改良的五子衍宗丸联合序贯疗法治疗脾肾阳虚型卵巢早衰的临床观察  

Clinical Observation on Modified Wuzi Yanzong Pills Combined with Sequential Therapy in the Treatment of Premature Ovarian Failure of Yang Deficiency of Spleen and Kidney Type

作　　者：邓修绚 郭晓燕[1] 刘婷婷 李坤寅 DENG Xiuxuan;GUO Xiaoyan;LIU Tingting;LI Kunyin(Dept.of Gynecology and Obstetrics,Huizhou Hospital of Traditional Chinese Medicine,Huizhou 516000 Guangdong,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510240 Guangdong,China)

机构地区：[1]惠州市中医医院妇产科,广东惠州516000 [2]广州中医药大学第三附属医院,广东广州510240

出　　处：《广州中医药大学学报》2025年第4期878-885,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81873331);惠州市医疗卫生领域科技计划项目(编号:2022CZ010164)。

摘　　要：【目的】观察改良的五子衍宗丸联合序贯疗法对脾肾阳虚型卵巢早衰(POF)患者的临床疗效及其对性激素、卵巢超声指标的影响。【方法】选取2022年9月至2023年9月在惠州市中医医院就诊的62例脾肾阳虚型POF患者为研究对象,采用随机数字表法将患者随机分为对照组和观察组,每组各31例。对照组给予雌孕激素序贯疗法治疗,观察组在对照组的基础上加用改良的五子衍宗丸治疗,疗程均为3个月经周期。观察2组患者治疗前后血清性激素、子宫与卵巢超声检查及血流动力学指标、中医证候积分、Kupperman评分的变化情况,比较2组患者的排卵率与疗效,并评价2组治疗方案的安全性。【结果】(1)脱落情况方面,研究期间,共脱落2例,最终纳入60例患者,其中对照组和观察组各30例。(2)疗效方面,治疗3个月经周期后,观察组的总有效率为90.00%(27/30),对照组为76.67%(23/30),组间比较,观察组的总有效率明显高于对照组(P<0.05)。(3)性激素水平方面,治疗后,2组患者的血清促卵泡生成素(FSH)、黄体生成素(LH)水平均较治疗前下降(P<0.05),血清雌二醇(E_(2))水平均较治疗前升高(P<0.05),且观察组对血清FSH、LH水平的下降幅度及对血清E_(2)水平的升高幅度均明显优于对照组(P<0.01)。(4)超声检查指标方面,治疗后,2组患者的子宫内膜厚度(EM)、卵巢平均容积(OVA)、卵巢最大平面的平均卵巢直径(MOD)、基础窦卵泡数(AFC)等超声检查指标均较治疗前升高(P<0.05),且观察组的升高幅度均明显优于对照组(P<0.01)。(5)卵巢血流动力学方面,治疗后,2组患者的卵巢最大血流速度(PSV)均较治疗前升高(P<0.05),卵巢阻力指数(RI)、卵巢搏动指数(PI)均较治疗前下降(P<0.05),且观察组对PSV的升高幅度及对RI、PI的下降幅度均明显优于对照组(P<0.01)。(6)Kupperman评分和中医证候积分方面,治疗后,2组患者的Kupperman评分和中医证候积分均较Objective To investigate the clinical efficacy of modified Wuzi Yanzong Pills combined with sequential therapy for the treatment of patients with premature ovarian failure(POF)of yang deficiency of spleen and kidney type,and to observe their effects on sex hormones and ovarian ultrasound indicators.Methods From September 2022 to September 2023,a total of 62 patients with POF of yang deficiency of spleen and kidney type who attended Huizhou Hospital of Traditional Chinese Medicine were selected as the study objects.The patients were randomly divided into the control group and the observation group by using a table of random numbers,with 31 patients in each group.The control group was treated with estrogen-progestin sequential therapy,and the observation group was treated with modified Wuzi Yanzong Pills on the basis of treatment for the control group.The two groups were treated for three menstrual cycles.Before and after treatment,the changes of serum sex hormones,uterine and ovarian ultrasonography and hemodynamic indicators,traditional Chinese medicine(TCM)syndrome scores,Kupperman score of the two groups were observed.The ovulation rate and therapeutic efficacy of the two groups were compared,and the safety of the therapeutic regimen for the two groups was evaluated.Results(1)Two cases fell off during the study period,and a total of 60 patients were eventually included in the study,of which 30 patients in each group.(2)After three menstrual cycles of treatment,the total effective rate of the observation group was 90.00%(27/30)and that of the control group was 76.67%(23/30),and the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).(3)After treatment,the serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels of the two groups of patients were decreased compared with those before treatment(P<0.05),and the serum estradiol(E_(2))level was increased compared with that before treatment(P<0.05),the decrease of the serum FSH and LH levels and

关 键 词：改良的五子衍宗丸 卵巢早衰 脾肾阳虚型 性激素 KUPPERMAN评分 排卵率 

分 类 号：R271.9[医药卫生—中西医结合]