左归饮加黄连阿胶汤联合针刺治疗多囊卵巢综合征不孕症的临床观察  

Clinical Observation of Zuogui Drink and Huanglian Ejiao Decoction Combined with Acupuncture in Treatment of Infertility Associated with Polycystic Ovary Syndrome

作　　者：黎晓静 张皓 张志玲[3] 郭蓓宁 LI Xiao-Jing;ZHANG Hao;ZHANG Zhi-Ling;GUO Bei-Ning(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Dongmen Community Health Service Center of Shenzhen Luohu Hospital Group,Shenzhen 518001 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市罗湖医院集团东门社康中心,广东深圳518001 [3]深圳市中医院,广东深圳518033

出　　处：《广州中医药大学学报》2021年第10期2145-2151,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市科技计划资助项目(编号:JCY20170817094838619);深圳市医疗卫生三名工程资助项目(编号:SZSM201512043);李惠林广东省名老中医专家传承工作室资助项目。

摘　　要：【目的】观察左归饮加黄连阿胶汤联合针刺治疗多囊卵巢综合征(PCOS)不孕症的临床疗效。【方法】将66例PCOS不孕症患者随机分为观察组和对照组,每组各33例,观察组给予左归饮联合黄连阿胶汤加减配合针刺疗法治疗,对照组给予枸橼酸氯米芬胶囊口服治疗。共治疗3个月经周期。治疗3个月后,评价2组临床疗效,观察2组患者治疗前后卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)、睾酮(T)含量的变化情况,以及子宫内膜厚度(ET)、子宫内膜螺旋动脉搏动指数(PI)及阻力指数(RI)的情况。比较2组患者治疗前后中医证候积分的变化情况。治疗1年后随访,比较2组患者的妊娠情况,包括妊娠率、排卵恢复率、月经正常率及流产率的情况。【结果】(1)治疗后,2组患者的FSH、E2、T、LH水平均明显改善(P<0.05),且观察组在改善FSH、E2、T、LH水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的ET、PI、RI水平均明显改善(P<0.05),且观察组在改善ET、PI、RI水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)观察组总有效率为93.94%(31/33),对照组为72.73%(24/33)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(4)治疗1年后随访,观察组妊娠率66.67%(22/33),排卵恢复率90.91%(30/33),月经正常率93.94%(31/33),流产率9.09%(2/33);对照组妊娠率39.39%(13/33),排卵恢复率69.70%(23/33),月经正常率72.73%(24/33),流产率30.77%(4/33)。观察组妊娠率、排卵恢复率、月经正常率及流产率均明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,观察组患者的中医证候积分明显改善(P<0.05),对照组患者的中医证候积分稍有改善,但差异无统计学意义(P>0.05)。观察组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】左归饮加黄连阿胶汤联合针刺治疗PCOS不孕症,能明显改善患者性激素�Objective To observe the clinical effect of Zuogui Drink and Huanglian Ejiao Decoction combined with acupuncture in the treatment of infertility with polycystic ovary syndrome(PCOS).Methods Sixty-six cases of PCOS infertility patients were randomly divided into observation group and control group,33 cases in each group.The observation group was given Zuogui Drink combined with Huanglian Ejiao Decoction combined with acupuncture,and the control group was given oral use of Clomiphene Citrate Capsules.The treatment course lasted for 3 consecutive menstrual cycles.After 3 months of treatment,the clinical efficacy of the two groups was evaluated,and the condition of contents of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),endometrial thickness(ET),helical artery pulse index(PI)and resistance index(RI)of the two groups were observed before and after treatment.The changes of traditional Chinese medicine(TCM)syndrome scores in the two groups were compared before and after treatment.After one year of treatment,the pregnancy situation including pregnancy rate,ovulation recovery rate,normal menstruation rate and abortion rate of the two groups were compared.Results(1)After treatment,the levels of FSH,E2,T,LH in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of FSH,E2,T,LH,the difference being statistically significant(P<0.05).(2)After treatment,the levels of ET,PI and RI in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of ET,PI and RI,the difference being statistically significant(P<0.05).(3)The total effective rate was 93.94%(31/33)in the observation group and 72.73%(24/33)in the control group.The curative effect of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(4)Follow-up was performed one year after treat

关 键 词：左归饮 黄连阿胶汤 针刺 多囊卵巢综合征 不孕症 性激素 子宫内膜容受性 妊娠 

分 类 号：R246.9[医药卫生—针灸推拿学]