当归芍药散加味联合达英-35治疗多囊卵巢综合征临床研究  

Clinical Study on Modified Danggui Shaoyao Powder Combined with Daying-35 for Polycystic Ovary Syndrome

作　　者：张杰 李丽娟 刘亚楠 ZHANG Jie;LI Lijuan;LIU Yanan

机构地区：[1]新郑市公立人民医院妇产科,河南新郑451100

出　　处：《新中医》2023年第4期7-12,共6页New Chinese Medicine

摘　　要：目的:观察当归芍药散加味联合达英-35治疗肾虚血瘀型多囊卵巢综合征(PCOS)的疗效及对血清性激素结合球蛋白(SHBG)、促肾上腺皮质激素(ACTH)水平的影响。方法:选取92例肾虚血瘀型PCOS患者为研究对象,按随机数字表法分为西药组及联合组各46例,西药组给予达英-35治疗,联合组予以当归芍药散加味联合达英-35治疗,2组均治疗3个疗程。比较2组临床疗效及不良反应发生情况,比较2组治疗前后中医证候积分、卵巢体积、子宫内膜厚度、子宫内膜磷脂酰肌醇3激酶(PI3K)、蛋白激酶B(Akt)、磷酸化Akt(p-Akt)蛋白表达及血清SHBG、ACTH水平的变化。结果:联合组总有效率为93.48%,西药组总有效率为78.26%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组月经周期、月经量、腰膝酸软或腰脊刺痛、头晕耳鸣、经行腹痛中医证候积分及总分均较治疗前下降(P<0.05),联合组上述5项中医证候积分及总分均低于西药组(P<0.05)。治疗后,2组两侧卵巢体积均较治疗前下降,子宫内膜厚度均较治疗前上升,差异均有统计学意义(P<0.05);治疗后,联合组两侧卵巢体积均小于西药组,子宫内膜厚度大于西药组,差异均有统计学意义(P<0.05)。治疗后,2组子宫内膜PI3K、Akt、p-Akt蛋白相对表达量均较治疗前升高(P<0.05),联合组均高于西药组(P<0.05)。治疗后,2组血清SHBG水平均较治疗前升高,ACTH水平均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,联合组SHBG水平高于西药组,ACTH水平低于西药组,差异均有统计学意义(P<0.05)。联合组不良反应发生率为4.35%,西药组为13.04%,2组比较,差异无统计学意义(P>0.05)。结论:当归芍药散加味联合达英-35治疗肾虚血瘀型PCOS疗效显著,能通过调控PI3K/AKT信号通路调节生殖轴,缓解患者临床症状,纠正性激素紊乱。Objective:To observe the clinical effect of the therapy of modified Danggui Shaoyao Powder combined with Daying-35(Ethinylestradiol and Cyproterone Tablets)on polycystic ovary syndrome(PCOS)of kidney deficiency and blood stasis type and its effect on levels of serum sex hormone-binding globulin(SHBG)and adrenocorticotropic hormone(ACTH).Methods:A total of 92 PCOS patients of kidney deficiency and blood stasis type were selected as research objects and divided into the western medicine group and the combination group according to random number table method,with 46 cases in each group.The western medicine group was treated with Daying-35,and the combination group was treated with modified Danggui Shaoyao Powder combined with Daying-35.Both groups were treated for 3 courses of treatment.The clinical effects and the occurrence of adverse reactions were compared between the two groups.The changes of traditional Chinese medicine(TCM)syndrome scores,ovarian volume,endometrial thickness,endometrial protein expressions of phosphatidylinositol 3 kinase(PI3K),protein kinase B(Akt),phosphorylated Akt(p-Akt)and serum SHBG and ACTH levels before and after treatment were compared between the two groups.Results:The total effective rate was 93.48% in the combination group and 78.26% in the western medicine group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores of menstrual cycle,menstrual blood volumn,sore and weak lumbar and knee or lumbar spine trickling,dizziness and tinnitus,and abdominal pain during menstruation and the total scores in the two groups were all decreased when compared with those before treatment(P<0.05),and the above TCM syndrome scores and the total score in the combination group were lower than those in the western medicine group(P<0.05).After treatment,the bilateral ovarian volume was decreased and endometrial thickness was increased in both groups when respectively compared with before treatment,differences being significant(P<0.05).After treatment,the bilateral ovarian volu

关 键 词：多囊卵巢综合征 肾虚血瘀型 当归芍药散 达英-35 血清性激素结合球蛋白 促肾上腺皮质激素 

分 类 号：R711.75[医药卫生—妇产科学]