone groups was recorded.Results：（l） Before GnRH-a therapy,the baseline parameter results were comparable in the three groups （P ＞ 0.05）.（2） After GnRH-a therapy,KMI and hot flash/sweating scores in all the three groups increased significantly （P ＜ 0.05）.At the 4th week after GnRH-a therapy,KMI and hot flash/sweating score results were as follows：Control group ＞ Kuntai group ＞ Tibolone group （P ＜ 0.05）; at the 8th and 12th week after GnRH-a therapy,KMI and hot flash/sweating score in Control group were significantly higher than the other two groups （P ＜ 0.05）,and no significant difference was identified between Kuntai and Tibolone group （P ＞ 0.05）.（3） No statistical change took place in the liver and renal functions and lipid profile in all the three groups after the treatment （P ＞ 0.05）.（4） The posttherapeutic serum follicle-stimulating hormone （FSH）,luteinizing hormone （LH） and estradiol （E2） level and endometrial thickness decreased significantly in all the three groups （P ＜ 0.05）.After therapy,serum E2 level in Tibolone group was obviously higher than the other two groups （P ＜ 0.05）,while FSH and LH levels were obviously lower （P ＜ 0.05）.（5） The incidence of vaginal bleeding,breast distending pain in Tibolne group was obviously higher than Kuntai group （P ＜ 0.05）.Conclusions：Kuntai capsule is effective on the peri-menopausal symptoms induced by postoperative GnRH-a administration to EMS patients,although its clinical effect might be a few weeks later than Tibolone.Kuntai capsule might be a little safer than Tibolone tablet.

Heyan Kuntai capsule versus dehydroepiandrosterone in treating Chinese patients with infertility caused by diminished ovarian reserve： a multicenter, randomized controlled trial

OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule(HYKT) in treating women with infertility caused by diminished ovarian reserve(DOR).METHODS: One hundred eight eligible patientsfrom three Chinese hospitals were randomly divided into an HYKT treatment group(n = 55) or a dehydroepiandrosterone(DHEA) treatment group(n =53). Patients in the HYKT group were treated orally with four 0.5 g HYKT three times a day; patients in the DHEA group were treated with one 25.0 mg DHEA capsule three times a day. All patients were treated for 3 months and followed up over a3-month period.RESULTS: Of 108 patients, 12 dropped out: six from the HYKT group, and six from the DHEA group. Eleven patients got pregnant during the treatment. Serum anti-Müllerian hormone levels and antral follicle counts increased significantly in both groups after treatment(P < 0.05) especially in the HYKT group(P < 0.05). Serum follicle stimulating hormone(FSH) levels and FSH/luteinizing hormone ratios decreased(P < 0.05) with no significant difference between the two groups. Estradiol levels in the HYKT group and DHEA-sulfate levels in the DHEA group both increased(P < 0.05). The spontaneous pregnancy rates were 12% and 11% in the HYKT and DHEA groups, respectively(not significant). During the follow-up period, 16 patients in the HYKT group underwent in vitro fertilization-embryo transfer(IVF-ET) and the number of retrieved oocytes was(5.1 ± 1.8). In DHEA group, 20 patients underwent IVF-ET and the number of retrieved oocyte was(4.2 ± 1.9)(not significant); clinical pregnancy rates were 38% in the HYKT group and 20%in DHEA group(not significant). No significant adverse reactions were observed.CONCLUSION: HYKT can improve the ovarian re-serve and hormone levels in patients with infertility caused by DOR. Pregnancy rates after HYKT treatment were similar to those of DHEA treatment.HYKT might be an alternative to the treatment of infertility caused by DOR.

A Multi-center,Randomized,Controlled and Open Clinical Trial of Heyan Kuntai Capsule (和颜坤泰胶囊) and Hormone Therapy in Perimenopausal Women

Objective： To evaluate the efficacy and safety of Heyan Kuntai Capsule（和颜坤泰胶囊, HYKT） and hormone therapy（HT） on perimenopausal syndromes（PMSs）. Methods： From 2005 to 2008, 390 women with PMSs were recruited from 4 clinic centers. The inclusion criteria included ages 40 to 60 years, estradiol（E2） below 30 ng/L, and follicle stimulating hormone（FSH） above 40 IU/L, etc. The patients were randomly assigned to HYKT group or HT group by random number table method, administrated HYKT or conjugated estrogen with/without medroxyprogesterone acetate tablets for 12 months. During treatment, the patients were interviewed quarterly, Kupperman Menopausal Index（KMI） scores, hot flush scores, insomnia scores, Menopause-Specific Quality of Life（MENQOL） scores and adverse effects were used for evaluating drug efficacy and safety respectively. The last interview was made at the end of 12-month treatment. Results： After treatment, KMI scores of HYKT group and HT group were both significantly decreased compared with baseline（P〈0.01） and there was no significant difference between groups（P〉0.05）, except that KMI of HYKT group was higher after 3-month treatment（P〈0.05）. After treatment, hot flush and insomnia scores were both improved significantly in two groups（P〈0.01）; and HT had a better performance than HYKT in improving hot flush（P〈0.05）. MENQOL were significantly improved in both groups after treatment（P〈0.01）; but there was no significant difference between two groups（P〉0.05）. The incidence of adverse event in the HYKT group was much lower than that in the HT group（P〈0.01）. Conclusions： HYKT could effectively relieve PMSs and improve patient quality of life without severe adverse reactions. Although HYKT exerted curative effects more slowly than hormone, it possessed better safety profile than hormone.

Effects of Heyan Kuntai Capsule(和颜坤泰胶囊)on Follicular Development and Oocyte Cohesin Levels in Aged Mice

Objective： To evaluate the effect of Heyan Kuntai Capsule （和颜坤泰胶囊, HYKT） on the ovarian function of aged mice and expressions of cohesion complexes in oocytes. Methods： Twenty-five 9-month-old female C57BL/6J mice were randomly divided into 5 groups by block randomization method （n=5 per group）, including the control group （saline）, 17β-estradiol group [E2, 100 μg/（kg·d）], and low-, medium-, and high- dose of HYKT groups [0.3, 0.9, 2.7 g/（kg·d）, respectively]. All mice were treated by intragastric administration for 4 weeks. Hematoxylin and eosin staining and anti-VASA staining were used to detect the amounts of follicles. The apoptosis of follicles was measured by anti-gamma H2A histone family member X （γ, H2AX） staining and TdT-mediated dUTP Nick-End Labeling （TUNEL） assay. The density of cohesin subunits, REC8 meiotic recombination protein （REC8）, structural maintenance of chromosome （SMC） 1 β and SMC3 in oocytes were evaluated by immunofluorescent staining. Results： After administration of E2 and high-dose of HYKT, the total number of follicles as well as the number of primordial and primary follicles were significantly increased （P〈0.05）. Anti-γ/H2AX staining and TUNEL assay demonstrated that high-dose of HYKT and E2 partly suppressed the apoptosis of follicles （P〈0.05）. Furthermore, it showed an increased trend in the levels of REC8 and SMC1 β, after administration with E2 and HYKT, and no obvious change in the level of SMC3. Conclusion： HYKT could enhance the number of follicles, suppress apoptosis of oocytes and have a trend to elevate the meiotic-specific cohesin subunits （REC8 and SMC1 β） in oocytes of aged mice, indicating a beneficial effect on the ovarian function in terms of the quantity and quality of follicles.

坤泰胶囊对围绝经期综合征治疗作用的研究

目的探讨坤泰胶囊对围绝经期综合征(peripheral menopause syndrome,PMS)的治疗作用。方法共收集60例患PMS的志愿者,随机分为治疗组和对照组,每组30例。治疗组服用坤泰胶囊,对照组则为替勃龙。坤泰胶囊,饭后0.5 h口服,每次2 g,1日3次。替勃龙,晚饭后0.5 h口服,每次2.5 mg,1次/d。所有患者均服药3个月。检测两组志愿者服药前后血清激素(FSH、LH、E2)浓度和改良后Kupperman评分(mKMI),判断坤泰胶囊对的治疗作用。结果mKMI比较:组间治疗前后有改善(P<0.05);服用药物3个月后,治疗组比对照组治疗和改善患者症状的效果更好(P<0.05)。性激素方面:与对照组相比,治疗组E2上升(P<0.05);治疗后FSH、LH两组均下降(P<0.05)。临床疗效治疗组疗效更好。结论坤泰胶囊治疗PMS的总疗效上更好。

Hormone-like activities of Kuntai capsule in the uteri of ovariectomized rats and immature rabbits

OBJECTIVE: To investigate the hormone-like activities of Kuntai capsule(KTC) in the uteri of ovariectomized rats and immature rabbits.METHODS: Following bilateral ovariectomy, rats were randomly divided into six groups including sham group, control group, estradiol valerate group, KTC 0.24, 0.6, and 1.5 g/kg groups. The rats were treated with 0.5% CMC-Na, estradiol valerate and KTC(0.24, 0.6, and 1.5 g/kg), respectively for 28 consecutive days. Then the estrous cycle, uterine changes and pathological changes were examined.Serum levels of estradiol(E2), and progesterone(P4)were measured by enzyme-linked immunosorbent assay(ELISA). Protein levels of estradiol receptor(ER), progesterone receptor(PR), vascular endothelial growth factor(VEGF), proliferating cell nuclear antigen(PCNA) and nuclear-associated antigen-67(Ki-67) in uterine tissues were detected by western blot. Immature rabbits were estrogen-primed prior to intragastric administration with KTC for 6 d consecutively. Then, the uteri underwent hematoxylin-eosin staining to observe endometrial transformation.RESULTS: Compared with the control group, 0.6and 1.5 g/kg KTC markedly decreased the uterine organ coefficient and endometrial thickness(P <0.05). The serum level of P4 was increased in the KTC 0.6 g/kg group(P < 0.05). There were no significant variations in the serum level of E2 in the KTC groups compared with the control group. ERβ, but not ERα, was markedly upregulated after KTC administration(P < 0.05). Furthermore, 1.5 g/kg KTC significantly decreased the protein level of PRA(P <0.05) and 0.6 g/kg KTC increased the protein level of PRB in the uteri(P < 0.05). VEGF was highly expressed after treatment with 0.24 and 0.6 g/kg KTC,and Ki-67 was markedly reduced in ovariectomized rats treated with 1.5 g/kg KTC. No difference was found in the expression of PCNA. KTC 0.24 and0.6 g/kg promoted endometrial transformation in immature rabbit uteri.CONCLUSION: KTC does not demonstrate obvious estrogen-like effect on uteri after ovariectomy, but it does exhibit weak progestogen-like effect, by which mechanism of action is yet to be further investigated.

探讨坤泰胶囊治疗卵巢早衰的作用机制

目的:探讨坤泰胶囊治疗卵巢早衰的主要活性成分、核心靶点、相关通路等药理学作用机制。方法:用TCMSP与BATMAN-TCM两大数据库获取药物成分及对应靶点,在Uniprot数据库中进行靶点蛋白名称的标准化处理;用GeneCards与OMIM两大数据库获取疾病靶点;用Venny 2.1.0平台获得药物与疾病的交集靶点;用Cytoscape3.8.0对“药物-活性成分-相关靶点”与“蛋白与蛋白相互作用(PPI)”进行可视化展示;用DAVID数据库获得GO富集分析及KEGG通路分析相关数据,用Bioinformatics平台进行可视化展示;最后,用Autodock tools与Autodock Vina两大软件对核心药物活性成分与核心靶点进行分子对接验证,使用Pymol软件对对接结果进行可视化展示。结果:最终得到坤泰胶囊的药物成分80个、潜在靶点蛋白219个,卵巢早衰相关靶点2497个;GO富集分析共得到1012个条目,KEGG通路分析共检索到169条通路;分子对接结果表明,主要药物活性成分能与核心靶点蛋白稳定的结合。结论:坤泰胶囊通过槲皮素、β-谷固醇、山萘酚等药物成分作用于TP53、AKT1、MAPK1等靶点蛋白,经IL-17信号通路、TNF信号通路、PI3K-Akt等信号通路,对雌二醇的反应、对缺氧的反应、凋亡过程的负调控等过程发挥作用,起到对卵巢早衰的治疗效果。阐明坤泰胶囊通过多成分、多靶点、多通路对卵巢早衰的作用机制。

坤泰胶囊联合炔雌醇环丙孕酮片治疗多囊卵巢综合征的临床效果

目的观察坤泰胶囊联合炔雌醇环丙孕酮片治疗多囊卵巢综合征的临床效果。方法选取2019年8月—2022年8月广东医科大学顺德妇女儿童医院收治的多囊卵巢综合征患者100例,采用随机数字表法分为研究组和对照组各50例。对照组给予炔雌醇环丙孕酮片治疗,研究组在对照组基础上给予坤泰胶囊治疗,3个疗程后比较2组临床疗效,治疗前后性激素[黄体生成素(LH)、睾酮(T)、促卵泡激素(FSH)]水平、中医证候评分及不良反应。结果研究组治疗总有效率为94.00%,高于对照组的74.00%(χ^(2)=7.441,P=0.006);治疗3个疗程后,2组LH、T、FSH水平及经行先期、量少色红、五心烦热、咽干口渴、头晕心悸、腰酸腿软评分均低于治疗前,且研究组低于对照组(P<0.01);研究组与对照组不良反应总发生率比较差异无统计学意义(8.00%vs.6.00%,P=1.000)。结论坤泰胶囊联合炔雌醇环丙孕酮片治疗多囊卵巢综合征效果肯定,能改善患者性激素水平,改善临床症状,安全性高。

坤泰胶囊联合雌二醇片/雌二醇地屈孕酮片复合包装对围绝经期综合征患者性激素的影响

目的 观察坤泰胶囊联合雌二醇片/雌二醇地屈孕酮片复合包装对围绝经期综合征(PMS)患者性激素的影响。方法 选取2019年1月—2022年12月昆山市第一人民医院收治的103例PMS患者作为研究对象,根据治疗方案将患者分为A组35例和B组68例。A组患者服用雌二醇片/雌二醇地屈孕酮片复合包装治疗,B组患者在A组基础上联合坤泰胶囊治疗,2组均连续用药12周。比较2组用药前后性激素指标[雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)]、匹兹堡睡眠质量指数(PSQI)评分,症状/体征改善效果及药物相关不良反应。结果 用药12周后,2组E2水平高于用药前,FSH、LH水平及睡眠质量、睡眠时间、睡眠障碍评分低于用药前,且B组高/低于A组(P<0.01)。B组症状/体征改善总有效率高于A组(88.24%vs. 71.43%,χ^(2)=4.530,P=0.033)。治疗期间,B组药物相关不良反应总发生率低于A组(13.24%vs.31.43%,χ^(2)=4.890,P=0.027)。结论 坤泰胶囊联合雌二醇片/雌二醇地屈孕酮片复合包装治疗PMS患者可更有效地纠正性激素异常分泌,调节性激素表达水平,从而改善患者的临床症状,且安全性较高。

坤泰胶囊联合戈舍瑞林治疗中重度子宫内膜异位症腹腔镜术后患者的效果

目的:观察坤泰胶囊联合戈舍瑞林治疗中重度子宫内膜异位症(EMT)腹腔镜术后患者的效果。方法:选取2020年4月至2023年4月于该院行腹腔镜手术的106例中重度EMT患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各53例。对照组术后予以戈舍瑞林治疗,观察组在对照组基础上联合坤泰胶囊治疗,两组均治疗3个月。比较两组临床疗效,治疗前后性激素[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)]水平、子宫动脉血流动力学指标[收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)]水平、炎性指标[可溶性细胞间黏附分子-1(sICAM-1)、基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)]水平,以及不良反应发生率。结果:观察组治疗总有效率为94.34%(50/53),高于对照组的73.58%(39/53),差异有统计学意义(P<0.05);治疗后,观察组FSH、E2、LSH水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组PSV、EDV水平均高于对照组,RI水平低于对照组,差异有统计学意义(P<0.05);治疗后,观察组sICAM-1、MMP-9、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:坤泰胶囊联合戈舍瑞林治疗中重度EMT腹腔镜术后患者可提高治疗总有效率,降低性激素和炎性指标水平,改善子宫动脉血流动力学指标水平,效果优于单纯戈舍瑞林治疗。

坤泰胶囊治疗糖尿病多汗症验案4则

糖尿病是内分泌疾病中第一大疾病,糖尿病多汗症是糖尿病常见并发症之一,83%~94%的糖尿病患者会出现泌汗异常。现代西药治疗糖尿病多汗症效果差,而中药汤剂存在煎煮及服药不便。在临床工作中,作者遵循中医异病同治的原则,对于阴虚火旺型糖尿病多汗症患者,予以中成药坤泰胶囊治疗,效果显著。文章介绍运用坤泰胶囊治疗中医辨证为阴虚的糖尿病多汗症患者验案4例,并进行分析、讨论。

芬吗通联合坤泰胶囊治疗围绝经期综合征疗效及对5-HT、NE、DA水平的影响

目的探讨芬吗通联合坤泰胶囊治疗围绝经期综合征疗效及对5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)水平的影响。方法选择2020年3月—2022年5月天水四零七医院80例围绝经期综合征患者作为研究对象,采用随机数表法将其分为对照组和试验组,每组40例。对照组予以芬吗通单药治疗,试验组予以芬吗通联合坤泰胶囊治疗。评价两组临床疗效及安全性,治疗前后检测性激素[雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成激素(LH)]及神经递质(5-HT、NE、DA)水平。结果试验组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后,试验组E_(2)水平明显高于对照组,差异有统计学意义(P<0.05),两组FSH、LH水平比较,差异无统计学意义(P>0.05)。治疗后,试验组NE、DA水平明显高于对照组,差异有统计学意义(P<0.05),两组5-HT水平比较,差异无统计学意义(P>0.05)。试验组乳房胀痛发生率明显低于对照组,差异有统计学意义(P<0.05)。结论坤泰胶囊辅助芬吗通治疗围绝经期综合征的疗效好,安全可靠,可有效改善E_(2)水平及神经递质水平。

更年期综合征患者采用坤泰胶囊联合黄体酮治疗的临床效果

目的 分析坤泰胶囊联合黄体酮治疗更年期综合征的临床效果。方法 选取更年期综合征患者80例为研究对象,按照随机数表法将其分为对照组(n=40)及研究组(n=40)。对照组采用黄体酮治疗,研究组采用坤泰胶囊联合黄体酮治疗。比较两组患者的激素水平、子宫内膜厚度及临床疗效。结果 使用药物后,研究组促黄体生成素(LH)、促卵泡生成激素(FSH)、雌二醇(E_(2))水平分别为(4.41±0.98)ng/ml、(3.71±0.74)IU/L、(271.15±20.49)pmol/L,均明显优于对照组的(5.42±1.06)ng/ml、(5.42±0.86)IU/L、(210.73±19.76)pmol/L,差异有统计学意义(P<0.05)。使用药物后,研究组子宫内膜厚度为(3.65±0.52)mm,明显厚于对照组的(2.71±0.46)mm,差异有统计学意义(P<0.05)。使用药物后,研究组生活质量量表中心理方面、身体方面、社会方面、环境方面评分均高于对照组,差异有统计学意义(P<0.05)。使用药物后,对照组睡眠时长、入睡时间、夜间觉醒次数均优于对照组,差异有统计学意义(P<0.05)。两组使用药物后的副作用发生率比较,差异无统计学意义(P>0.05)。结论 采用坤泰胶囊联合黄体酮治疗的更年期综合征患者,其激素水平更稳定、子宫内膜更厚,临床效果更好。

芬吗通联合坤泰胶囊对围绝经期功能失调性子宫出血临床疗效和激素水平的影响

目的分析芬吗通联合坤泰胶囊对围绝经期功能失调性子宫出血(DUB)患者临床疗效和激素水平的影响。方法选取76例DUB患者,依据随机数字表法分为两组,各38例。对照组予以芬吗通治疗,观察组予以芬吗通联合坤泰胶囊治疗。比较两组患者的临床疗效、治疗前后性激素水平。结果观察组的总有效率94.74%高于对照组的78.95%,差异具有统计学意义(P<0.05)。治疗后观察组患者卵泡刺激素(FSH)、促黄体生成素(LH)水平均低于对照组,雌二醇(E_(2))水平高于对照组(P<0.05)。结论芬吗通联合坤泰胶囊治疗DUB患者的临床效果确切,可调节激素水平,值得临床推广。

坤泰胶囊联合雌二醇片/雌二醇地屈孕酮片治疗卵巢早衰的效果分析

目的探讨卵巢早衰患者采用坤泰胶囊联合雌二醇片/雌二醇地屈孕酮片治疗的效果。方法选取80例卵巢早衰患者为研究对象,根据奇偶分组原则分为对照组和试验组,每组40例。对照组给予雌二醇片/雌二醇地屈孕酮片治疗,试验组在对照组基础上给予坤泰胶囊治疗,比较两组性激素水平、卵巢功能、不良反应。结果治疗前,两组雌二醇(E_(2))、卵泡刺激素(FSH)、促黄体生成素(LH)水平比较差异均无统计学意义(P>0.05);治疗后,试验组E_(2)水平高于对照组,FSH、LH水平低于对照组(P<0.05);治疗前,两组子宫内膜厚度、卵巢收缩期峰值血流速度、窦卵泡数比较,差异均无统计学意义(P>0.05);治疗后,试验组子宫内膜厚度、窦卵泡数、卵巢收缩期峰值血流速度均优于对照组(P<0.05);两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论卵巢早衰患者采用雌二醇片/雌二醇地屈孕酮片联合坤泰胶囊治疗可调节患者性激素水平,有助于改善患者卵巢功能,且用药安全性高,值得临床推广与应用。