基于瘀热论自拟清热化瘀方及调经促孕针法联合西药治疗早发性卵巢功能不全合并不孕的临床研究  

Clinical Study on the Treatment of Premature Ovarian Insufficiency Complicated with Infertility by Combining Western Medicine with Self-Made Qingre Huayu Decoction and Acupuncture for Regulating Menstruation and Promoting Pregnancy Based on the Theory of Blood Stasis and Heat

作　　者：孙红燕[1] 孙莉 施巨芳 刘春丽[3] 梁志超[1] 杨慧[1] 董士霞 SUN Hong-yan;SUN Li;SHI Ju-fang;LIU Chun-li;LIANG Zhi-chao;YANG Hui;DONG Shi-xia(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000;980 Hospital of the Joint Logistics Support Force,Shijiazhuang Hebei 050082;The Seventh People's Hospital of Hebei Province,Baoding Hebei 073000;Department of Traditional Chinese Medicine,Community Health Service Center,Dongyuan Sub District Office,Yuhua District,Shijiazhuang Hebei 050022)

机构地区：[1]石家庄市中医院,河北石家庄050000 [2]联勤保障部队第980医院,河北石家庄050082 [3]河北省第七人民医院,河北保定073000 [4]石家庄市裕华区东苑街道办事处社区卫生服务中心中医科,河北石家庄050022

出　　处：《世界中西医结合杂志》2023年第7期1401-1405,1410,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：2021年河北中医药管理局科研计划项目(2021264);河北省第五批中医临床优秀人才研修项目。

摘　　要：目的观察基于瘀热论自拟清热化瘀方及调经促孕针法联合西药治疗早发性卵巢功能不全(Premature ovarian insufficiency,POI)合并不孕的临床疗效。方法选取2018年2月—2020年2月期间石家庄市中医院、联勤保障部队第980医院、河北省第七人民医院收治的108例POI患者作为研究对象,按随机数字表法分为西医组、中医组、联合组,每组各36例。西医组予以芬吗通治疗,中医组予以清热化瘀方结合调经促孕针法治疗,联合组予以芬吗通及清热化瘀方结合针刺治疗,3组患者均治疗3个月经周期。观察比较3组患者临床疗效,中医证候积分及女性绝经期自测表Kupperman改良评分,卵泡刺激素(Follicle stimulating hormone,FSH)、雌二醇(Estradiol,E_(2))、抗苗勒氏管激素(Anti-mullerian hormone,AMH)水平,双侧卵巢体积(Ovarian volume,OV)及窦卵泡数(Antral follicle count,AFC),治疗安全性及妊娠情况。结果治疗后联合组总有效率93.94%(31/33)高于西医组70.59%(24/34)、中医组75.00%(24/32),差异有统计学意义(P<0.05)。治疗后3组中医证候积分、Kupperman评分均低于治疗前,差异有统计学意义(P<0.05);且联合组均低于西医组、中医组,差异有统计学意义(P<0.05)。治疗后3组患者FSH水平较治疗前降低,E2、AMH水平与OV、AFC均较治疗前升高,差异有统计学意义(P<0.05);且联合组均较西医组、中医组改善明显,差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。联合组妊娠率45.45%(15/33)高于西医组20.59%(7/34)、中医组21.88%(7/32),差异有统计学意义(P<0.05)。结论基于瘀热论使用清热化瘀方及调经促孕针法联合西药治疗POI在改善患者症状及性激素水平、促进卵巢恢复方面疗效理想且安全性高,值得临床推广。Objective To observe the clinical efficacy of self-made Qingre Huayu Decoction and acupuncture for regulating menstruation and promoting pregnancy based on the theory of blood stasis and heat combined with Western medicine in the treatment of premature ovarian insufficiency(POI)complicated by infertility.Methods From February 2018 to February 2020,108 patients with POI admitted to Shijiazhuang Hospital of Traditional Chinese Medicine were selected as study subjects and divided into the Western medicine group,Chinese medicine group,and combined group according to the random number table,with 36 cases in each group.The Western medicine group was treated with Femoston;the Chinese medicine group was treated with Qingre Huayu Decoction combined with acupuncture for regulating menstruation and promoting pregnancy,and the combined group was treated with Femoston and Qingre Huayu Decoction combined with acupuncture for regulating menstruation and promoting pregnancy.All three groups were treated for three menstrual cycles.This article compared the clinical efficacy,Chinese medicine syndromes and the Kupperman score,follicle-stimulating hormone(FSH),estradiol(E_(2)),anti-mullerian hormone(AMH)level,bilateral ovarian volume(OV),antral follicle count(AFC),treatment safety,and pregnancy status of the three groups.Results After treatment,the total effective rate of the combined group was 93.94%(31/33),higher than 70.59%(24/34)in the Western medicine group and 75.00%(24/32)in the Chinese medicine group,and the difference was statistically significant(P<0.05).After treatment,the Chinese medicine syndromes and Kupperman scores of all three groups were lower than those before treatment(P<0.05);the combined group was lower than the Western medicine group and the Chinese medicine group(P<0.05).After treatment,the FSH levels in the three groups were lower than before treatment,and E2,AMH,OV,and AFC were higher than those before treatment(P<0.05);the combined group improved significantly compared with the Western and Chinese medicine

关 键 词：早发性卵巢功能不全 瘀热论 清热化瘀方 调经促孕针法 

分 类 号：R271.14[医药卫生—中医妇科学]