化痰祛瘀、补肾调周法治疗多囊卵巢综合征痰湿瘀滞证临床观察  

Clinical observation of the therapy of removing phlegm-blood stasis and tonifying kidney-regulating menstrual cycle on polycystic ovarian syndrome with phlegm-damp stagnation syndrome

作　　者：万朝霞 施亚平 姚石安 陈冬梅 胡丽新 宋倩 

机构地区：[1]江苏省南通市中医院妇科,江苏南通226001 [2]江苏省南通市妇幼保健医院,江苏南通226001

出　　处：《河北中医》2017年第12期1782-1786,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：南通市科学技术局2014年度南通市市级科技计划(指导性)项目(编号:HS149082)

摘　　要：目的观察化痰祛瘀、补肾调周法治疗多囊卵巢综合征(PCOS)痰湿瘀滞证的临床疗效。方法将90例PCOS痰湿瘀滞证患者随机分为3组,中药组30例予化痰祛瘀、补肾调周中药治疗,西药组30例予炔雌醇环丙孕酮片治疗,中西药组30例予化痰祛瘀、补肾调周中药+炔雌醇环丙孕酮片治疗,3组均治疗3个月经周期后予枸橼酸氯米芬片促排卵治疗。观察患者治疗前后体质量指数(BMI)、卵巢排卵情况、月经情况及药物反应;测定患者治疗前后性激素[雌二醇(E_2)、卵泡刺激素(FSH)、黄体生成激素(LH)、睾酮(T)]指标变化;测定患者治疗前后空腹血糖(FPG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(IR);观察患者治疗前后血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]变化。结果 3组治疗后月经周期、小卵泡数、有排卵周期例数、多毛积分、痤疮积分均优于本组治疗前(P<0.05);中药组、中西药组治疗后BMI低于本组治疗前(P<0.05);西药组、中西药组治疗后多毛积分、痤疮积分均低于中药组(P<0.05);中西药组治疗后有排卵周期例数优于中药组、西药组(P<0.05)。3组治疗后LH、T均较本组治疗前降低(P<0.05);治疗后中西药组LH、T均低于中药组、西药组(P<0.05)。中药组、中西药组治疗后FINS均较本组治疗前升高(P<0.05),IR降低(P<0.05);中药组、中西药组治疗后FINS高于西药组(P<0.05),IR低于西药组(P<0.05);中药组与中西药组治疗后FINS、IR比较差异均无统计学意义(P>0.05)。中药组、中西药组治疗后TC、TG、LDL-C均较本组治疗前降低(P<0.05);治疗后中药组、中西药组TC、TG、LDL-C均低于西药组(P<0.05);中药组、中西药组治疗后TC、TG、LDL-C比较差异均无统计学意义(P>0.05)。结论化痰祛瘀、补肾调周法治疗PCOS痰湿瘀滞证疗效满意,推测中药对于PCOS痰湿瘀滞证的作用机制在于有效调节糖、脂代谢。Objective To observe the effects the therapy of removing phlegm-blood stasis and tonifying kidney-regulating menstrual cycle on polycystic ovarian syndrome( PCOS) with phlegm-damp stagnation syndrome.Methods 90 PCOS patients with phlegm-damp stagnation syndrome were randomly divided into three groups. 30 cases in the traditional Chinese medicine( TCM) group were treated by herbs. 30 cases in the western medicine group were treated by Ethinylestradiol cyproterone tablets. 30 cases in the TCM plus western medicine group were treated by herbs combined with Ethinylestradiol cyproterone tablets. The three groups were treated by Ethinylestradiol cyproterone tablets ovulation therapy after treatment three menstrual cycles. The body mass index( BMI),ovarian ovulation,menstruation and drug reaction before and after treatment were observed. The sex hormones including estradiol( E_2),follicle-stimulating hormone( FSH),luteinizing hormone( LH) and testosterone( T) before and after treatment were detected. The fasting blood-glucose( FBG) and fasting insulin( FINS) before and after treatment were detected,and the insulin resistance index( IR) was evaluated. The serum lipid indexes including total cholesterol( TC),triglyceride( TG) and low-density lipoprotein cholesterol( LDL-C) before and after treatment were detected. Results The scores of menstrual cycle,the number of small follicles,the number of ovulation cycles,hairy and acne after treatment were better than before in three groups( P < 0. 05). The BMI after treatment in the TCM group and the TCM plus western medicine group were lower than before treatment( P < 0. 05). The scores of hairy and acne after treatment in the western medicine group and the TCM plus western medicine group were lower than that in the TCM group( P < 0. 05).The number of ovulation cycles after treatment in TCM plus western medicine group was superior to that in the TCM group and western medicine group( P < 0. 05). The LH and T after treatment were reduced in three groups( P <0. 05),and which in the

关 键 词：多囊卵巢综合征 辨证分型 中医疗法 

分 类 号：R711.750.5[医药卫生—妇产科学] R737.310.5[医药卫生—临床医学]