小陷胸汤加味联合二甲双胍对肥胖型PCOS痰热证患者胰岛素抵抗及性激素的影响  

Effect of Xiaoxianxiong Decoction plus metformin on insulin resistance and sex hormonesin obese PCOS patients with phlegm heat syndrome

作　　者：许建红 侯晓 沙婕 李路路 蔡平平 XU Jianhong;HOU Xiao;SHA Jie;LI Lulu;CAI Pingping(The Affiliated Hospital of Shandong Academy of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Shandong Maternal and Child Health Hospital,Jinan 250014,Shandong,China;Shandong Rehabilitation Hospital,Jinan 250000,Shandong,China;Zhangdian District Hospital of Traditional Chinese Medicine,Zibo 255020,Shandong,China;Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong,China)

机构地区：[1]山东省中医药研究院附属医院,山东济南250014 [2]山东省妇幼保健院,山东济南250014 [3]山东省康复医院,山东济南250000 [4]淄博市张店区中医院,山东淄博255020 [5]山东第一医科大学附属省立医院,山东济南250021

出　　处：《现代中西医结合杂志》2022年第19期2663-2669,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：山东省中医药科技发展计划项目(2019-0294,2019-0328);国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);山东省医药卫生科技发展计划项目(2019WS416)。

摘　　要：目的 观察小陷胸汤加味联合二甲双胍对肥胖型多囊卵巢综合征(PCOS)痰热证患者胰岛素抵抗及性激素的影响。方法 选择2019年11月—2021年7月就诊于山东省中医药研究院附属医院妇科门诊及山东第一医科大学附属省立医院中医门诊的痰热型PCOS不孕患者60例,按照随机数字表法将患者分为2组。对照组30例给予二甲双胍治疗,治疗组30例在对照组治疗基础上联合小陷胸汤加味治疗,2组均治疗3个月经周期。观察2组患者治疗前后体质指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH、睾酮(T)水平及子宫内膜分型及厚度、月经情况变化,比较2组排卵率及妊娠率。结果 治疗后2组BMI、FPG、FINS、HOMA-IR及LH、LH/FSH、T水平均较治疗前明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。治疗后2组子宫内膜分型、平均厚度较治疗前明显改善(P均<0.05),且治疗组改善更显著(P均<0.05)。治疗组排卵率及妊娠率均明显高于对照组(P均<0.05)。结论 小陷胸汤加味联合二甲双胍可以改善肥胖型PCOS痰热证患者的胰岛素抵抗,调节性激素水平,改善子宫内膜,提高排卵率及妊娠率。Objective It is to observe the effect of Xiaoxianxiong Decoction plus metformin on insulin resistance and sex hormones in obese polycystic ovary syndrome(PCOS)patients with phlegm heat syndrome.Methods Sixty patients with PCOS infertility with phlegm heat syndrome treated in the gynaecological clinic of the Affiliated Hospital of Shandong Academy of Traditional Chinese Medicine and the Shandong Provincial Hospital Affiliated to Shandong First Medical University from November 2019 to July 2021 were selected.The patients were divided into two groups according to the random number table.30 cases in the control group were treated with metformin,30 cases in the treatment group were treated with modified Xiaoxianxiong Decoction on the basis of the treatment in the control group,and both groups were treated for 3 menstrual cycles.The changes in body mass index(BMI),waist hip ratio(WHR),levels of fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),luteinizing hormone(LH),follicle stimulating hormone(FSH),LH/FSH,testosterone(T),endometrial type and thickness,and menstruation of the patients in both groups were observed before and after treatment,and the ovulation rate and pregnancy rate were compared between the two groups.Results After treatment,the BMI,levels of FPG,FINS,HOMA-IR,LH,LH/FSH and T in the two groups were significantly lower than those before treatment(all P<0.05),and those in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the endometrial classification and average thickness in the two groups were significantly improved compared with those before treatment(P<0.05),and the improvement in the treatment group was more significant(P<0.05).The ovulation rate and pregnancy rate in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion Xiaoxianxiong Decoction plus metformin can improve insulin resistance,regulate sex hormone level,improve endometrium,and increase ovulation rate and pregnan

关 键 词：多囊卵巢综合征 胰岛素抵抗 小陷胸汤加味 中西医结合疗法 

分 类 号：R711.75[医药卫生—妇产科学]