基于“情志致病”理论探究丹栀逍遥丸联合治疗肝郁证多囊卵巢综合征所致不孕症的效果  

Effect of Combined Treatment with Danzhi Xiaoyao Pills on Infertility Caused by Liver-depression Type of Polycystic Ovary Syndrome Based on the Theory of Emotional Pathogenesis

作　　者：张晶晶 朱冉冉 刘娜 马梅 李曼 ZHANG Jingjing;ZHU Ranran;LIU Na;MA Mei;LI Man(Department of Surgical Anesthesiology,the People's Hospital of Handan City,Hebei 056001,China;Department of Obstetrics and Gynecology,the People's Hospital of Handan City,Hebei 056001,China;Department of Obstetrics and Gynecology,the Fourth Central Hospital of Baoding City,Hebei 072350,China;Department of Obstetrics and Gynecology,the Hospital of Dingzhou City,Hebei 073000,China;Department of Obstetrics and Gynecology,the Second Hospital of Xinji City,Xinji,Hebei 052300,China)

机构地区：[1]邯郸市人民医院手麻科,河北邯郸056001 [2]邯郸市人民医院妇产科,河北邯郸056001 [3]保定市第四中心医院妇产科,河北保定072350 [4]定州市人民医院妇产科,河北定州073000 [5]辛集市第二医院妇产科,河北辛集052300

出　　处：《临床误诊误治》2024年第6期77-81,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2023年保定市科学技术局第二批项目(2341ZF228)。

摘　　要：目的基于“情志致病”理论探究丹栀逍遥丸联合治疗肝郁证多囊卵巢综合征(PCOS)所致不孕症的效果及对相关因子和临床结局的影响。方法选择2021年7月—2023年10月收治的肝郁证PCOS所致不孕症128例,依据随机数字表法分为CG组、EG组。CG组采用常规西药治疗,EG组在CG组基础上给予丹栀逍遥丸治疗,治疗3个月经周期后观察临床疗效,比较治疗前后2组心理状态评分[抑郁自评量表(SDS)、焦虑自评量表(SAS)]、血清性激素指标[睾酮(T)、雌二醇(E_(2))、黄体生成素(LH)、促卵泡激素(FSH)]、子宫内膜容受性指标[优势卵泡数、子宫内膜厚度(Em)及子宫动脉搏动指数(PI)、阻力指数(RI)],并统计妊娠情况及不良反应。结果EG组总有效率为92.19%(59/64)高于CG组的78.12%(50/64)(P<0.05)。治疗后,EG组SAS及SDS评分、血清LH和T水平、子宫动脉RI和PI均低于CG组(P<0.05)。治疗后,EG组优势卵泡数、Em以及血清E_(2)和FSH水平高于CG组(P<0.05)。随访后,EG组妊娠率65.62%(42/64)高于CG组的37.50%(24/64)(P<0.05)。2组流产率及不良反应总发生率比较无明显差异(P>0.05)。结论肝郁证PCOS所致不孕症应用丹栀逍遥丸联合治疗临床效果较好,对性激素有调节作用,并可促进卵泡的成熟,增强子宫内膜容受性,从而提高受孕成功率。Objective To study the effect of combined treatment with Danzhi Xiaoyao pills on infertility caused by liver-depression type of polycystic ovary syndrome(PCOS)based on the theory of Emotional Pathogenesis.Methods A total of 128 patients with infertility caused by liver-depression type of PCOS treated from July 2021 to October 2023 were selected and divided into CG group and EG group according to random number table method.CG group was treated with conventional western medicine,while EG group was treated with Danzhi Xiaoyao pills on the basis of CG group,and the clinical effect was observed after 3 menstrual cycles.The psychological status scores[Self-rating Depression Scale(SDS),self-rating Anxiety Scale(SAS)],serum sex hormone indexes[testosterone(T),estradiol(E_(2)),luteinizing hormone(LH),follicle stimulating hormone(FSH)],endometrial tolerance indexes[dominant follicle number,endometrial thickness(Em)and uterine artery pulse index(PI),resistance index(RI)]were compared between the two groups before and after treatment,and pregnancy and adverse reactions were recorded.Results The total effective rate of EG group was 92.19%(59/64),which was higher than that of CG group[78.12%(50/64)](P<0.05).After treatment,the scores of SAS and SDS,serum LH and T levels,uterine artery RI and PI in EG group were lower than those in CG group(P<0.05).After treatment,the dominant follicle number,Em and serum E_(2) and FSH levels in EG group were higher than those in CG group(P<0.05).After follow-up,the pregnancy rate in EG group was 65.62%(42/64),which was higher than that in CG group[37.50%(24/64)](P<0.05).There were no significant differences in the abortion rate and the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Combined treatment with Danzhi Xiaoyao pills has remarkable clinical effect in treating infertility caused by liver-depression type of PCOS.It can regulate sex hormone levels,promote follicle development,and enhance endometrial receptivity,thereby increasing pregnancy rate.

关 键 词：多囊卵巢综合征 肝郁证 不孕症 情志致病 丹栀逍遥丸 抑郁 雌二醇 妊娠结局 

分 类 号：R271[医药卫生—中医妇科学]