加味调肝汤联合西药治疗肝郁肾虚型月经过少疗效及对患者子宫内膜厚度的影响  

Clinical efficacy of modified Tiaogan decoction combined with western medicine in the treatment of hypomenorrhea of liver depression and kidney deficiency type and its influence on endometrial thickness

作　　者：刘淑君[1] 赵欣 贾艳清 李晓瑜 潘龙 LIU Shujun;ZHAO Xin;JIA Yanqing;LI Xiaoyu;PAN Long(Obstetrics and Gynecology,Tangshan Traditional Chinese Medicine Hospital,Tangshan 063000,China)

机构地区：[1]唐山市中医医院妇产科,河北唐山063000

出　　处：《陕西中医》2024年第1期41-45,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2021395)。

摘　　要：目的:研究加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效及对患者子宫内膜厚度的影响。方法:选取肝郁肾虚型月经过少患者共124例,采用随机数字表法分为观察组和对照组,其中对照组62例采用戊酸雌二醇(E2)、地屈孕酮治疗,观察组62例采用加味调肝汤联合戊酸雌二醇、地屈孕酮治疗。比较两组治疗效果、不良反应发生率,两组治疗前后中医证候积分、子宫内膜厚度、子宫血流阻力指数(RI)和卵泡期性激素水平。结果:观察组治疗总有效率为90.32%,较对照组总有效率75.81%高(P<0.05)。治疗前两组中医证候积分对比差异无统计学意义(P>0.05),治疗3个月后观察组上述积分较对照组更低(P<0.05)。治疗前两组卵泡期子宫内膜厚度、RI值比较,差异无统计学意义(P>0.05),治疗3个月后观察组卵泡期子宫内膜厚度较对照组更厚;RI较之于对照组更低(P<0.05)。治疗前两组卵泡期E2、FSH、LH水平比较无统计学差异(P>0.05);治疗3个月后观察组卵泡期性激素水平比对照组高(P<0.05)。观察组不良反应发生率为11.29%,与对照组的24.19%比较差异无统计学意义(P>0.05)。结论:加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效比单用西药治疗效果更佳,能促进子宫内膜生长,降低RI值,调节卵泡期性激素水平。Objective:To study the clinical efficacy of modified Tiaogan decoction combined with western medicine in the treatment of hypomenorrhea of liver depression and kidney deficiency type and its influence on endometrial thickness.Methods:124 patients with hypomenorrhea of liver depression and kidney deficiency type were included and classified into observation group and control group by means of the random number table method.62 cases in the control group were treated with estradiol valerate and dydrogesterone,and 62 cases in the observation group were given modified Tiaogan decoction combined with estradiol valerate and dydrogesterone.Treatment effect,incidence rates of adverse reactions,TCM syndromes scores,endometrial thickness,uterine blood flow Resistance Index(RI)and levels of follicular phase sex hormones before and after treatment were compared between the two groups.Results:In observation group,the total effective rate of treatment with 90.32%was higher than 75.81%in control group(P<0.05).The TCM syndromes scores before treatment were no statistically different between the two groups(P>0.05),and the above scores in observation group after 3 months of treatment were lower compared to control group(P<0.05).No statistically significant differences were shown in follicular phase endometrial thickness and RI value between both groups before treatment(P>0.05).After 3 months of treatment,the follicular phase endometrial thickness in observation group was thicker and the RI was lower(P<0.05).There were no differences in the levels of E2,FSH and LH in follicular phase before treatment(P>0.05).The levels of above sex hormones in follicular phase in observation group after 3 months of treatment were higher compared with those in control group(P<0.05).The total incidence rate of adverse reaction revealed no statistical significance between observation group(11.29%)and control group(24.19%)(P>0.05).Conclusion:Modified Tiaogan decoction combined with western medicine has a better treatment effect than western medicine in

关 键 词：月经过少 子宫内膜厚度 肝郁肾虚型 加味调肝汤 性激素 子宫血流阻力指数 

分 类 号：R711.75[医药卫生—妇产科学]