疏肝补肾活血汤治疗围绝经期综合征肾虚肝郁兼血瘀证的临床疗效  

Clinical Efficacy on Shugan Bushen Huoxue Decoction in Treating Perimenopausal Perio Syndrome(Kidney Deficiency and Liver Depression and Blood Stasis Syndrome)

作　　者：周松晶[1] 史佳[1] 韩平 ZHOU Song-jing;SHI Jia;HAN Ping(Hainan General Hospital,Hainan Affiliated Hospital of Hainan Nniversity,Haikou 570311,China;The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)

机构地区：[1]海南省人民医院,海南医学院附属海南医院,海口570311 [2]海南医学院第一附属医院,海口570102

出　　处：《中国实验方剂学杂志》2021年第13期83-88,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：海南省卫生计生行业科研项目(19A200094)。

摘　　要：目的:观察疏肝补肾活血汤治疗围绝经期综合征(PPS)肾虚肝郁兼血瘀证的临床疗效及作用机制。方法:将112例患者按随机数字表法分为对照组和观察组。两组均采用莉芙敏片,1片/次,早、晚2次吞服。对照组口服妇科养荣胶囊,4粒/次,3次/d;观察组口服疏肝补肾活血汤,1剂/d;两组疗程均为治疗12周。进行治疗前后改良Kupperman(KI),中医证候、绝经期生存质量量表(MENQOL),抑郁自评量表(SDS)和焦虑自评量表(SAS)评分;检测治疗前后促卵泡激素(FSH),促黄体生成素(LH),血清雌激素(E2),5-羟色胺(5-HT),多巴胺(DA),去甲肾上腺素(NE),5-羟吲哚乙酸(5-HIAA),内皮素(ET),一氧化氮(NO)水平。结果:治疗后观察组改良KI,中医证候,SDS和SAS评分均低于对照组(P<0.01);观察组MENQOL各维度评分均低于对照组(P<0.01);观察组FSH,LH,ET水平均低于对照组(P<0.01),5-HT,5-HIAA,DA,NE,NO和E2水平均高于对照组(P<0.01);观察组临床疗效明显高于对照组(Z=2.073,P<0.05);观察组中医证候疗效明显高于对照组(Z=2.086,P<0.05)。结论:疏肝补肾活血汤可明显减轻肾虚肝郁兼血瘀证PPS患者临床症状及抑郁、焦虑情况,并能调节性激素、血管舒缩因子和单胺类神经递质,提高生活质量,临床疗效显著,值得临床使用。Objective:To observe the clinical efficacy and mechanism of Shugan Bushen Huoxue decoction in the treatment of perimenopausal perio syndrome(PPS)with kidney deficiency,liver depression and blood stasis syndrome.Method:One hundred and twelve patients were randomly divided into control group and observation group according to random number table.Both groups took Remifemin orally,1 tablet/time,by swallowing in the morning and evening.The patients in control group additionally took Fuke Yangrong capsules,4 capsules/time,3 times/day.The patients in observation group additionally took Shugan Bushen Huoxue decoction,1 dose/day.The course of treatment was 12 weeks in both groups.Before and after treatment,scores were graded for modified Kupperman index(KI),traditional Chinese medicine(TCM)syndromes,menopausal quality of life scale(MENQOL),self-rating depression scale(SDS)and self-rating anxiety scale(SAS).Follicle stimulating hormone(FSH),luteinizing hormone(LH),serum estrogen(E2),5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NE),5-hydroxyindole acetic acid(5-HIAA),endothelin(ET),and nitric oxide(NO)levels were detected before and after therapy.Result:In the observation group,scores of KI,TCM syndrome,SDS and SAS were lower than those in the control group(P<0.01).All dimensions of MENQOL scores in the observation group were lower than those in the control group(P<0.01).FSH and LH levels in the observation group were lower than those in the control group,and the E2 level was higher than that of the control group(P<0.01).The levels of 5-HT,5-HIAA,DA and NE in the observation group were higher than those in the control group(P<0.01).The ET level in the observation group was lower than that in the control group,and the NO level was higher than that of the control group(P<0.01).In observation group,the clinical efficacy was superior to that in control group(Z=2.073,P<0.05),and the efficacy of TCM syndromes was also superior to that in control group(Z=2.086,P<0.05).Conclusion:Shugan Bushen Huoxue decoction in the treat

关 键 词：围绝经期综合征 肾虚肝郁 血瘀 一贯煎 疏肝补肾活血汤 血管舒缩因子 单胺类神经递质 

分 类 号：R289[医药卫生—方剂学] R271[医药卫生—中药学]