滋肾育胎丸合滋癸益经汤治疗早发性卵巢功能不全的临床研究  

Clinical Study of Zishen Yutai Pills Combined with Zigui Yijing Decoction for the Treatment of Premature Ovarian Insufficiency

作　　者：简焕玲 赵颖[2] JIAN Huan-Ling;ZHAO Ying(The Gynecology Dept.,the Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510145 Guangdong,China;The Gynecology Dept.,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第三附属医院妇科,广东广州510145 [2]广州中医药大学第一附属医院妇科,广东广州510405

出　　处：《广州中医药大学学报》2021年第4期703-711,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2016A020215180);国家中医药管理局张玉珍全国名老中医药专家传承工作室(编号:国中医药人教函[2018]134号);广东省中医药局张玉珍广东省名老中医药专家传承工作室(编号:粤中医办函[2017]209号)。

摘　　要：【目的】观察滋肾育胎丸合滋癸益经汤治疗早发性卵巢功能不全(POI)的临床疗效,为“治疗POI应当大补气血精而非单纯滋阴补肾”的诊疗思路提供事实依据。【方法】将90例POI患者随机分为观察组46例和对照组44例。2组患者均给予滋癸益经汤治疗,在此基础上,观察组合用滋肾育胎丸治疗,对照组合用维生素E治疗,3个月为1个疗程,连续治疗2个疗程。观察2组患者治疗前后月经情况评分、中医症候评分、改良Kupperman评分、血清性激素[促卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)及抗缪勒氏管激素(AMH)]水平以及子宫附件彩超指标的变化情况,评价2组患者的综合疗效。【结果】(1)治疗过程中,观察组脱落1例,对照组脱落5例,最终共84例完成试验,其中观察组45例,对照组39例。(2)疗效方面,治疗6个月后,观察组总有效率为68.9%(31/45),对照组为51.3%(20/39),观察组的综合疗效优于对照组,差异有统计学意义(P<0.05)。(3)月经情况评分方面,治疗6个月后,观察组除了周期及经期外,其余月经情况评分均较治疗前明显改善(P<0.05),对照组在经色、经质、痛经、经前乳胀、腰膝酸软上的评分也较治疗前明显改善(P<0.05),但2组患者对各项月经情况评分的改善作用均无显著性差异(P>0.05)。(4)中医症候评分和改良Kupperman评分方面,在治疗3、6个月后,2组患者的绝大多数症候评分、改良Kupperman评分及其总积分较治疗前改善(P<0.05或P<0.01),且观察组在治疗3、6个月后对中医症候总积分和改良Kupperman总积分的改善作用均明显优于对照组(P<0.05或P<0.01)。(5)血清性激素方面,治疗3、6个月后,2组患者血清性激素水平均较治疗前有不同程度改善,其中FSH、LH水平较治疗前下降,E2、AMH水平较治疗前上升;且观察组在改善FSH、LH水平方面均优于对照组(P<0.05)。(6)彩超指标方面,治疗3、6个月后,2组患者的子宫大小、子�Objective To observe the curative effect of Zishen Yutai Pills combined with Zigui Yijing Decoction for the treatment of premature ovarian insufficiency(POI),so as to provide evidence for the thoughts that treatment of premature ovarian insufficiency should be achieved by potently tonifying qi,blood and essence rather than simply nourishing yin and tonifying the kidney.Methods A total of 90 qualified POI patients were randomly divided into observation group(46 cases)and control group(44 cases).The two groups were given oral use of Zigui Yijing Decoction orally,and additionally,the observation group was treated with Zishen Yutai Pills orally and the control group was treated with vitamin E soft capsules orally.Three months constituted a course of treatment,and the treatment for the two groups lasted 2 continuous courses.Before and after treatment,we observed the scores of menstruation,traditional Chinese medicine(TCM)syndrome scores,modified Kupperman indexe scores,and serum hormone levels such as follicle-stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),and anti-Mullerian hormone(AMH)as well as the color Doppler ultrasonography parameters for uterine appendages in the two groups.After treatment,the comprehensive therapeutic efficacy in the two groups was evaluated.Results(1)During the trial,one case from the observation group and 5 cases from the control group dropped out,and a total of 84 cases(45 cases of the observation group and 39 cases of the control group)completed the trial.(2)After treatment for 6 months,the total effective rate of the observation group was 68.9%(31/45)and that of the control group was 51.3%(20/39).The intergroup comparison showed that the clinical efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(3)After treatment for 6 months,the scores of each items of menstruation status except for the menstrual cycle and menstrual period in the observation group were improved in comparison with those be

关 键 词：滋肾育胎丸 滋癸益经汤 早发性卵巢功能不全 补肾填精 益气养血 

分 类 号：R271.9[医药卫生—中西医结合]