疏肝滋肾方治疗肝郁肾虚型卵巢储备功能减退临床研究  

Clinical study on Shugan Zishen Formula in the treatment of ovarian reserve dysfunction of liver depression and kidney deficiency type

作　　者：康华 马建新[1] 王旭初[1] 郝镁娟 KANG Hua;MA Jianxin;WANG Xuchu;HAO Meijuan(Department of the Reproductive Medicine,Cangzhou Hospital of Integrated TCM-WM·Hebei(Hebei Collaborative Innovation Center of Integrated Traditional and Western Medicine on Reproductive Disease),Cangzhou,Hebei 061001)

机构地区：[1]河北省沧州中西医结合医院生殖医学科(河北省中西医结合生殖疾病协同创新中心),河北沧州061001

出　　处：《河北中医》2023年第10期1627-1630,1634,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2023年度中医药类科学研究计划课题项目(编号:2023246)。

摘　　要：目的观察疏肝滋肾方治疗肝郁肾虚型卵巢储备功能减退(DOR)的临床疗效。方法将河北省沧州中西医结合医院生殖医学科门诊就诊的肝郁肾虚型DOR患者48例,采用随机数字表法分为对照组和治疗组,每组24例。对照组行激素替代治疗,治疗组在激素替代治疗的基础上加用疏肝滋肾方辅助治疗,2组均治疗3个月经周期。比较2组患者治疗前后中医证候评分、血清性激素[卵泡刺激素(FSH)、雌二醇(E_(2))]、抗苗缪勒管激素(AMH)水平以及基础窦卵泡(AFC)数目;在治疗周期结束后4、7、10个月进行随访,统计并比较2组患者累计生化妊娠率、累计临床妊娠率、累计流产率及累计活产率。结果与本组治疗前比较,治疗组治疗后中医证候评分、FSH水平均降低(P<0.05),E_(2)、AMH均升高(P<0.05),且与对照组治疗后比较差异均有统计学意义(P<0.05)。对照组治疗后中医证候评分、FSH水平均低于本组治疗前(P<0.05),E_(2)水平高于本组治疗前(P<0.05)。在治疗周期结束后4、7、10个月,2组累计生化妊娠率和临床妊娠率比较差异无统计学意义(P>0.05),治疗结束后7、10个月2组流产率比较差异无统计学意义(P>0.05),治疗结束后10个月2组活产率治疗组较对照组无统计学意义(P>0.05)。结论疏肝滋肾方可改善肝郁肾虚型DOR患者中医症状,改善血清性激素水平,增加AFC数量,从而改善卵巢储备功能。治疗后2组妊娠率、流产率、活产率均有所改善,比较无明显差异。Objective To study the effect of Shugan Zishen Formula in the treatment of ovarian reserve dysfunction(ORD)of liver depression and kidney deficiency type.Methods Forty eight DOR patients(liver depression and kidney deficiency type)who visited to the Department of the Reproductive Medicine,Cangzhou Hospital of Integrated TCM-WM·Hebei were randomly assigned into the control group(n=24)and the treatment group(n=24).All patients were treated with hormone replacement therapy,and the patients of the treatment group were addtationlly received Shugan Zishen Formula.The treatment was performed for 3 menstrual cycles in the two groups,aiming to compare the traditional Chinese medicine(TCM)syndrome scores,serum sex hormone levels(follicle-stimulating hormone[FSH],Estradiol[E_(2)]),anti-mullerian hormone(AMH),and basic antral follicle numbers between groups before and after treatment.The follow-ups were conducted on months 4,7,and 9 of the end of treatment cycles,the cumulative biochemical pregnancy rate,cumulative clinical pregnancy rate,cumulative miscarriage rate and cumulative live birth rate were assessed.Results After treatment,the TCM syndrome scores and FSH levels in the treatment group were significantly decreased(P<0.05),while E2 and AMH were significantly increased(P<0.05),and with statistically significant difference between the treatment group and the control group(P<0.05).After treatment,the TCM syndrome scores and FSH levels in the control group were significantly decreased(P<0.05),and the E2 level was significantly increased(P<0.05).There were no statistically significant difference in the cumulative biochemical pregnancy rates and clinical pregnancy rates between groups on months 4,7 and 10 of the end of treatment cycle(P>0.05).The differences were no statistically significant in the cumulative miscarriage rates between groups on months 7 and 10 months of the end of treatment cycle(P>0.05).The cumulative live birth rates in the treatment group were comparable to the control group on months 10 of the end of

关 键 词：卵巢储备功能下降 中医药疗法 

分 类 号：R588.605.31[医药卫生—内分泌]