补肾活血方治疗肾虚血瘀型卵巢储备功能下降患者的临床疗效观察  

Clinical observation on the therapeutic effect of Bushen Huoxue Recipe on patients with diminished ovarian reserve of kidney deficiency and blood stasis type

作　　者：尹晓丹[1] 杨维[1] 辛明蔚[1] 武颖[1] 韩倩 管斯琪 何军琴[1] YIN Xiaodan;YANG Wei;XIN Mingwei;WU Ying;HAN Qian;GUAN Siqi;HE Junqin(Department of Traditional Chinese Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院(北京妇幼保健院)中医科,北京100026

出　　处：《中国性科学》2024年第2期130-134,共5页Chinese Journal of Human Sexuality

基　　金：国家自然科学基金项目(82004134);北京市自然科学基金项目(7242218)。

摘　　要：目的观察补肾活血方对肾虚血瘀型卵巢储备功能下降(DOR)患者的治疗效果。方法选取北京妇产医院中医科2021年1月至2022年12月就诊的180例诊断为DOR的肾虚血瘀型患者作为研究对象,采用计算机随机分组法分为雌二醇片/雌二醇地屈孕酮片组(西药组)、补肾活血方组(中药组)和补肾活血方联合雌二醇片/雌二醇地屈孕酮片组(联合组),各60例。观察三组治疗前后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、抗米勒管激素(AMH)、窦卵泡数(AFC)、卵巢体积、卵巢动脉和子宫动脉阻力指数(RI)、子宫内膜厚度的变化,比较三组中医证候评分及疗效。结果11例患者(4例来自西药组,3例来自中药组,4例来自联合组)退出研究。6个月后,三组FSH和LH均显著降低,E_(2)和AMH升高(P<0.05);西药组和联合组较中药组FSH降低更显著,E_(2)升高更显著(P<0.01)。治疗后,中药组和联合组卵巢体积增加(P<0.05),AFC显著增加(P<0.01),卵巢动脉RI显著降低(P<0.01);西药组卵巢体积增加不显著(P>0.05),AFC显著增加(P<0.05),卵巢动脉RI显著降低(P<0.05);三组子宫动脉RI均无显著改善(P>0.05)。三组子宫内膜厚度均显著增加(P<0.05),西药组和联合组较中药组增加更显著(P<0.01)。与治疗前相比,三组治疗后中医证候评分均显著降低(P<0.05),且中药组和联合组中医证候评分降低的程度大于西药组(P<0.05)。西药组总有效率为71.43%,中药组为82.46%,联合组为85.96%;联合组的疗效优于西药组(P<0.05)。结论补肾活血方能够通过平衡激素水平、促进排卵和修复子宫内膜对DOR患者产生良好的治疗效果,联合应用雌二醇片/雌二醇地屈孕酮片可能是治疗DOR的一种行之有效的治疗策略。Objective To observe the therapeutic effect of Bushen Huoxue Recipe on patients with diminished ovarian reserve(DOR)of kidney deficiency and blood stasis type.Methods A total of 180 kidney deficiency and blood stasis type patients diagnosed with DOR admitted to Department of Traditional Chinese Medicine(TCM)Beijing Obstetrics and Gynecology Hospital were selected as study subjects.They were divided into estradiol tablets/estradiol and dydrogesterone tablets group(wesetern medicine group),Bushen Huoxue Recipe group(TCM group)and Bushen Huoxue Recipe combined with estradiol tablets/estradiol and dydrogesterone tablets group(combined group)by computer random grouping method,with 60 cases each.The changes of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),anti-Müllerian hormone(AMH),antral follicle count(AFC),ovarian volume,ovarian artery and uterine artery resistance index(RI)and endometrial thickness before and after treatment in the three groups were observed,and the TCM syndrome scores and therapeutic effects of three group were compared.Results A total of 11 patients(4 in western medicine group,3 in TCM group and 4 in combined group)withdrew from the study.After 6 months,FSH and LH were significantly decreased in all three groups,while E_(2) and AMH were increased(P<0.05).The FSH decreasing and E_(2) increasing were significant in western medicine group and combined group compared with TCM group(P<0.01).After treatment,the ovarian volume of the TCM group and the combination group increased(P<0.05),AFC was significantly increased(P<0.01),and ovarian artery RI significantly was decreased(P<0.01).The ovarian volume of western medicine group was not significantly increased(P>0.05),AFC was significantly increased(P<0.05),and ovarian artery RI was significantly decreased(P<0.05).There was no significant improvement in uterine artery RI in the three groups(P>0.05).Endometrial thickness increased significantly in all three groups(P<0.05),the increase of western medicine group and combined gro

关 键 词：卵巢储备功能下降 补肾活血方 肾虚血瘀型 中医药疗法 

分 类 号：R711[医药卫生—妇产科学]