俞氏清肝方治疗肝经湿热型多囊卵巢综合征随机对照研究  

The Effects of Yushi Qinggan Recipe in Treating Polycystic Ovary Syndrome with Dampness-heat of Gan Channel: A Randomized Controlled Trial

作　　者：俞瑾 刘璐茜 翟东霞[1] 张丹英[1] 程雯[1] 姚睿嫔[1] 白玲玲[1] 孙帅[1] 俞超芹[1] YU Jin;LIU Lu-qian;ZHAI Dong-xia;ZHANG Danying;CHEN Wen;YAO Rui-pin;BAI Lin-lin;SUN Shuai;YU Chao-qin(Department of Gynaecolagy,Changhai Hospital Affiliated of The Second Military University,Shanghai,200433)

机构地区：[1]第二军医大学附属长海医院中医妇科,上海200433

出　　处：《中国中西医结合杂志》2019年第3期282-287,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年基金项目(No.81603646)

摘　　要：目的观察俞氏清肝方治疗肝经湿热型多囊卵巢综合征的临床疗效。方法采用随机对照研究,将175例肝经湿热型多囊卵巢综合征患者根据随机数字表法分为治疗组(86例)和对照组(89例),分别给予俞氏清肝方和达英-35药物治疗连续3个月并于治疗后随访3个月。统计各组患者的妊娠及排卵情况,观察并比较两组患者治疗前后BMI、WHR及临床症状(多毛、痤疮、黑棘皮症、月经不调、经前乳胀、心烦易怒、口干口苦、便秘、发油/脱发)的改善情况,检测治疗前后患者血清内分泌[促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)、游离睾酮(FT)、雌酮(E_1)、雌二醇(E_2)、硫酸脱氢表雄酮(DHEAS)、催乳素(PRL)、性结合球蛋白(SHBG)、瘦素、空腹血糖(FBG)、胰岛素(INS)]水平并计算INS曲线下面积(IAUC)、INS抵抗指数(HOMA-IR)及INS敏感指数(ISI)的变化情况,超声观察患者子宫卵巢的一般情况及基质血流情况。结果治疗组治疗后患者的妊娠率为12.16%(9/74),周期排卵率为57.95%,临床总有效率为75.68%(56/74),显著高于对照组的临床总有效率[50.98%(26/51),P<0.05]。与本组治疗前比较,治疗后两组患者血清LH、LH/FSH、T、FT、DHEAS、INS_(30 min)、INS_(60 min)、INS_(120 min)水平及IAUC明显降低(P<0.05),痤疮以及月经不调、经前乳胀、心烦易怒、发油/脱发症状得到明显改善(P<0.05);治疗组子宫内膜厚度、子宫动脉最大流速及卵巢动脉流速明显增加,卵巢体积明显缩小(P<0.05)。与对照组比较,治疗后治疗组患者经前乳胀症状、口干口苦、大便秘结症状减轻(P<0.05),FT水平升高,SHBG及IAUC水平降低(P<0.05)。结论俞氏清肝方可明显改善肝经湿热型多囊卵巢综合征患者的临床症状及子宫卵巢内环境,调整患者紊乱的内分泌水平,可有效促进患者排卵,有利于妊娠。Objective To observe the clinical curative effects of Yushi Qinggan Recipe(YQR) in treating of Polycystic ovary syndrome(PCOS) with dampness-heat of Gan channel. Methods A randomized controlled trial was conducted, 175 PCOS patients with dampness-heat of Gan channel were randomly assigned to the treatment group(86 cases)and control group(89 cases). Patients were administrated drugs by YQR or Diane35 respectively for 3 months and 3-month follow-up was performed after treatment. The cycle ovulation rate and pregnancy rate were caculated. The body mass index(BMI),waist-hip ratio(WHR) and the clinical symptoms including hirsutism, acne, acanthosis nigricans, irregular menoxenia, breast distention before menstruation, irritability, dry and bitter mouth, constipation and greasy hair/hair loss were observed. The endocrine indexes including luteinizing hormone(LH), follicle stimulating hormone(FSH), testosterone(T), free testosterone(FT), estrone(E1), estradiol(E2), dehydroepiandrosterone sulfate(DHEAS), prolactin(PRL), sex binding globulin(SHBG), leptin, fasting blood-glucose(FBG) and insulin, insulin area under curve(IAUC), insulin resistance index(HOMA-IR), insulin sensitivity index(ISI) were detected and compared between the two groups of patients before and after the treatments. The general condition of uterus and ovary and stromal blood flow were observed by ultrasound. Results The clinical pregnancy rate of the treatment group was 12.16%(9/74) and the periodic ovulation rate was 57.95%, and the clinical efficacy rate was 75.68%(56/74), which was significantly higher than that of the control group [50.98%(26/51), P<0.05]. Compared with the before treatment in same group, the level of endocrine indexes including LH, LH/FSH, T, FT, DHEAS and INS30 min, INS60 min, INS120 min, IAUC of patients in two groups were obviously reduced(P<0.05). Also the symptoms of acne, irregular menoxenia, irritability, breast distention before menstruation, greasy hair/hair loss of patients were obviously improved(P<0.05). Meanwhile, the

关 键 词：俞氏清肝方 肝经湿热 多囊卵巢综合征 

分 类 号：R271.9[医药卫生—中西医结合]