【作者】 高向慧；

【导师】 王东梅；

【作者基本信息】 山东中医药大学 ， 中医妇科学， 2003， 硕士

【摘要】 目的 探讨温肾调经汤配合CC对PCOS的临床疗效及其对HPO轴和HPT轴功能影响的作用机理。方法 对22例非肥胖（Ⅰ型组）患者和21例肥胖（Ⅱ型组）患者治疗前后及20例正常对照组妇女采用放射免疫法测定血清LH、FSH、E₂、T、INS、TSH、FT₃、FT₄水平，比较治疗前后及与对照组间各激素水平的差异。并观察患者临床症状及体征变化。结果 温肾调经汤配合CC治疗PCOS患者43例，总有效率90.70％，排卵率81.20％，妊娠率48.15％。排除年龄差异后，与对照组比较，PCOS患者治疗前均有较高水平的血清T、INS、TSH和较低水平的E₂、FT₃、FT₄；两患者组比较，Ⅰ型组的FT₃、FT₄、INS显著低于Ⅱ型组，T显著高于Ⅱ型组；Ⅱ型组的LH、LH/FSH与对照组相似，显著低于Ⅰ型组；3组的FSH水平相似；治疗后两患者组各激素水平及临床症状皆有不同程度恢复和好转。结论 内分泌紊乱及代谢障碍是PCOS的重要病理特征，PCOS患者存在亚临床甲状腺功能低下状态；温肾调经汤配合CC可有效调节PCOS患者紊乱的HPO轴、HPT轴及代谢功能，使患者生殖和代谢功能恢复正常。更多还原

【Abstract】 Objective To explore the curative effect and mechanism of treation PCOS patients by Wenshentiaojing Decoction(WSTJD) and Clomiphene Citrate(CC). Methods Radioimmunoassay was used to measure the serum hormone(T, E2, LH, INS, TSH, FT3, FT4) in each subjects of two PCOS groups (nonobesity Grope 1, n=22; obesity, Group 2,n=21) and the control (n=20). Changes were accessed in the level of serum T, E2, LH, INS, TSH, FT3, FT4. Observe the changes of patients’ syndrome. Results The total effective rate is percent 90.70,the ovulation rate is percent 81.20, the pregnant rate is percent 48.15. Serum T, INS, TSH levels before treatment in affected subjects were significantly higher than in controls and serum FT3,FT4 were lower; serum FT3, FT4 and INS in Group 1 were significantly lower than Group 2, but serum T, LH were higher than Group 2.After treatment both the serum and the syndrome were significantly resumed. Conclusion Endocrine turbulence and decompensation are two important pathological characteristics in PCOS patients, and subclinical hypothyroidism may exist in them. WSTJD and CC can regulate the unbalanced metabolization and the turbulence of HPO and HPT axes in PCOS patients, help to resume the balance.更多还原