加减温经汤治疗肾虚血瘀型卵巢储备功能减退患者的疗效观察及对T淋巴细胞亚群水平的影响  

Observation on the Curative Effect of Modified Wenjing Decoction in the Treatment of Patients with Diminished Ovarian Reserve Caused by Kidney Deficiency and Blood Stasis and Its Effect on T Lymphocyte Subsets

作　　者：曾根[1] 王韫琪[1] 戴海青[1] ZENG Gen;WANG Yunqi;DAI Haiqing(Hainan Provincial Hospital of Chinese Medicine,Haikou 570203 Hainan,China)

机构地区：[1]海南省中医院,海南海口570203

出　　处：《中药新药与临床药理》2021年第8期1206-1210,共5页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：第六批全国老中医专家学术经验继承项目(琼财社[2018]186号);海南省医药卫生研究项目(2001360102A2005)。

摘　　要：目的探讨加减温经汤联合西药治疗肾虚血瘀型卵巢储备功能减退的疗效及对T淋巴细胞亚群水平的影响。方法选取2018年至9月至2020年10月海南省中医院肾虚血瘀型卵巢储备功能减退患者94例,随机分为对照组(47例)和观察组(47例)。所有患者皆给予常规生活方式干预,包括禁止饮食辛辣生冷的食物、保证营养均衡及规范生活作息等。对照组患者给予戊酸雌二醇/雌二醇环丙孕酮片治疗,观察组在对照组的基础上给予加减温经汤治疗,2组患者进行3个月经周期的治疗。观察2组患者治疗前后中医症状评分、性激素[雌二醇(E2)、促卵泡生成素(FSH)、促黄体生成素(LH)]及CD3^(+)、CD4^(+)和CD8^(+)T细胞水平的改变,并评价2组患者的临床疗效和安全性。结果观察组总有效率为93.62%(44/47)高于对照组的76.60%(36/47),差异有统计学意义(P<0.05)。2组患者治疗后的经期少腹痛、月经延后及颜色暗或紫等中医症状评分较治疗前显著降低,且观察组各项中医症状评分明显低于对照组(P<0.05)。治疗后,2组患者E2水平较治疗前明显升高,FSH和LH水平明显降低,且观察组改善性激素水平优于对照组(P<0.05)。治疗后,2组患者CD3^(+)和CD4^(+)T细胞水平较治疗前明显提高,CD8^(+)T细胞水平显著降低,且观察组改善CD3^(+)、CD4^(+)和CD8^(+)T细胞水平均优于对照组(P<0.05)。治疗过程中,观察组患者肥胖、胃肠道反应、乳房肿胀及头疼等不良反应的发生率为10.64%(5/47)低于对照组的27.66%(13/47),差异有统计学意义(P<0.05)。结论加减温经汤联合西药治疗卵巢储备功能减退患者疗效确切,可有效减轻患者的临床症状,改善患者性激素和免疫功能水平,安全性较高。Objective To explore the curative effect of modified Wenjing decoction combined with western medicine in the treatment of ovarian reserve hypofunction caused by kidney deficiency and blood stasis,and observe its influence on the levels of T lymphocyte subsets.Methods From September 2018 to October 2020,94 patients with ovarian reserve hypofunction due to kidney deficiency and blood stasis in Hainan Provincial Hospital of Chinese Medicine were selected and randomly divided into control group(47 cases)and observation group(47 cases).All patients were given routine life style interventions,and asked to avoid spicy or cold food,ensure balanced nutrition,and standardize life and rest.The control group was given estradiol valerate/estradiol cyproterone tablets,and the observation group was given modified Wenjing decoction on the basis of the control group.2 groups of patients were treated for three menstrual cycles.The changes of TCM symptom scores,sex hormones E2,FSH,LH,CD3^(+),CD4^(+)and CD8^(+)T cells levels were observed before and after treatment in the 2 groups,and evaluated the clinical efficacy and safety of 2 groups of patients.Results The total effective rate of the observation group was 93.62%(44/47),which was higher than 76.60%(36/47)of the control group,the difference was statistically significant(P<0.05).After treatment,the scores of TCM symptom such as abdominal pain during menstruation,delayed menstruation,dark or purple of mense in the two groups were significantly lower than those before treatment,and the scores of TCM symptom in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of estradiol E2 in the two groups were significantly higher than those before treatment,and the levels of FSH and LH were significantly reduced.The observation group was better than the control group in improving sex hormone levels(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)T cells in the two groups were significantly higher than those before treatmen

关 键 词：加减温经汤 卵巢储备功能减退 临床疗效 安全性 CD3^(+)T细胞 CD4^(+)T细胞 CD8^(+)T细胞 

分 类 号：R285.6[医药卫生—中药学]