【摘要】 【目的】探讨理气化痰方（由苍附导痰汤加减组成）治疗痰瘀互结型多囊卵巢综合征（PCOS）伴高雄激素血症（HA）的临床疗效。【方法】将60例痰瘀互结型PCOS-HA患者随机分为达英组和联合组，每组各30例。达英组患者给予达英-35口服治疗（于月经第5天开始），联合组患者在达英组的基础上加服理气化痰方治疗，1个月经周期为1个疗程，共治疗3个月经周期。观察2组患者治疗前后体质量指数（BMI）、Ferriman-Gallway多毛评分、痤疮综合分级系统（GAGS）评分、中医证候积分和性激素水平的变化情况，并评价2组患者的临床疗效和安全性。【结果】（1）疗效方面，治疗3个月经周期后，联合组的总有效率为96.67%(29/30)，达英组为86.67%(26/30)，组间比较（秩和检验），联合组的疗效明显优于达英组，差异有统计学意义（P<0.05）。（2）症状体征方面，治疗后，2组患者的BMI、Ferriman-Gallway多毛评分、GAGS评分及中医证候积分均较治疗前降低（P<0.05），且联合组的降低作用均明显优于达英组，差异均有统计学意义（P<0.01）。（3）性激素水平方面，治疗后，2组患者的黄体生成素（LH）、黄体生成素/卵泡刺激素（LH/FSH）、雌二醇（E2）、睾酮（T）水平均较治疗前降低（P<0.05），且联合组的降低作用均明显优于达英组，差异均有统计学意义（P<0.05或P<0.01）。（4）安全性方面，治疗过程中，2组患者均无明显不良反应发生，且2组患者的血、尿、大便常规及肝肾功能等安全性指标均无异常变化。【结论】在常规西药治疗基础上联合理气化痰方治疗痰瘀互结型PCOS-HA患者疗效确切，可有效调节月经周期，缓解临床症状，改善性激素水平。更多还原

【Abstract】 Objective To investigate the clinical efficacy of Liqi Huatan Recipe(composed of modified Cangfu Daotan Decoction)for the treatment of polycystic ovary syndrome(PCOS)complicated with hyperandrogenemia(HA)of phlegm blended with blood stasis type. Methods Sixty PCOS-HA patients with phlegm blended with blood stasis syndrome were randomly divided into the Diane-35 group and the combination group,with 30 patients in each group. Patients in the Diane-35 group were treated with oral use of Diane-35(starting on the fifth day of menstrual period),while patients in the combination group were treated with the Liqi Huatan Recipe and Diane-35 orally. One menstrual cycle constituted a course of treatment,and the treatment lasted for a total of 3 menstrual cycles. Before and after treatment, changes in body mass index(BMI), Ferriman-Gallway hirsutism score,global acne grading system(GAGS)score, TCM syndrome score and sex hormone level in both groups were observed. After treatment, the clinical efficacy and safety of the two groups were evaluated. Results(1)After3 menstrual cycles of treatment,the overall effective rate of the combination group was 96.67%(29/30)and that of the Diane-35 group was 86.67%(26/30). The intergroup comparison by rank sum test showed that the efficacy of the combination group was significantly superior to that of the Diane-35 group, and the difference was statistically significant(P<0.05).(2)After treatment, the BMI, Ferriman-Gallway hirsutism score, GAGS score and TCM syndrome score of the two groups were all decreased compared with those before treatment(P<0.05),and the decrease of the scores in the combination group was significantly superior to that in the Diane-35group, the difference being statistically significant(P<0.01).(3)After treatment, the sex hormone levels of luteinizing hormone(LH), luteinizing hormone/follicle-stimulating hormone(LH/FSH), estradiol(E2)and testosterone(T)in both groups were lower than those before treatment(P<0.05),and the combination group had stronger effect on decreasing the sex hormone levels than the Diane-35 group,the difference being statistically significant(P<0.05 or P<0.01).(4)No significant adverse reactions occurred in the two groups during treatment,or there were no abnormal changes in the safety indexes of blood,urine,stool routine test and liver and kidney function in the two groups, either. Conclusion Conventional western medicine combined with Liqi Huatan Recipe exerts certain effect in treating PCOS-HA patients with phlegm blended with blood stasis syndrome.The combined therapy is effective on regulating menstrual cycles,relieving clinical symptoms and improving sex hormone levels.更多还原