启宫丸汤联合奥利司他治疗肥胖型多囊卵巢综合征不孕的疗效与安全性研究  

Efficacy and safety of Qigongwan Soup combined with orlistat in the treatment of obesity-related polycystic ovary syndrome infertility

作　　者：李贺琦 赵爱丽 LI He-qi;ZHAO Ai-li(Department of Obstetrics and Gynecology,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,Henan,CHINA;Department of Traditional Chinese Medicine,Nanyang Wolong Maternal and Child Health Care Hospital,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市中医院妇产科,河南南阳473000 [2]南阳市卧龙区妇幼保健院中医科,河南南阳473000

出　　处：《海南医学》2025年第3期366-371,共6页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20232975)。

摘　　要：目的探讨启宫丸汤联合奥利司他治疗肥胖型多囊卵巢综合征(PCOS)不孕的临床效果及安全性。方法选取2021年7月至2023年7月南阳市中医院收治的108例肥胖型PCOS不孕患者作为研究对象,采用随机数表法分为常规组和研究组各54例。常规组患者采取奥利司他治疗,研究组患者采用启宫丸汤联合奥利司他治疗,两组患者均治疗3个月。治疗3个月后比较两组患者的中医疗效以及治疗前后的中医证候积分、微小核糖核酸(miRNAs)表达、病情相关指标[体质量指数(BMI)、卵泡雌激素(FSH)、腰臀比(WHR)、睾酮(T)、黄体生成素(LH)]水平,同时比较两组患者治疗期间的不良反应发生情况及治疗后6个月的宫内妊娠率。结果治疗后,研究组患者的中医疗效总有效率为88.89%,明显高于常规组的66.67%,差异有统计学意义(P<0.05);治疗后,研究组患者的形体肥胖、经行后期、婚久不孕、带下量多、头晕心悸积分分别为(1.37±0.32)分、(1.29±0.30)分、(1.42±0.31)分、(1.21±0.30)分、(1.15±0.30)分,明显低于常规组的(1.76±0.34)分、(1.70±0.32)分、(1.80±0.33)分、(1.53±0.31)分、(1.57±0.32)分,差异均有统计学意义(P<0.05);治疗后,研究组患者的miR-222、miR-27a、miR-874-3p表达分别为1.31±0.30、1.43±0.38、1.40±0.31,明显低于常规组的1.63±0.33、1.80±0.41、1.75±0.33,差异均有统计学意义(P<0.05);治疗后,研究组患者的BMI、WHR、T、F SH、LH分别为(25.01±1.25)kg/m^(2)、0.65±0.20、(0.71±0.25)nmol/L、(3.02±0.47)IU/L、(11.17±1.65)IU/L,明显低于常规组的(26.42±1.45)kg/m^(2)、0.84±0.23、(0.83±0.27)nmol/L、(4.41±0.53)IU/L、(13.35±2.12)IU/L,差异均有统计学意义(P<0.05);两组患者治疗期间不良反应发生率比较差异均无统计学意义(P>0.05);随访6个月,研究组患者的宫内妊娠率为44.23%,明显高于常规组的19.23%,差异有统计学意义(P<0.05)。结论启宫丸汤联合奥利司他治疗肥胖型PCOS不孕能Objective To investigate the clinical efficacy and safety of Qigongwan Soup combined with orlistat in the treatment of obesity-related polycystic ovary syndrome(PCOS)infertility.Methods A total of 108 patients with obesity-related PCOS infertility admitted to Nanyang Hospital of Traditional Chinese Medicine from July 2021 to July 2023 were selected.The patients were divided into a conventional group and a study group using the random number table,with 54 patients in each group.Patients in the conventional group were treated with orlistat,while those in the study group were treated with Qigongwan Soup combined with orlistat,for 3 months.After 3 months of treatment,the efficacy of traditional Chinese medicine between the two groups was compared,as well as the scores of traditional Chinese medicine symptoms,the expression of microRNAs(miRNAs),and the levels of disease-related indicators(body mass index[BMI],follicle stimulating hormone[FSH],waist-to-hip ratio[WHR],testosterone[T],luteinizing hormone[LH])before and after treatment.At the same time,the adverse reactions during the treatment period and the intrauterine pregnancy rate at 6 months after treatment were compared between the two groups.Results The total effective rate in the study group was 88.89%,which was significantly higher than the conventional group's 66.67%(P<0.05).After treatment,the scores of body obesity,late menstruation,long-term infertility,excessive discharge,dizziness and palpitations in the study group were(1.37±0.32)points,(1.29±0.30)points,(1.42±0.31)points,(1.21±0.30)points,and(1.15±0.30)points,respectively,which were significantly lower than(1.76±0.34)points,(1.70±0.32)points,(1.80±0.33)points,(1.53±0.31)points,and(1.57±0.32)points in the conventional group(P<0.05).After treatment,the expression levels of miR-222,miR-27a,and miR-874-3p in the study group were 1.31±0.30,1.43±0.38,and 1.40±0.31,respectively,which were significantly lower than 1.63±0.33,1.80±0.41,and 1.75±0.33 in the conventional group(P<0.05).After treatmen

关 键 词：多囊卵巢综合征 启宫丸汤 不孕 肥胖 奥利司他 妊娠 安全性 

分 类 号：R711.75[医药卫生—妇产科学]