补肾养精汤分阶段治疗DOR引起月经过少的疗效及对淋巴细胞亚群的影响  

Observation of therapeutic effect and lymphocyte subsets about Bushenyangjing Decoction on Hypomenorrhea caused by DOR in stages

作　　者：郑伟 王新华 李蔚 于潇 刘金星[2] 薛玲 ZHENG Wei;WANG Xinhua;LI Wei(Department of Gynecology,Qingdao Integrated Traditional Chinese and Western Medicine Hospital,Qingdao Shandong 266002,China)

机构地区：[1]山东青岛中西医结合医院妇科,山东青岛266002 [2]山东中医药大学附属医院妇科,山东济南250014 [3]山东青岛中西医结合医院药剂科,山东青岛266002

出　　处：《四川中医》2024年第1期164-168,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金-青年科学基金项目(编号:82104917);青岛市中医药科研项目(编号:2019-zyy028)。

摘　　要：目的:临床观察补肾养精汤分阶段治疗卵巢储备功能减退(DOR)引起月经过少(肾虚血瘀型)的疗效及对外周血淋巴细胞亚群表达的影响。方法:将70例肾虚血瘀型月经过少的DOR患者随机分成治疗组(补肾养精汤)和对照组(芬吗通),每组35例,分卵泡期和黄体期两阶段给药,连续治疗3个月经周期。观察两组患者治疗前、后的临床症状、血清激素水平、淋巴细胞亚群、窦卵泡数量以及卵巢间质血流变化,比较两组临床疗效及药物安全性。结果:治疗后,两组患者中医证候积分减少、经量积分增加,血清bFSH降低、bE2升高,CD8^(+)T细胞减少、CD4^(+)T细胞和B细胞增多(P<0.05或P<0.01);治疗组患者经期积分增加,卵巢间质PSV增加、RI降低,AMH和AFC均增高(P<0.05)。与对照组比较,治疗组患者中医证候积分、CD8^(+)细胞和PI均显著降低(P<0.05),经量积分、经期积分、AMH、AFC、PSV、CD4^(+)T细胞及B细胞均显著升高(P<0.05)。综合疗效比较,治疗组愈显率(48.57%)和总有效率(88.57%)较对照组(28.57%,65.71%)明显升高。研究过程中未出现不良事件。结论:补肾养精汤分阶段治疗可以有效改善DOR合并月经过少(肾虚血瘀型)患者的卵巢储备,增加经量、延长经期,还可以改善卵巢间质血流,调节机体免疫平衡,疗效优于激素替代治疗,值得临床推广应用。Objective:To observe the clinical effect of Bushenyangjing Decoction on Hypomenorrhea(kidney deficiency and blood stasis type)caused by Diminished Ovarian Reserve(DOR)in stages and the effect on peripheral blood lymphocyte subsets.Methods:70patients with Hypomenorrhea of kidney deficiency and blood stasis type caused by DOR were randomly divided into the treatment group(Bushenyangjing decoction)and the control group(Fenmotong).35patients in each group were treated in follicular phase and luteal phase for 3consecutive menstrual cycles.The clinical symptoms,serum hormone levels,lymphocyte subsets,antral follicle counting,changes in ovarian stromal blood flow and drug safety of the two groups were observed before and after treatment.Results:After treatment,for both groups of patients,on one hand,the scores of menstrual volume,bE_(2),CD4^(+)T cells and B cells were increased,on the other hand,the scores of TCM syndrome serum bFSH,and CD8^(+)T cells were decreased(P<0.05or P<0.01).In the treatment group,menstrual score,ovarian interstitial PSV,AMH,and AFC were prolonged,while RI were reduced(P<0.05).Compared with the control group,the TCM syndrome score,CD8^(+)T cells,and PI in the treatment group were significantly decreased(P<0.05),while the menstrual volume score,menstrual period score,AMH,AFC,PSV,CD4^(+)T cells,and B cells were clearly increased(P<0.05).Compared between groups,the curative effect rate(48.57%)and total effective rate(88.57%)in the treatment group were apparently higher than the control group(28.57%,65.71%).No adverse events occurred during the study.Conclusion:Bushenyangjing Decoction can effectively improve the ovarian reserve of patients with Hypomenorrhea(kidney deficiency and blood stasis type)caused by DOR,increase menstrual volume,prolong menstrual period,improve ovarian interstitial blood flow,regulate the immune balance of the body,and has a better curative effect than hormone replacement therapy,which is worthy of clinical application.

关 键 词：卵巢储备功能减退 月经过少 肾虚血瘀 补肾养精 淋巴细胞 卵巢间质 

分 类 号：R711.75[医药卫生—妇产科学]