二术二陈汤加减对脾虚痰湿证多囊卵巢综合征患者的调理作用  

Regulatory Effect of Modified Erzhu Erchentang on Patients with Polycystic Ovary Syndrome and Spleen Deficiency and Phlegm Dampness

作　　者：李雪娇 赵锐 陈惠丽 李丽红 吴敏[2] LI Xue-jiao;ZHAO Rui;CHEN Hui-li;LI Li-hong;WU Min(Hainan Women and Children's Medical Center,Haikou 570206,China;Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430011,China)

机构地区：[1]海南省妇女儿童医学中心,海口570206 [2]华中科技大学同济医学院附属协和医院,武汉430011

出　　处：《中国实验方剂学杂志》2021年第8期101-106,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：海南省医药卫生科研项目(1601320313A2001)。

摘　　要：目的:观察二术二陈汤加减对脾虚痰湿证多囊卵巢综合征(PCOS)代谢的调节效果,以及对脂肪细胞因子的影响。方法:将140例患者按随机数字表法分为对照组和观察组各70例。两组均口服盐酸二甲双胍片,500 mg/次,3次/d。对照组口服越鞠二陈丸,0.5 g/次,3次/d;观察组内服二术二陈汤加减,1剂/d;两组疗程均为24周。检测治疗前后空腹血糖(FBG),空腹胰岛素(FINS),糖化血红蛋白(HbA1c),餐后2 h血糖(2 h PG)水平,计算胰岛素抵抗指数(HOMA-IR);检测治疗前后血脂水平;测量治疗前后腰围(WC),体质量指数(BMI),腰臀比(WHR);检测治疗前后黄体生成素(LH),卵泡刺激素(FSH),血清睾酮(T),雌二醇(E2),硫酸脱氢表雄酮(DHEAS),性激素结合球蛋白(SHBG)水平;记录月经和排卵恢复情况;进行治疗前后脾虚痰湿证评分;测量治疗前后卵巢体积;检测治疗前后瘦素(LP),脂联素(APN),抵抗素,内脂素和肿瘤坏死因子-α(TNF-α)水平。结果:观察组FBG,2 hPG,HbA1c,FINS和HOMA-IR均低于对照组(P<0.01);观察组甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C)均低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组(P<0.01);观察组BMI,WC和WHR均低于对照组(P<0.05);观察组LH,FSH,T,E2,DHEAS水平均低于对照组(P<0.01),SHBG水平高于对照组(P<0.01);观察组脾虚痰湿证评分低于对照组(P<0.01),卵巢体积小于对照组(P<0.01);观察组LP,抵抗素,内脂素和TNF-α水平均低于对照组(P<0.01),APN水平高于对照组(P<0.01);观察组患者BMI正常率为49.23%(32/65),高于对照组的30.30%(20/66)(χ^(2)=5.151,P<0.05),观察组患者血脂正常率为93.85%(61/65),高于对照组的81.82%(54/66)(χ^(2)=4.418,P<0.05);观察组患者血糖正常率为96.92%(63/65),高于对照组的86.36%(57/66)(χ^(2)=4.474,P<0.05)。结论:在口服二甲双胍治疗的基础上,二术二陈汤加减可调节脾虚痰湿证PCOS患者脂肪细胞因子,改善糖、脂代谢和超重情况,并能调节内分�Objective: To observe the regulatory effect of modified Erzhu Erchentang on metabolization of polycystic ovary syndrome(PCOS)with spleen deficiency and phlegm dampness syndrome.Method: Patients 140 cases were divided into control group and observation group. Both groups were given metformin hydrochloride tablets,500 mg/time,3 times/day. Control group was given Yuejun Erchen pills,0.5 g/time,3 times/day,while observation group was given modified Erzhu Erchentang,1 dose/day. The course of treatment lasted for 24 weeks. Before and after treatment,levels of fasting blood glucose(FBG),fasting insulin(FINS),glycosylated hemoglobin Alc(HbA1c),2-hour postprandial blood glucose(2 h PG),blood lipid,waist circumference(WC),body mass index(BMI),waist hip ratio(WHR),luteinizing hormone(LH),follicle stimulating hormone(FSH),serum testosterone(T),estradiol(E2),dehydroepiandrosterone sulfate(DHEAS),sex hormone binding globulin(SHBG),leptin(LP),adiponectin(APN),resistin,visfatin and tumor necrosis factor-α (TNF-α) were detected. Homeostasis model assessment insulin resistance(HOMA-IR)was calculated,modified Erzhu Erchentang was scored,and recovery of menstruation and ovulation and ovarian volume were recorded. Result: Levels of FBG,2 h PG,HbA1c,FINS,HOMA-IR,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),LH,FSH,T,E2,DHEAS, LP, resistin, visfatin and TNF-α in observation group were lower than those in control group(P<0.01),and levels of BMI,WC and WHR were lower than those of control group(P<0.05). And levels of high-density lipoprotein cholesterol(HDL-C), SHBG and APN were higher than those in control group(P<0.01). Score of modified Erzhu Erchentang was lower than that in control group(P<0.01),and ovarian volume was smaller than that in control group(P<0.01). The normal rate of BMI was 49.23%(32/65),which was higher than 30.30%(20/66)in control group(χ^(2)=5.151,P<0.05). The normal rate of blood lipid was 93.85%(61/65),which was higher than 81.82 %(54/66)in control group(χ^(2)=4.418,P<0.05)

关 键 词：多囊卵巢综合征 脾虚痰湿证 二术二陈汤 代谢异常 脂肪细胞因子 

分 类 号：R289[医药卫生—方剂学] R271[医药卫生—中药学]