调经汤对多囊卵巢综合征不孕卵泡质量和激素分泌的影响  

Influence of Tiaojing Decoction on Quality of Follicle and Hormone Secretion on Polycystic Ovary Syndrome

作　　者：吴霍曼[1] 李兆萍[1] 王藴琪 向丽娟[1] 

机构地区：[1]海南省中医院妇产科,海口570203

出　　处：《中国实验方剂学杂志》2014年第18期200-203,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:探讨调经汤治疗多囊卵巢综合征不孕(PCOS)的疗效及作用机制。方法:将84例PCOS患者随机按数字表法分为调经汤组和对照组各42例。对照组采用炔雌醇环丙孕酮片+枸橼酸氯米芬+注射用尿促性素治疗;调经汤组在对照组治疗的基础上加用调经汤。两组疗程均为3个月经周期。采用B超监测卵泡发育情况,并测定主导卵泡膜血流,记录搏动指数(PI)和阻力指数(RI);检测人绒毛膜促性腺激素(HCG)注射日,黄体生成素(LH)、血清睾酮(T)、雌二醇(E2)水平和卵泡刺激素(FSH)水平;检测治疗前后空腹血糖(FBG)、空腹胰岛素(FINS)水平和瘦素(LP)水平,并计算胰岛素抵抗指数(HOMAIR);记录月经恢复率、排卵率、妊娠率。结果:调经汤组月经恢复率、排卵率和妊娠率为92.86%,83.33%和57.14%分别优于对照组的73.81%,61.90%和35.71%(P<0.05)。治疗后两组PI比治疗前有明显上升,调经汤组高于对照组(P<0.01);治疗后两组RI较治疗前下降,调经汤组低于对照组(P<0.01);治疗后调经汤组FSH,LH和E2水平高于对照组(P<0.01),血清睾酮水平低于对照组(P<0.01);治疗后两组FINS,LP,IR均比治疗前下降,调经汤组治疗后FINS,LP,IR低于对照组(P<0.05)。结论:在西医常规治疗的基础上,调经汤能改善卵巢血流,提高卵泡质量,并能改善高雄激素血症和胰岛素抵抗,提高了排卵率和妊娠率。Objective：Curative effect and mechanism of Tiaojing decoction on polycystic ovary syndrome （PCOS） were investigated.Method：Eighty-four patients with PCOS were randomly divided into control groupand Tiaojing decoction group （42 cases,respectively） by random number table.Patients in control group received ethinylestradiol and cyproterone acetate tablets,clomifene citrate and menotrophin injection.Based on the treatment of control group,Tiaojing decoction was added in Tiaojing decoction group.Course of treatment in two groups were 3 menstrual cycles.Condition of follicular development was monitored by B-ultrasonic wave and the blood flow of follicularis membrane was also detected,pulsatility index （PI） and resistance index （RI） were recorded.And levels of human chorionic gonadotropin （HCG）,luteinizing hormone （LH） （injection day）,serum testosterone （T）,estradiol （E2） and follicle-stimulating hormone （FSH） were detected.Levels of fasting blood-glucose （FBG）,fasting insulin （FINS） and leptin （LP） were detected,and homeostasis model assessment of insulin resistance （HOMA-IR） was calculated before and after treatment.Rates of menstruation recovery,ovulation and pregnancy were recorded.Result：Rates of menstruation recovery,ovulation and pregnancy in Tiaojing decoction group were 92.86％,83.33％ and 57.14％ respectively,which were superior to those in control group （73.81％,61.90％ and 35.71％） （P ＜ 0.05）.Compared with that before treatment,PI in both groups increased,and which in Tiaojing decoction group was higher than in control group （P ＜ 0.01）.Compared with that before treatment,RI in both groups decreased,and which in Tiaojing decoction group was lower than in control group （P ＜ 0.01）.Levels of FSH,LH and E2 in Tiaojing decoction group were higher than those in control group （P ＜ 0.01）,and level of serous testosterone was lower than in control group （P ＜ 0.01）.After treatment,compared with those before treatment,FIN

关 键 词：多囊卵巢综合征 不孕 卵泡质量 激素内分泌 瘦素 调经汤 

分 类 号：R287[医药卫生—中药学]