【作者】 张秀； 陈玥； 卢燕； 陈思； 王佩娟；

【Author】 Zhang Xiu;Chen Yue;Lu Yan;Chen Si;WANG Peijuan;The First Clinical College Nanjing University of Chinese Medicine;Obstertrics and Gynecology Department,Integrated Chinese-western Medicine Hospital of Jiangsu;

【机构】 南京中医药大学第一临床学院； 江苏省中西医结合医院妇产科；

【摘要】 目的:通过研究补肾活血汤治疗肾虚肝郁型卵巢储备功能减退患者的临床疗效,阐明补肾活血汤对肾虚肝郁型卵巢储备功能减退的防治作用。方法:收集41例辩证属于肾虚肝郁型卵巢储备功能减退患者,随机分为治疗组21例和对照组20例。治疗组予补肾活血汤治疗,对照组予激素替代治疗,治疗3月后观察两组治疗前后的临床症状、血清性激素、AFC、OVD及RI的变化。结果:1.治疗组综合临床疗效为76%,对照组综合临床疗效为70%,两组间统计无显著差异(P>0.05)。治疗组中医症候总有效率为81%,对照组中医证候总有效率为75%,两组组间统计无显著差异(P>0.05),两组治疗后与治疗前均有显著差异(P<0.05)。治疗组和对照组均能改善卵巢功能减退患者月经不调与肾虚肝郁的临床症状。2.两组治疗后FSH,FSH/LH水平下降、E2水平上升,与治疗前均有显著差异(P<0.05);治疗组LH水平下降,与治疗前相比有显著差异(P<0.05),对照组LH水平有所下降,但与治疗前无显著差异(P>0.05);治疗后两组组间LH、FSH比较有显著差异(P<0.05),E2,FSH/LH无显著差异(P>0.05)。3.治疗组和对照组AFC治疗前后均有显著差异(P<0.05),OVD、RI治疗前后均无显著差异(P>0.05);治疗后两组组间AFC、RI比较有显著差异(P<0.05),OVD比较无统计学意义(P>0.05)。结论:补肾活血汤能降低血清FSH、LH、FSH/LH,升高E2,升高AFC,调整下丘脑-垂体-卵巢轴,改善肾虚肝郁卵巢储备功能减退患者月经不调等临床症状,保护卵巢剩余组织,延缓卵巢功能衰退。更多还原

【Abstract】 Purpose:To support theoretical foundation for clinical traditional Chinese medicine treatment the primary ovarian insufficiency, To explore the preventive and therapeutic effect of Bushenhuoxue decoction on primary ovarian insufficiency with kindey insuffiency and liver depression, this paper studies the clinical effect of bushenhuoxue decoction for the primary ovarian insufficiency with kindey insuffiency and liver depression. Method: Collection 41 cases suffer from ovarian function decline with kidney insufficiency and liver depression. The 41 cases were divided into treatment group and control group,treatment group is 21 cases and control group is 20 cases.The treatment group were treat with bushenhuoxue decoction and the control group were treat with hormone, and observe the clinical symptoms of the two groups pretherapy and posttreatment, the change of serum sex hormone, AFC, OVD and the change of RI after three months, and also observe the differences between the two groups. Result One. The comprehensive clinical curative effect of treatment group was 76% and the control group was 70%, and there was no significant statistical differences between the two groups(P>0.05). Traditional Chinese mdicine symptoms in treatment group total effective rate was 81% and the control group was 75%, and there was no significant statistical differences between the two groups(P>0.05). Both the two group have a significant different between the pretherapy and post-treatment(P<0.05). The treatment group and control group can improve patient’s clinical symptoms of irregular menstruation and renal deficiency and hepatic stagnation with ovarian function decline. Two. After the therapy, the level of FSH, FSH/LH decline and the level of E2 ascend, and there was a significant difference compared with prior treatment.(P<0.05). The level of LH is decline in treatment group, and there was a significant difference compare with prior treatment(P>0.05). After treatment, the level of AFC and RI between the two groups has significant difference(P<0.05), but the comparison of E2 and FSH/LH between the two groups has no significant difference(P>0.05). Three. Through the pretherapy and post-treatment(P<0.05), the AFC of treatment group has significant difference(P<0.05), and the OVD and RI has no significant difference. Through the pretherapy and post-treatment, the AFC and RI of control group has significant difference(P>0.05), and the OVD has no significant difference(P<0.05).The comparison of E2 and FSH/LH between the two groups has no significant difference(P>0.05), and the comparison of OVD has no statistical significance. Conclusion Bushenhuoxue decoction can improve patient’s clinical symptoms of irregular menstruation and renal deficiency and hepatic stagnation with primary ovarian insufficiency,also can decline FSH LH, FSH/LH of serum and ascend E2. In the same time,its can adjust the hypothalamus-pituitary-ovarian axis, Promote the follicular development, improve the ovarian blood supply, protect the remaining ovary organization, and delay ovarian function decline.更多还原