80例丹栀逍遥散加减治疗多囊卵巢综合征高雄激素血症痤疮(肝郁血热型)的临床观察  

Clinical observation of treatment of 80 cases of polycystic ovary syndrome with hyperandrogenism and acne (Ganyu blood heat type) by Danzhi Xiaoyao powder

作　　者：邓丽玲[1] 侯丽莹[1] 罗佩[1] 杨正望[2] 余曦明[1] 

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院妇产科,湖南长沙410007

出　　处：《中国计划生育和妇产科》2016年第12期58-61,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：湖南省自然科学基金项目(项目编号:S2014J504I)

摘　　要：目的观察丹栀逍遥散加减治疗多囊卵巢综合征（polycysticovarysyndrome，PCOS）高雄激素血症痤疮（肝郁血热型）的临床疗效。方法选取2015年3—11月在湖南中医药大学第一附属医院妇科门诊就诊并被确诊为PCOS高雄激素血症痤疮的患者（中医辨证分型为肝郁血热型）共80例，根据不同用药方法分为研究组（40例）和对照组（40例），研究组于正常月经干净后口服本院中药汤剂丹栀逍遥散加减，连服两月；对照组在正常月经或孕激素撤退后出血的第1天起，每天口服1片达英-35，连服21d后停药，撤退性出血后第1天开始下一疗程，连续2个疗程。观察两组治疗前和治疗后2个月的临床皮损症状、睾酮（testosterone，T）、促黄体素（1uteinizinghormone，LH）、促卵泡激素（folliclestimulatinghormone，FSH）和妇科彩超检查双侧卵巢多囊、内膜厚度变化情况，比较两组临床疗效。结果①皮损疗效比较，服药2个月后两组患者痤疮症状均有明显改善，其中研究组临床治愈29例（72．5％），有效9例（22．5％），无效2例（5．0％），总有效率95．0％；对照组临床治愈19例（47．5％），有效ll例（27．5％），无效10例（25．0％），总有效率75．O％。研究组总有效率显著优于对照组（P〈0．05）。②性激素水平测定对比，所有入选患者治疗前均有明显血清T升高，服药2月后，两组血清T水平均降低，治疗组降低效果明显优于对照组（P〈0．05）。③超声检查双侧卵巢多囊和子宫内膜变化，两组比较，差异均无统计学意义（P〉0．05）。两组用药期间均无特殊不适。结论丹栀逍遥散加减与达英-35均能改善痤疮皮损、降低雄激素水平，但丹栀逍遥散加减使雄激素水平下降更快，临床疗效更好，且无不良作用，容易被女性接受和采纳，值得临床推广和应用。Objective To observe the clinical curative effect of Danzhi Xiaoyao powder in the treatment of polycystic ovary syndrome （PCOS）hyperandrogenism acne（ Ganyu blood heat type）. Methods 80 patients in Department of Gynecology and Obestrics, the First Affiliated Hospital of Hunan University of Chinese Medicine diagnosed as PCOS hyperandrogenism Ganyu blood heat type ache were randomly divided into research group and control group after syndrome differentiation of traditional chinese medicine, each group with 40 cases. The research group took oral Chinese medicine Danzhi Xiaoyao powder for 2 months ; the control group were treated with ethinylestradiol and cyproterone acetate tablets post natural menstrual or progestogen, I tablet a day, stopped after 21 days, repeated for 2 cycles. Testosterone （ T）, luteinizing hormone （ LH）, follicle stimulating hormone （FSH） and ultrasound examination of ovarian and endometrlal thickness changing were observed before and 2 months after treatment. Results （~） Comparison of curative effect of skin lesions, the acne symptoms were significantly improved in both groups after 2 months＇ teatment. 29 were cured in research group （72. 5% ）, 9 were markedly improved （22. 5% ）, 2 were invalid （5.0%） ; 19 were cured in control group （47. 5% ）, 11 were markedly improved （27. 5% ）, 10 were invalid（25.0% ）. The total effective rate of research group（95.0% ） was obviously higher than that of control group（75.0% ）. The difference was statistically significant （P 〈 0. 05）. ~） Comparison of hormone levels, androgen level of the research group was significantly reduced than the control grounp after 2 months＇ teatment, the difference was statistically significant（ P 〈 0.05 ）. （~） Comparison of ultrasound exam of the situation of bilateral polycystic ovaries and endometrial changes, the two groups had no significant differences（P 〉 0. 05）. No adverse reaction in both groups. Conclusion The Danzhi Xiaoyao powder and Diane

关 键 词：丹栀逍遥散 肝郁血热型 痤疮 多囊卵巢综合征 高雄激素血症 

分 类 号：R246.3[医药卫生—针灸推拿学]