健脾温肾化痰祛湿法对PCOS伴胰岛素抵抗临床疗效及对双侧卵巢体积变化、性激素水平和糖脂代谢的影响  

Clinical effects of Jianpi Wenshen Huatan Qushi Decoction in treating PCOS with insulin resistance and the influence on bilateral ovarian volume,sexual hormone levels,and glucose and lipid metabolism

作　　者：何锦妮 任利 尚国涛 HE Jinni;REN Li;SHANG Guotao(Department of Gynecology,Yangling Demonstration Zone Hospital,Yangling Shaanxi 712100,China;Department of Traditional Chinese Medicine,Yangling Demonstration Zone Hospital,Yangling Shaanxi 712100,China)

机构地区：[1]杨凌示范区医院妇科,陕西杨凌712100 [2]杨凌示范区医院中医科,陕西杨凌712100

出　　处：《四川中医》2024年第9期182-185,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探究多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者采用健脾温肾化痰祛湿法治疗的效果及对卵巢体积、性激素和糖脂代谢的影响。方法:选取2020年6月~2022年7月本院收治的PCOS伴IR患者,共136例,采取随机数表法分为两组。对照组(n=68)给予常规西医治疗,观察组(n=68)予以健脾温肾化痰祛湿法联合常规西医治疗,比较两组患者疗效、中医证候积分、双侧卵巢体积大小、性激素水平以及糖脂代谢指标变化情况。结果:观察组总有效为94.12%,高于对照组88.24%(χ^(2)=1.462,P=0.227);治疗后两组月经周期、腰膝痠软等中医证候积分、双侧卵巢体积均降低,且观察组低于对照组(P<0.05);治疗后黄体生成激素(LH)、LH/卵泡刺激素(FSH)、睾酮(T)水平逐渐降低,且观察组低于对照组,而FSH、性激素结合球蛋白(SHBG)水平逐渐升高,且观察组高于对照组(P<0.05);治疗后空腹胰岛素(FINS)、空腹血糖(FPG)、HOMA-IR水平均降低,且观察组低于对照组,而脂联素(APN)水平升高,且观察组高于对照组(P<0.05)。结论:健脾温肾化痰祛湿法治疗PCOS伴胰岛素抵抗效果显著,该方可有效改善患者中医证候积分、调节患者性激素水平和糖脂代谢指标。Objective To investigate the therapeutic effects of Jianpi Wenshen Huatan Qushi Decoction on PCOS with IR,and the influence on ovarian volume,sexual hormones and glucose and lipid metabolism.Methods A total of 136 patients with PCOS and IR who were admitted to the hospital from June 2020 to July 2022 were divided into two groups using the random number table.68 patients in the control group were treated with conventional western medicine,and 68 patients in the observation group were treated with Jianpi Wenshen Huatan Qushi Decoction on this basis.Therapeutic effects,TCM syndrome scores,bilateral ovarian volume,the levels of sexual hormones and glucose and lipid metabolism indicators were compared between groups.Results After treatment,the total effective rate was 94.12%in the observation group,higher than 88.24%in the control group(χ^(2)=1.462,P=0.227).After treatment,the scores for menstrual cycle and soreness and weakness of waist and knees,and bilateral ovarian volume of both groups decreased.Above indicators of the observation group were lower(P<0.05).The levels of LH,LH/FSH and T decreased,and levels in the observation group were lower.The levels of FSH and SHBG increased,and levels in the observation group were higher(P<0.05).FINS,FPG and HOMA-IR decreased.The three indicators in observation group were lower.APN levels in both groups increased,and the observation group had higher APN level(P<0.05).Conclusion Jianpi Wenshen Huatan Qushi Decoction is effective in treating PCOS with IR.It can effectively improve TCM syndrome scores,regulate the levels of sexual hormones and glucose and lipid metabolism indicators in the patients.

关 键 词：多囊卵巢综合征 胰岛素抵抗 健脾温肾化痰祛湿法 双侧卵巢体积 性激素水平 糖脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]