桃红四物汤加减治疗肾虚血瘀型卵巢储备功能低下临床研究  

Clinical Study on Modified Taohong Siwu Decoction in Treating Diminished Ovarian Reserve of Kidney Deficiency and Blood Stasis Type

作　　者：周笑梅 钱海墨 陈颖异 ZHOU Xiaomei;QIAN Haimo;CHEN Yingyi(Department of Chinese Medicine,the Third Affiliated Hospital of Wenzhou Medical University(Ruian People's Hospital),Wenzhou Zhejiang,325200)

机构地区：[1]温州医科大学附属第三医院/瑞安市人民医院中医科,浙江温州325200

出　　处：《新中医》2025年第5期36-40,共5页New Chinese Medicine

基　　金：浙江省温州市基础性科研项目(Y2023243)。

摘　　要：目的:观察桃红四物汤加减治疗肾虚血瘀型卵巢储备功能低下(DOR)的疗效。方法:选取2023年4月—2024年4月温州医科大学附属第三医院收治的108例肾虚血瘀型DOR患者,按信封法随机分为对照组及观察组各54例。对照组给予戊酸雌二醇片加地屈孕酮片治疗,观察组在对照组基础上给予桃红四物汤加减治疗。比较2组临床疗效及不良反应发生率,比较2组治疗前后月经情况评分、肾虚血瘀证候评分、血清性激素[促卵泡激素(FSH)、促黄体生成激素(LH)、雌二醇(E_(2))、孕酮(P)、泌乳素(PRL)、抗苗勒氏管激素(AMH)、FSH/LH]水平、卵巢间质动脉血流参数[收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)]值的变化。结果:治疗后,2组月经情况评分、肾虚血瘀证候评分均较治疗前下降(P<0.05),观察组月经情况评分及肾虚血瘀证候评分均低于对照组(P<0.05)。治疗后,2组FSH、LH、PRL及FSH/LH水平均较治疗前下降(P<0.05),E_(2)、P、AMH水平均较治疗前上升(P<0.05);观察组FSH、LH、PRL及FSH/LH水平均低于对照组(P<0.05),E_(2)、P、AMH水平均高于对照组(P<0.05)。治疗后,2组PSV值均较治疗前上升(P<0.05),PI、RI值均较治疗前下降(P<0.05);观察组PSV值高于对照组(P<0.05),PI、RI值均低于对照组(P<0.05)。观察组临床疗效总有效率为94.44%(51/54),对照组为79.63%(43/54),2组比较,差异有统计学意义(P<0.05)。治疗期间,2组均未发生严重不良反应。结论:桃红四物汤加减治疗肾虚血瘀型DOR疗效较好,可有效缓解临床症状,改善卵巢储备功能,安全性高。Objective:To observe the therapeutic effects of modified Taohong Siwu Decoction in treating diminished ovarian reserve(DOR)of kidney deficiency and blood stasis type.Methods:A total of 108 DOR patients of kidney deficiency and blood stasis type admitted to the Third Affiliated Hospital of Wenzhou Medical University from April 2023 to April 2024 were randomly divided into the control group and the observation group by the envelope method,with 54 patients in each group.The control group was treated with Estradiol Valerate Tablets and Dydrogesterone Tablets,while the observation group received modified Taohong Siwu Decoction on the basis of the control group's treatment.The clinical effects and incidence of adverse reactions were compared between the two groups.The menstrual condition scores,syndrome scores of kidney deficiency and blood stasis,serum sex hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),progesterone(P),prolactin(PRL),anti-Müllerian hormone(AMH),FSH/LH],and ovarian stromal artery blood flow parameters[peak systolic velocity(PSV),pulsatility index(PI),resistance index(RI)]before and after treatment were compared between the two groups.Results:After treatment,the menstrual condition scores and the syndrome scores of kidney deficiency and blood stasis were decreased in both groups when compared with those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of FSH,LH,PRL,and FSH/LH were decreased in both groups when compared with those before treatment(P<0.05),while the levels of E_(2),P,and AMH were increased(P<0.05).The levels of FSH,LH,PRL,and FSH/LH in the observation group were lower than those in the control group(P<0.05),while the levels of E_(2),P,and AMH were higher(P<0.05).After treatment,the PSV values were increased in both groups when compared with those before treatment(P<0.05),while the PI and RI values were decreased(P<0.05).The PSV value in the observation g

关 键 词：卵巢储备功能低下 肾虚血瘀型 肾-天癸-冲任-胞宫轴 桃红四物汤 

分 类 号：R271.9[医药卫生—中西医结合]