二至天癸颗粒治疗肾阴虚低促性腺激素性腺功能减退症的机理研究  

Mechanism of Erzhi Tiangui Granule in treating kidney yin-deficiency hypogonadotropic hypogonadism

作　　者：连方[1] 张心耸 肖征[2] Lian Fang;Zhang Xinsong;Xiao Zheng(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011)

机构地区：[1]山东中医药大学附属医院,山东济南250011 [2]济宁医学院附属医院兖州院区

出　　处：《中国现代医药杂志》2017年第2期20-24,共5页Modern Medicine Journal of China

摘　　要：目的探讨二至天癸颗粒治疗肾阴虚低促性腺激素性腺功能减退症(HH)的作用机理。方法 60例肾阴虚低促性腺激素性腺功能减退症患者随机分为两组,研究组口服二至天癸颗粒治疗,对照组口服六味地黄颗粒,并选取同期门诊30例育龄妇女作空白对照。测定3组患者月经期2~3天性激素和子宫长度、内膜厚度、卵巢平均体积、窦卵泡个数以及子宫、卵巢血流动力学;测定研究组和对照组HCG注射日子宫、卵巢动脉血流动力学,血清LH、E2、P、VEGF水平以及子宫内膜厚度、类型、内膜血流分布;比较研究组和对照组治疗前后月经变化、基础内分泌水平和肾阴虚证候变化。结果 (1)HCG注射日研究组与对照组相比子宫、卵巢血流为高速低阻型,E2、LH、VEGF水平比对照组高,子宫内膜厚度、类型、内膜血管形态比对照组好,差异有统计学意义(P<0.05);(2)治疗后月经期FSH、LH、E2水平升高幅度,月经量及周期改善程度,肾阴虚证候改善程度,研究组比对照组更明显,差异有统计学意义(P<0.05);(3)研究组排卵率、妊娠率均高于对照组,差异有统计学意义(P<0.05)。结论二至天癸颗粒可以提高HH患者卵泡期FSH、LH、E2水平,提高围排卵期VEGF水平,提高排卵前LH水平,改善子宫内膜容受性,促进卵泡生长发育、成熟及排出,进一步提高胚胎着床率及妊娠率。Objective To evaluate the mechanism of Erzhi Tiangui Granule in treating kidney yin-deficiency hypogonadotropic hypogonadism(HH).Methods60cases of kidney yin-deficiency hypogonadotropic hypogonadism patients were randomly divided into two groups,the study group were treated with Erzhi Tiangui Granule,the control group were treated with Liuwei Dihuang Granule.Chose30cases of outpatient women of childbearing age in the same period as blank.Three groups of patients were detected sex hormones and uterine length,thickness of endometrium,ovary average volume,the number of follicles sinus,hemodynamic changes in the uterus and ovaries in the2~3days of menstrual period.Study group and control group were measured uterine and ovarian artery hemodynamics,serum LH,E2,P,VEGF levels and endometrial thickness,type,endometrial blood flow distribution on the HCG-injected day.Study group and control group were compared menstrual changes,changes in sex hormone levels and kidney-deficiency before and after treatment.Results①Uterine and ovarian blood flow of the study group compared with the control group was high speed and low resistance on the HCG-injected day.E2,LH and VEGF levels of the study group were higher than those in the control group.The endometrial thickness,type and vascular morphology of the study group were better than those in the control group.The difference between the two groups was statistically significant.②After treatment,the levels of FSH,LH and E2were increased,the amount of menstruation and the period of the menstrual cycle were improved,and the improvement of kidney deficiency syndrome was more obvious than that in the control group,and the difference between the two groups was statistically significant.③The rates of ovulation and pregnancy in the study group were higher than those in the control group,the difference was statistically significant.Conclusion Erzhi Tiangui Granule can improve the levels of FSH,LH,E2in patients with HH during the follicular phase,increase VEGF levels around ovulation,impr

关 键 词：低促性腺激素性腺功能减退症 经阴道彩色多普勒超声 血流动力学 血管内皮生长因子 中药治疗 

分 类 号：R259[医药卫生—中西医结合]