经阴道超声评价补肾化痰中药治疗多囊卵巢综合征胰岛素抵抗的临床研究

目的:探讨经阴道彩色多普勒超声(TV-CDU)血流动力学参数在评价补肾化痰中药治疗胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)治疗效果中的临床应用价值.方法:选择临床诊断为PCOS-IR的患者51例,给予补肾化痰中药干预3月,利用TV-CDU比较治疗前后卵巢基质动脉血流动力学参数(收缩期峰值流速PSV、舒张期速度PDV、阻力指数RI、收缩期峰值流速与舒张期速度比S/D),测定治疗前后外周血生殖激素:促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)及空腹血糖(FBS)、空腹胰岛素(FIN)水平,并计算胰岛素抵抗指数(Homa-IR).将卵巢形态学参数和血流动力学参数的变化与血激素水平的变化进行统计学相关分析.结果:①PCOS-IR患者治疗后Homa-IR、T降低,差异有统计学意义(P＜0.05),LH、LH/FSH显著降低(P＜0.05).②血流动力学参数PSV、PDV显著降低(P＜0.05),RI、S/D显著升高(P＜0.05).结论:补肾化痰中药可以改善卵巢血流动力学状态,从而改善PCOS患者的胰岛素抵抗状态.

Clinical study of transvaginal ultrasound valuating invigorating kidney and removing phlegm herbs therapeutic effect in polycystic ovary syndrome patients accompanied by insulin resistance

Objective：To investigate the clinical value of transvaginal color Doppler ultrasound （TV-CDU） and to discuss the ovarian blood dynamics parameter in polycystic ovarian syndrome （PCOS） accompanied with insulin resistance （IR） treated with invigorating kidney and removing phlegm herbs. Methods： The 51 patients with PCOS-IR were treated with Chinese herbs last- ing for three months. The blood dynamics parameters of ovarian stromal artery （peak systolic velocity （PSV）, peak diastolic velocity （PDV）, resistance index （RI）, peak systolic velocity/peak diastolic velocity（S/D）） were detected with TV-CDU. The levels of luteinizing hormone （LH）, follicle stimulating hormone （FSH）, testosterone （T）, fasting blood-glucose （FBS） and fasting serum insulin （FIN） were tested; HOMA-IR were calculated before and after treatment. The statistical relativity analysis was proceeding about the change of the ovarian morphological parameter and blood dynamics parameter and the blood IR index. Results： ①The levels of T and HOMA-IR were decreased significantly （P〈0.05）; LH, LH/FSH were also decreased significantly （P〈0.05）. QThe ovarian blood dynamics parameters PSV and PDV decreased significantly （P〈0.05） while RI and S/D increased significantly （P〈0.05）. Conclusion： Invigorating kidney and removing phlegm herbs can relief IR of PCOS by improving ovarian blood dynamics state.