加减苍附导痰汤联合二甲双胍、炔雌醇环丙孕酮片治疗痰湿型多囊卵巢综合征的疗效及对血清Ghrelin的影响  

Therapeutic Effect of Modified Cang Fu Daotan Decoction Combined with Metformin and Diane-35 for Polycystic Ovary Syndrome of Phlegmdamp Syndrome Type and Its Effect on Serum Ghrelin

作　　者：董文超 朱晶瑜[1] 相振华 谷雨明 国文潇 姜梅芳[2] DONG Wen-Chao;ZHU Jing-Yu;XIANG Zhen-Hua;GU Yu-Ming;GUO Wen-Xiao;JIANG Mei-Fang(Affiliated Hospital of Weifang Medical University,Weifang 261031 Shandong,China;Weifang Medical University,Weifang 261053 Shandong,China)

机构地区：[1]潍坊医学院附属医院,山东潍坊261031 [2]潍坊医学院,山东潍坊261053

出　　处：《广州中医药大学学报》2022年第11期2545-2553,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：山东省中医药管理局科技发展计划项目(编号:2019-0431)。

摘　　要：【目的】探究加减苍附导痰汤联合二甲双胍、炔雌醇环丙孕酮片治疗痰湿型多囊卵巢综合征(PCOS)的疗效及对血清生长激素释放肽(Ghrelin)的影响,探讨其可能的作用机制。【方法】将68例痰湿型PCOS患者随机分为对照组和观察组,每组各34例。对照组给予二甲双胍、炔雌醇环丙孕酮片治疗,观察组在对照组的基础上予以加减苍附导痰汤治疗,疗程为3个月经周期。观察2组患者治疗前后中医证候积分、肥胖指标、糖脂代谢指标、性激素指标及血清Ghrelin水平的变化情况,评价2组患者的综合疗效,并分析血清Ghrelin水平与胰岛素抵抗指数(HOMA-IR)的相关性。【结果】(1)研究过程中,对照组脱落4例,观察组无脱落病例,最终共有64例患者完成全部疗程的治疗,其中,对照组30例,观察组34例。(2)治疗3个月经周期后,观察组的总有效率为91.18%(31/34),对照组为70.00%(21/30),组间比较,观察组的综合疗效明显优于对照组(P<0.05)。(3)治疗后,2组患者的中医证候积分、体质量指数(BMI)、腰臀比(WHR)均较治疗前降低(P<0.01),且观察组的降低幅度均明显大于对照组(P<0.05或P<0.01)。(4)治疗后,2组患者的空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR均较治疗前降低(P<0.01),且观察组的降低幅度均明显大于对照组(P<0.05或P<0.01)。(5)治疗后,2组患者的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前降低(P<0.01),高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高(P<0.01),且观察组TG、LDL-C的降低幅度和HDL-C的升高幅度均明显大于对照组(P<0.05或P<0.01)。(6)治疗后,2组患者的雌二醇(E2)水平均较治疗前升高(P<0.01),观察组的黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH、睾酮(T)水平和对照组的LH、T水平均较治疗前降低(P<0.01),且观察组E2水平的升高幅度和LH、FSH、LH/FSH、T水平的降低幅度均明显大于对照组(P<0.05或P<0.01)Objective To investigate the therapeutic effect of modified Cang Fu Daotan Decoction combined with Metformin and Diane-35 on polycystic ovary syndrome(PCOS)of phlegm-damp syndrome type and to observe its effect on serum growth hormone releasing peptide(Ghrelin),so as to explore its possible therapeutic mechanism.Methods Sixty-eight patients with PCOS of phlegm-damp type were randomly divided into control group and observation group,with 34 cases in each group.The control group was given Metformin and Diane-35 Tablets,while the observation group was treated with modified Cang Fu Daotan Decoction on the basis of treatment for the control group.The period of treatment lasted for 3 menstrual cycles.The changes in the traditional Chinese medicine(TCM)syndrome scores,indexes of obesity,glucose and lipid metabolism,and sex hormone,and serum Ghrelin level in the two groups were observed before and after treatment.The overall efficacy of the two groups was evaluated,and the correlation between serum Ghrelin level and HOMA-IR was analyzed.Results(1)During the trial,4 cases in the control group and none in the observation group fell off.A total of 64 patients,30 in the control group and 34 in the observation group eventually completed the full course of treatment.(2)After 3 menstrual cycles of treatment,the overall effective rate of the observation group was 91.18%(31/34)and that of the control group was 70.00%(21/30),and the intergroup comparison showed that the overall efficacy of the observation group was significantly superior to that of the control group(P<0.05).(3)After treatment,the TCM syndrome scores,body mass index(BMI)and waist-to-hip ratio(WHR)in both groups were decreased compared with those before treatment(P<0.01),and the reduction in the observation group was significantly greater than that in the control group(P<0.05 or P<0.01).(4)After treatment,the levels of fasting plasma glucose(FPG),fasting insulin(FINS)and insulin resistance index(HOMA-IR)were all decreased in both groups compared with those before tr

关 键 词：加减苍附导痰汤 多囊卵巢综合征 痰湿型 胰岛素抵抗 生长激素释放肽(Ghrelin) 

分 类 号：R271.9[医药卫生—中西医结合]