蔡氏妇科育肾法结合芬吗通治疗卵巢储备功能低下的临床研究  

A clinical study of Cai's gynaecological Yushen therapy for the treatment of diminished ovarian reserve

作　　者：唐红 洪文顺 王玲玲 庄梦斐[2] 曹阳[2] 谭丽[2] 张婷婷[2] Tang Hong;Hong Wenshun;Wang Lingling;Zhuang Mengfei;Cao Yang;Tan Li;Zhang Tingting(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Gynecology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学附属岳阳中西医结合医院妇科,上海200437

出　　处：《国际中医中药杂志》2025年第2期171-176,共6页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82374499);上海中医药大学科技发展基金项目(23KFL116);中医妇科流派上海蔡氏妇科传承创新团队项目(2021LPTD-002);张婷婷教授上海市名老中医学术经验研究工作室建设项目(SHGZS-20222)。

摘　　要：目的评价蔡氏妇科育肾法结合芬吗通治疗卵巢储备功能低下(DOR)的临床疗效,探讨其作用机制。方法随机对照试验研究。选择2020年9月-2022年1月上海中医药大学附属岳阳中西医结合医院妇科门诊63例DOR患者作为观察对象,采用随机数字表法分为观察组32例、对照组31例。对照组口服芬吗通,观察组在对照组基础上结合蔡氏妇科育肾法治疗。2组均治疗3个月经周期。采用阴道超声行双侧窦卵泡计数(AFC),ELISA法检测血清TGF-β1、IL-1β、IL-2、IL-6、IL-21水平,生化法检测血清FSH、LH、雌二醇(E2)、抗缪勒管激素(AMH)、MDA水平;采用中医证候评分评估症状严重程度、月经评分评估月经异常情况;评价临床疗效。结果观察组总有效率为87.50%(28/32)、对照组为58.06%(18/31),2组比较差异有统计学意义(χ^(2)=8.42,P=0.004)。观察组治疗后AFC[(3.93±2.32)个比(2.21±2.18)个,t=3.03]高于对照组(P<0.01);血清FSH[10.05(8.35,21.48)IU/L比20.60(8.00,43.30)IU/L,Z=2.18]水平低于对照组(P<0.05),血清AMH[0.19(0.03,0.47)μg/L比0.02(0.01,0.24)μg/L,Z=-1.54]水平高于对照组(P<0.05)。观察组治疗后血清TGF-β1[(68.27±11.76)ng/L比(55.33±13.03)ng/L,t=4.14]、IL-1β[(58.00±7.53)ng/L比(52.31±8.06)ng/L,t=2.89]水平高于对照组,IL-6[(33.26±7.45)ng/L比(40.69±11.69)ng/L,t=3.02]、IL-21[(118.37±15.56)ng/L比(140.43±25.51)ng/L,t=-4.04]水平低于对照组(P<0.01)。结论蔡氏妇科育肾法结合芬吗通可增加DOR患者AFC,提高临床疗效,其作用机制可能与降低血清FSH、LH水平,升高E2水平有关。Objective To evaluate the clinical efficacy of Cai's gynecological nourishing kidney therapy for patients with diminished ovarian reserve(DOR).Methods A randomly controlled trail was conducted.A total of 63 patients with DOR who were treated in the gynecology outpatient clinic of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from September 2020 to January 2022 were set as observation subjects,and were divided into control group(n=31)and observation group(n=32)according to the random number table method.The patients in the control group were treated with Femoston,and the patients in the observation group were treated with Cai's gynecological nourishing kidney therapy on the basis of Femoston treatment.Both groups were treated for 3 menstrual cycles.Both antral follicle count(AFC)was performed by vaginal ultrasound,serum levels of TGF-β1,IL-1β,IL-2,IL-6 and IL-21 were detected by ELISA,and serum levels of FSH,LH,E2,anti-Müllerian hormone(AMH)and MDA were detected by biochemical methods.The TCM syndrome score was used to evaluate the severity of symptoms,and the menstrual score was used to evaluate the abnormal menstruation.Clinical efficacy was evaluated.Results The total effective rate was 87.50%(28/32)in the observation group and 58.06%(18/31)in the control group,with statistical significance(χ^(2)=8.42,P=0.004).After treatment,the AFC in the observation group(3.93±2.32 vs.2.21±2.18,t=3.03)was higher than that of the control group(P<0.01).After treatment,the serum FSH level of the observation group[10.05(8.35,21.48)IU/L vs.20.60(8.00,43.30)IU/L,Z=2.18]was lower than that of the control group(P<0.05),and the level of AMH[0.19(0.03,0.47)μg/L vs.0.02(0.01,0.24)μg/L,Z=-1.54]in the observation group was higher than that of the control group(P<0.05).The serum levels of TGF-β1[(68.27±11.76)ng/L vs.(55.33±13.03)ng/L,t=4.14]and IL-1β[(58.00±7.53)ng/L vs.(52.31±8.06)ng/L,t=2.89]in the observation group were higher than

关 键 词：卵巢储备 蔡氏妇科育肾法 中西医结合疗法 机制探讨 

分 类 号：R711.75[医药卫生—妇产科学]