二甲地黄汤联合苍附导痰汤加减治疗痰湿型多囊卵巢综合征不孕症疗效观察及对血清Kisspeptin的影响  

Curative Effect of Modified Erjia Dihuang Decoction Combined with Cangfu DaotanDecoction on Infertility due to Polycystic Ovary Syndrome of Phlegm-Damp Type andIts Effect on Serum Kisspeptin

作　　者：兰苏平[1] 石明晴[1] 章芳芳 LAN Suping;SHI Mingqing;ZHANG Fangfang(Lishui Hospital of Traditional Chinese Medicine,Lishui Zhejiang 323000,China)

机构地区：[1]丽水市中医院,浙江丽水323000

出　　处：《新中医》2024年第13期132-136,共5页New Chinese Medicine

基　　金：丽水市科技计划项目(2020SJZC072)。

摘　　要：目的:观察二甲地黄汤联合苍附导痰汤加减治疗痰湿型多囊卵巢综合征(PCOS)不孕症的疗效及对血清Kisspeptin的影响。方法:选取86例痰湿型PCOS不孕症患者,按随机数字表法分为对照组及观察组各43例。对照组采用来曲唑片治疗,观察组在对照组基础上加用二甲地黄汤联合苍附导痰汤加减治疗。2组均连续治疗3个月经周期。比较2组临床疗效及排卵率、妊娠率、活产率,比较2组治疗前后妇科B超指标值、血清性激素[睾酮(T)、促卵泡生成素(FSH)、促黄体生成素(LH)、LH/FSH]水平、血清Kisspeptin水平的变化。结果:治疗后,对照组总有效率为74.42%,观察组总有效率为95.35%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组直径0.2~0.9 cm的卵泡数量均较治疗前减少(P<0.05),观察组数量少于对照组(P<0.05)。治疗后,2组卵巢体积均较治疗前缩小,观察组卵巢体积小于对照组,观察组组内、组间比较,差异有统计学意义(P<0.05)。治疗后,2组血清T、LH、LH/FSH指标值均较治疗前下降(P<0.05),观察组血清T、LH、LH/FSH指标值均低于对照组(P<0.05)。治疗后,2组血清Kisspeptin水平均较治疗前下降(P<0.05),观察组Kisspeptin水平低于对照组(P<0.05)。治疗后,观察组排卵率、妊娠率均高于对照组,差异均有统计学意义(P<0.05)。结论:二甲地黄汤合苍附导痰汤加减治疗痰湿型PCOS不孕症疗效显著,能改善卵巢多囊状态,调节性激素,提高排卵率、妊娠率,其作用机制可能与调节Kisspeptin在血清中的表达有关。Objective:To observe the curative effect of modified Erjia Dihuang Decoction combined with Cangfu Daotan Decoction on infertility due to polycystic ovary syndrome(PCOS)of phlegm-damp type and its effect on serum Kisspeptin.Methods:A total of 86 cases of patients with infertility due to PCOS of phlegm-damp type were selected and divided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was treated with Letrozole Tablets,and the observation group was treated with modified Erjia Dihuang Decoction combined with Cangfu Daotan Decoction based on the treatment of the control group.Both groups were treated continuously for three menstrual cycles.The clinical effects,ovulation rates,pregnancy rates,and live birth rates were compared between the two groups.The changes in levels of gynecological ultrasoundindicators,serum sex hormones[testosterone(T),follicle stimulating hormone(FSH),luteinizing hormone(LH),and LH/FSH],and serum Kisspeptin were compared before and after treatment between the twogroups.Results:After treatment,the total effective rate was 74.42%in the control group,and 95.35%inthe observation group,the difference being significant(P<0.05).After treatment,the number of follicleswith a diameter of 0.2-0.9 cm in the two groups was decreased when compared with that before treatment(P<0.05),the number in the observation group was fewer than that in the control group(P<0.05).Aftertreatment,the ovarian volume in the two groups were decreased when compared with that beforetreatment,and the ovarian volume in the observation group was smaller than that in the control group,thedifference being significant in the observation group and between the two groups(P<0.05).Aftertreatment,the levels of T,LH,and LH/FSH in serum in the two groups were decreased when comparedwith those before treatment(P<0.05),and the levels of T,LH,LH/FSH in serum in the observation groupwere lower than those in the control group(P<0.05).After treatment,the ser

关 键 词：多囊卵巢综合征 不孕症 痰湿型 二甲地黄汤 苍附导痰汤 性激素 血清Kisspeptin 

分 类 号：R711.75[医药卫生—妇产科学] R271.14[医药卫生—临床医学]