针刺联合育阴丸对卵巢储备功能下降患者临床及超声下卵巢改变情况的观察  

Clinical Observation on Acupuncture Combined with Yuyin Pills in Treating Patients with Decreased Ovarian Reserve and Changes of Ovarian Ultrasonogram

作　　者：冯晓玲[1] 谷玥儒 赵颜[1] 王炜 FENG Xiao-Ling;GU Yue-Ru;ZHAO Yan;WANG Wei(Section Two of Gynecology Dept.,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040 Heilongjiang,China;Doctoral Candidate of 2017,Graduate School of Heilongjiang University of Chinese Medicine,Harbin 150040 Heilongjiang,China)

机构地区：[1]黑龙江中医药大学附属第一医院妇科二科,黑龙江哈尔滨150040 [2]黑龙江中医药大学研究生学院,黑龙江哈尔滨150040

出　　处：《广州中医药大学学报》2020年第9期1684-1689,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81574014);国家中医药管理局国家中医临床研究基地业务建设科研专项课题(编号:JDZX2015053)。

摘　　要：【目的】观察针刺联合中药育阴丸治疗肝肾阴虚型卵巢储备功能下降(DOR)患者的临床疗效及对性激素水平和卵巢超声检测指标的影响。【方法】将43例20岁<年龄<40岁并符合月经过少诊断的肝肾阴虚型DOR患者随机分为治疗组21例和对照组22例。治疗组给予电针联合中药育阴丸治疗,对照组给予安慰针联合中药育阴丸治疗,疗程为3个月。观察2组患者治疗前后月经血量(MBL)积分、性激素[卵泡刺激素(FSH)、黄体生成素(LH)、FSH/LH和雌二醇(E2)]水平及卵巢彩色多普勒超声检测指标[卵巢体积(MOD)、窦卵泡计数(AFC)、收缩期峰值血流速度(PSV)、阻力指数(RI)、搏动指数(PI)]的变化情况,并评价2组患者的综合疗效。【结果】(1)观察过程中,治疗组脱落1例,对照组脱落2例,最终治疗组和对照组各有20例患者完成全部疗程。(2)疗效方面:治疗3个月后,治疗组的总有效率为90.0%(18/20),对照组为75.0%(15/20),治疗组的综合疗效明显优于对照组,差异有统计学意义(P<0.01)。(3)月经情况方面:治疗后,2组患者MBL积分均较治疗前明显升高(P<0.01),且治疗组的MBL积分明显高于对照组,差异有统计学意义(P<0.05)。(4)性激素水平方面:治疗后,2组患者血清FSH、FSH/LH水平及治疗组血清LH水平均较治疗前降低,血清E2水平均较治疗前升高,差异均有统计学意义(P<0.05或P<0.01),且治疗组在降低LH水平和升高E2水平方面均优于对照组,差异均有统计学意义(P<0.05)。(5)超声检测指标方面:治疗后,2组患者的MOD、AFC、PSV、PI、RI均较治疗前改善,差异均有统计学意义(P<0.01)。治疗后组间比较,治疗组在改善PSV、PI、RI指标方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】电针联合中药育阴丸治疗肝肾阴虚型DOR具有较好疗效,可有效改善患者临床症状,调节患者性激素水平,增强卵巢基质血流状态,从而有助于提高患者的排卵率�Objective To explore the clinical effect of acupuncture plus Chinese medicine Yuyin Pills for the treatment of decreased ovarian reserve with the syndrome of liver and kidney yin deficiency,and to observe the effects on sex hormone levels and related ovarian ultrasonogram indexes. Methods Forty-three scanty menstruation patients with the syndrome of liver and kidney yin deficiency and aged 20 ~ 40 years old were randomized into treatment group(n = 21)and control group(n = 22). The treatment group was given electroacupuncture plus oral use of Chinese medicine Yuyin Pills, and the control group was given placebo acupuncture plus oral use of Chinese medicine Yuyin Pills. The treatment for the two groups covered 3 months. Before and after treatment,we observed the changes in the scores of menstrual blood loss(MBL),the levels of sex hormones such as folliclestimulating hormone(FSH),luteinizing hormone(LH),the ratio of LH to FSH(LH/FSH),and estradiol(E2),and the ovarian color Doppler ultrasonography assessment parameters such as the maximum ovarian diameters(MOD),antral follicle count(AFC),peak systolic velocity(PSV),resistance index(RI)and pulsatility index(PI). After treatment,the comprehensive clinical efficacy in the two groups was evaluated. Results(1)During the trial,one case from the treatment group and 2 cases from the control group dropped out,and a total of 20 cases in the treatment group and 20 cases in the control group completed the whole trial.(2)After treatment for 3 months,the total effective rate in the treatment group was 90.0%(18/20),and the total effective rate in the control group was 75.0%(15/20). The comprehensive clinical efficacy in the treatment group was superior to that in the control group,and the difference was statistically significant(P<0.01).(3)After treatment,the MBL scores in the two groups were increased in comparison with those before treatment(P<0.01),and the MBL scores in the treatment group was significantly higher than those in the control group after treatment, the difference b

关 键 词：育阴丸 针刺 卵巢储备功能下降 肝肾阴虚型 性激素 超声检测 

分 类 号：R246.3[医药卫生—针灸推拿学]