六味地黄汤合苍附导痰汤加味对肥胖型PCOS合并不孕患者炎症水平、糖脂代谢及妊娠率的影响  

Effect of modified Liuwei Dihuang Decoction combined with Cangfu Daotan Decoction on inflammation level,glycolipid metabolism and pregnancy rate in obese patients with PCOS combined with infertility

作　　者：姚玮娜 代文娟 黄楠 YAO Wei-na;DAI Wen-juan;HUANG Nan(Reproductive Center,Fuyang Women and Children's Hospital,Fuyang Anhui 236504,China;Department of Laboratory,Fuyang Women and Children's Hospital,Fuyang Anhui 236504,China)

机构地区：[1]阜阳市妇女儿童医院生殖中心,安徽阜阳236504 [2]阜阳市妇女儿童医院检验科,安徽阜阳236504

出　　处：《临床和实验医学杂志》2025年第3期303-307,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省重点研究与开发计划项目(编号:2022e07020003)。

摘　　要：目的观察六味地黄汤合苍附导痰汤加味对肥胖型多囊卵巢综合征(PCOS)合并不孕患者炎症水平、糖脂代谢及妊娠率的影响。方法前瞻性选取2020年8月至2023年10月就诊于阜阳市妇女儿童医院生殖中心的90例肥胖型PCOS合并不孕患者为研究对象。按照随机数字表法将其分为西医组和中西医组,每组各45例。西医组给予二甲双胍片和屈螺酮炔雌醇片治疗,中西医组在西医组基础上给予六味地黄汤合苍附导痰汤加味辅助治疗,两组均连续治疗3个月。比较两组患者治疗前、治疗3个月后的体重指数、腰臀比、月经周期、卵巢体积、优势卵泡直径、中医证候评分、炎症因子[单核细胞趋化蛋白-1(MCP-1)、白细胞介素-6(IL-6)]、糖脂代谢相关因子[甘油三酯、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、稳态模型下的胰岛素抵抗指数(HOMA-IR)]、睾酮、性激素[黄体生成素/促泡刺激素(LH/FSH)]水平,随访6个月记录两组妊娠结局情况。结果治疗3个月后,两组的体重指数、腰臀比均较治疗前下降,且中西医组的体重指数、腰臀比均低于西医组,差异均有统计学意义(P<0.05)。治疗3个月后,两组的月经周期均较治疗前缩短,卵巢体积、中医证候评分均较治疗前下降,优势卵泡直径均较治疗前升高,且中西医组的月经周期短于西医组,卵巢体积、中医证候评分均低于西医组,优势卵泡直径高于西医组,差异均有统计学意义(P<0.05)。治疗3个月后,两组MCP-1、IL-6水平均较治疗前下降,且中西医组的MCP-1、IL-6水平均低于西医组,差异均有统计学意义(P<0.05)。治疗3个月后,两组的甘油三酯、LDL-C、FPG、HbA1c、HOMA-IR均较治疗前下降,且中西医组的糖脂代谢相关因子均低于西医组,差异均有统计学意义(P<0.05)。治疗3个月后,两组睾酮、LH/FSH均较治疗前下降,且中西医组的睾酮、LH/FSH水平均低于西医Objective To observe the effects of modified Liuwei Dihuang Decoction combined with Cangfu Daotan Decoction on inflammation level,glycolipid metabolism and pregnancy rate in obese patients with polycystic ovary syndrome(PCOS)combined with infertility.Methods Ninety obese PCOS patients with infertility who were treated in the Reproductive Center,Fuyang Women and Children's Hospital from August 2020 to October 2023 were prospectively selected as subjects.According to the random number table method,they were divided into the western medicine group and the Chinese and western medicine group,45 cases in each group.The western medicine group was treated with metformin tablets and drospirenone ethinylestradiol tablets,and the Chinese and western medicine group was given auxiliary treatment of Liuwei Dihuang Decoction and Cangfu Daotan Decoction on the basis of the western medicine group.The two groups were treated continuously for three months.The body mass index,waist-to-hip ratio,menstrual cycle,ovarian volume,dominant follicle diameter,traditional chinese medicine syndrome score,inflammatory factors[monocyte chemoattractant protein-1(MCP-1),interleukin-6(IL-6)],glucose and lipid metabolism related factors[triglyceride,low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),Homeostasis model assessment of insulin resistance(HOMA-IR)],testosterone,sex hormones[luteinizing hormone/follicle stimulating hormone(LH/FSH)]levels were compared between the two groups before treatment and after 3 months of treatment,and pregnancy was recorded in the two groups at 6-month follow-up.Results After 3 months of treatment,the body mass index and waist-hip ratio of the two groups were lower than those before treatment,and the body mass index and waist-hip ratio of the Chinese and western medicine group were lower than those of the western medicine group,the differences were statistically significant(P<0.05).After 3 months of treatment,the menstrual cycle of the two groups was shorter than t

关 键 词：六味地黄汤 苍附导痰汤 肥胖型 多囊卵巢综合征 不孕 

分 类 号：R271.9[医药卫生—中西医结合]