加味左归丸联合激素替代疗法治疗卵巢早衰临床研究  

Clinical Study of Modified Zuogui Wan Combined with Hormone Replacement Therapy in the Treatment of Premature Ovarian Failure

作　　者：晏文娉 桑晓梅[1] 何晓焱[1] 潘广彪[1] 

机构地区：[1]泸州市人民医院,四川泸州646000

出　　处：《中医学报》2017年第8期1487-1490,共4页Acta Chinese Medicine

基　　金：四川省教育科研项目{川教函[2011]538号11ZB130}

摘　　要：目的:观察加味左归丸联合激素替代疗法治卵巢早衰(premature ovarian failure,POF)的临床疗效。方法:将96例POF患者随机分为对照组47例和观察组49例。对照组采用戊酸雌二醇片/雌二醇环丙孕酮片(克龄蒙)治疗,每日1片,无间断的服用21 d。撤退性出血5 d,第5天后重复使用此法,连续使用6个月经周期。观察组在对照组治疗的基础上加用加味左归丸(熟地黄20 g,山药15 g,枸杞子15 g,山萸肉10 g,菟丝子10 g,鹿胶10 g,龟胶10 g,党参20 g,女贞子20 g,墨旱莲20 g,川牛膝10 g,当归10 g,香附10 g,鸡血藤20 g,郁金10 g)治疗。共治疗6个月经周期。记录主要症状评分,检测两组治疗前后卵泡刺激素(follicle-stimulating hormone,FSH)、促黄体素(luteotropic hormone,LH)、雌二醇(estradiol,E2)水平,临床疗效和不良反应。结果:观察组有效率为91.84%,对照组有效率为74.47%,观察组高于对照组,差异有统计学意义(χ2=5.210,P<0.05);治疗后两组症状积分逐渐下降,差异有统计学意义(P<0.01),观察组在治疗后第3个月、第6个月经周期症状积分均低于对照组,差异有统计学意义(P<0.01);治疗后两组血清FSH和LH水平均较治疗前显著下降,差异有统计学意义(P<0.01),观察组下降更为显著,差异有统计学意义(P<0.01);治疗后两组E2水平较治疗前明显升高,差异有统计学意义(P<0.01),治疗后观察组E2水平高于对照组,差异有统计学意义(P<0.01);两组患者均无严重不良事件发生。对照组不良反应累积发生率为29.79%,高于观察组的10.20%,差异有统计学意义(χ2=5.795,P<0.05)。结论:加味左归丸联合激素替代疗法在改善POF围绝经期症状、纠正性激素的紊乱、促进卵巢功能恢复方面有较好临床疗效,且无严重不良事件发生。Objective ：To observe the clinical efficacy of modified Zuogui Wan combined with hormone replacement therapy in the treatment of premature ovarian failure （POF）. Methods ：96 patients with POF were randomly divided into 47 cases of the control group and 49 cases of the observation group. The control group was given Estradiol Valerate tablets / Estradiol Valerate and Cypro- terone Acetate tablets （CLIMEN）, 1 tablet daily, continuous taking 21 d. Withdrawal bleeding 5 d, repeated use fifth days later, continuous use of 6 menstrual cycles. The observation group was treated with modified Zuogui Wan, composition： Shudihuang（Pre-pared Rehmannia Root） 20 g, Shanyao （ Chinese Yam） 15 g, Gouqizi （ the Fruit of Chinese Wolfberry） 15 g, Shanyurou （ Fructus Cor- ni） 10 g, Tusizi （ Semen Cuscutae ） 10 g, Lujiao （ Deer-Horn Glue） 10 g, Guijiao （ Tortoise-Shell Glue ） 10 g, Dangshen （ Codonopsis Pilosula ） 20 g, Nvzhenzi （ Glossy Privet Fruit） 20 g, Mohanlian （Eclipta） 20 g, Chuanniuxi （ Radix Cyathulae） 10 g, Danggui （ Angeli- ca Sinensis）10 g,Xiangfu（ Cyperus Rotundus）10 g,Jixueteng（ Caulis Spatholobi）20 g,Yujin（ Radix Curcumae）10 g. A total of 6 menstrual cycles. Recorded the scores of main clinical symptoms, detected follicle stimulating hormone （ FSH）, luteotropic hormone （LH）, estradiol （E2 ） level, clinical efficacy and adverse reactions. Results：The effective rate of observation group was 91.84%, the control group was 74.47%, the difference was statistically significant （X2 = 5. 210, P 〈 0.05 ） ;after treatment, symptom scores decreased of the two groups, the difference was statistically significant （ P 〈 0.01 ）, in the 3rd and 6th month menstrual cycle symptom scores after treatment of the treatment of group were lower than the control group, the difference was statistically signifi- cant （P 〈0. O1 ） ;after treatment,serum FSH and LH levels of the two groups were significantly lower than before treatment（ P 〈 0.

关 键 词：卵巢早衰 加味左归丸 戊酸雌二醇片/雌二醇环丙孕酮片 中医药治疗 中西医结合 

分 类 号：R271.911[医药卫生—中西医结合]