补肾健脾化痰法治疗多囊卵巢综合征伴胰岛素抵抗的临床观察  

Clinical Observation on Therapy of Nourishing Kidney,Replenishing Spleen and Resolving Phlegm for Treatment of Polycystic Ovary Syndrome Complicated with Insulin Resistance

作　　者：冯丽 司雨 廖慧慧[1] FENG Li;SI Yu;LIAO Hui-Hui(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州中医药大学第一临床医学院,广东广州510405

出　　处：《广州中医药大学学报》2020年第9期1651-1657,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局第二轮学术流派传承工作室项目“岭南罗氏妇科流派传承工作室”(国中医药人教函[2017]9号);张玉珍全国名老中医药专家传承工作室(粤中医办函[2017]209号)。

摘　　要：【目的】观察以补肾健脾化痰法为治则,以五子补肾调经方和健脾化痰消脂方的双处方隔日交替服用法治疗多囊卵巢综合征伴胰岛素抵抗(PCOS-IR)患者的临床疗效。【方法】将78例脾肾不足兼痰湿证PCOS-IR患者随机分为试验组和对照组,每组各39例。试验组给予五子补肾调经方和健脾化痰消脂方隔日交替服用治疗,对照组给予五子补肾调经方联合二甲双胍治疗,疗程为6个月。观察2组患者治疗前后中医证候积分、月经周期、体质量指数(BMI)、性激素水平[促黄体生成素/促卵泡激素(LH/FSH)、催乳素(PRL)、睾酮(T)]、胰岛素抵抗指数(HOMA-IR)、卵巢体积的变化情况,比较2组患者治疗后基础体温(BBT)双相率和妊娠率情况,评价2组患者的临床疗效。【结果】(1)治疗过程中,试验组脱落2例,对照组脱落5例,最终试验组37例、对照组34例完成试验。(2)治疗6个月后,试验组的愈显率为91.89%(34/37),对照组为67.65%(23/37),试验组的疗效明显优于对照组(P<0.01)。(3)治疗后,2组患者的中医证候积分均较治疗前下降(P<0.05),且试验组的下降作用优于对照组(P<0.05或P<0.01)。(4)治疗后,2组患者的延后的月经周期均较治疗前明显缩短(P<0.01),且试验组的月经周期明显短于对照组(P<0.01)。(5)治疗后,2组患者的BMI均较治疗前下降(P<0.05),但组间比较,差异无统计学意义(P>0.05)。(6)治疗后,试验组LH/FSH、PRL、T值和对照组LH/FSH、PRL值均较治疗前下降(P<0.05),且试验组的LH/FSH、PRL、T值均明显低于对照组(P<0.05)。(7)治疗后,2组患者HOMA-IR值均较治疗前降低(P<0.05),且试验组的HOMA-IR值明显低于对照组(P<0.05)。(8)治疗后,2组患者的卵巢体积均较治疗前缩小(P<0.05),且试验组的卵巢体积小于对照组(P<0.05)。(9)治疗期间,试验组的BBT双相率为74.77%(166/222),明显高于对照组的50.98%(104/204),差异有统计学意义(P<0.01)。(10)试验组的妊娠率为60.90%Objective To observe the clinical efficacy of the double-recipe alternative medication of Wuzi Bushen Tiaojing Recipe and Jianpi Huatan Xiaozhi Recipe every other day based on the therapeutic principles of nourishing kidney,replenishing spleen and resolving phlegm for the treatment of patients with polycystic ovary syndrome complicated with insulin resistance(PCOS-IR). Methods Seventy-eight PCOS-IR patients with the insufficiency of spleen and kidney complicated with the phlegm and dampness syndrome were randomly divided into trial group and control group,39 cases in each group. The trial group was given the double-recipe alternative medication of Wuzi Bushen Tiaojing Recipe and Jianpi Huatan Xiaozhi Recipe every other day,and the control group was given Wuzi Bushen Tiaojing Decoction combined with metformin tablets,the course of treatment for the two groups lasting 6 months. Before and after treatment, the scores of traditional Chinese medicine(TCM)syndrome,menstrual cycle,body mass index(BMI),indexes of sex hormones such as the ratio of luteinizing hormone to follicle-stimulating hormone(LH/FSH),prolactin(PRL)and testosterone(T),homeostasis model assessment of insulin resistance(HOMA-IR), and ovarian volume in the two groups were detected. After treatment,basal body temperature(BBT)biphasic rate and pregnancy rate in the two groups were compared and the clinical efficacy was also evaluated. Results(1)During the trial,2 cases from the trial group and 5 cases from the control group dropped out,and a total of 37 cases in the trial group and 34 cases in the control group completed the trial.(2)After treatment for 6 months,the markedly effective rate in the trial group was 91.89%(34/37),and that in the control group was 67.65%(23/34),the clinical efficacy of the trial group being superior to that of the control group(P<0.01).(3)After treatment, the scores of TCM syndrome of both groups were decreased in comparison with those before treatment(P<0.05),and the decrease in the trial group was superior to that in the con

关 键 词：多囊卵巢综合征 胰岛素抵抗 脾肾不足兼痰湿证 补肾健脾化痰法 五子补肾调经方 健脾化痰消脂方 双处方隔日交替服用法 调经助孕 

分 类 号：R711.75[医药卫生—妇产科学] R271.9[医药卫生—临床医学]