不同方药对多囊卵巢综合征高瘦素血症的影响  

Intervention of different herbs on high serum leptin in women with polycystic ovary syndrome

作　　者：贾丽娜[1] 王兴娟[1] 

机构地区：[1]复旦大学附属华山医院中西医结合妇科,上海200040

出　　处：《复旦学报（医学版）》2008年第4期601-604,共4页Fudan University Journal of Medical Sciences

摘　　要：目的观察不同方药对多囊卵巢综合征（patients with polycystic ovary syndrome,PCOS）患者血清瘦素（leptin）的影响。方法选择PCOS患者共43例（PCOS组）,其中肾阴虚证患者25例,采用滋阴降火方药治疗（滋肾阴组）,脾气虚证患者18例,采用健脾益气方药治疗（补脾气组）;年龄相同健康女性20例（对照组）。各组分别检测体重指数（BMI）、腰臀比（WHR）、腰围（WC）及血清Leptin、睾酮（T）、胰岛素（INS）的浓度,比较PCOS组和对照组之间,以及PCOS各组治疗前后各项指标的差异。结果治疗前PCOS组的BMI、WHR、WC,及血清Leptin、T、INS水平均明显高于对照组（P〈0.01）;去除BMI、WHR、WC的影响后仍有显著性差异;43例PCOS患者中有33例的血清Leptin升高,但在两种证型之间分布无显著性差异（P〉0.05）;治疗后PCOS组（滋肾阴组、补脾气组）BMI、WHR、WC无明显变化,而血清Leptin、T、INS水平较治疗前降低（P〈0.05～P〈0.01）;其中滋肾阴组的血清T、INS水平较治疗前降低（P〈0.05～P〈0.01）;补脾气组的血清INS水平较治疗前有显著降低（P〈0.01）。滋肾阴组、补脾气组的血清Leptin较治疗前有下降趋势,但无统计学意义（P〉0.05）。结论血清Leptin水平异常增高是PCOS的发生发展中不可忽略因素,不同方药均有降调血清Leptin水平趋势,且能改善PCOS患者的高睾酮血症、高胰岛素血症状态,至于Leptin、T、INS因果问题,还有待进一步深入研究。Objective To investigate the effects of two prescriptions on patients with polycystic ovary syndrome （PCOS） patients. Methods In 43 PCOS women （PCOS group）, 25 PCOS women diagnosed with SHEN-YIN deficiency syndrome were treated by nourishing yin for lowering fire recipe （nourishing yin group） ; 18 PCOS women diagnosed with PI-QI deficiency syndrome were treated by strengthening the pi and replenishing qi recipe （benefiting qi group）, 20 ovulatory controls was included as control group. Measurements of body mass index （BMI）, waist-to-hip ratio（WHR）, waist circumference （WC）, fasting leptin, INS,T levels in women with PCOS and controls. Results Before treatment, BMI,WHR, WC and the serum leptin,INS,T levels of PCOS group,nourishing yin group and benefiting qi group were significantly higher than those of the controls （P〈 0. 01）; After adjustment by BMI, WHR or WC, the differences in leptin,INS,T concentration between PCOS and controls were still statistically significant. Among of the 43 PCOS patients, 33 patients had elevated serum leptin, but the distribution of patients with elevated leptin level between the two syndromes had no significant difference （P 〉 0. 05）. After treatment, BMI, WHR and WC of PCOS group （nourishing yin group and benefiting qi group） had no significant changes, however, serum leptin, T and INS levels were lower than those before treatment （P〈0.05 to P〈0.01）. After treated with nourishing yin, serum testosterone and insulin levels nourishing yin group decreased significantly（P〈 0.05）. After treated with strengthening pi and replenishing qi recipe, serum insulin levels in benefiting qi group decreased significantly （P 〈 0.01 ）. Both 25 PCOS women with SHEN-YIN deficiency syndrome （nourishing yin group）and 18 PCOS women with PI-QI deficiency syndrome（benefiting qi group） had a decrease in serum leptin without statistical significance （P〉0.05） ; The total 43 of PCOS patients had a significant reduction of serum lepti

关 键 词：多囊卵巢综合征 瘦素 滋肾阴方药 补脾气方药 

分 类 号：R711.75[医药卫生—妇产科学]