加味二陈汤对肾虚痰湿型多囊卵巢综合征患者卵巢多囊样改变、内分泌及代谢的影响

目的:探讨加味二陈汤对肾虚痰湿型肥胖型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者卵巢多囊样改变、内分泌及代谢的影响。方法:选取2015年3月—2016年3月河南省中医院收治的肾虚痰湿型肥胖型PCOS患者157例,以该批患者为研究对象,按随机数字表法分为治疗组(78例),对照组(79例)。对照组PCOS患者给予醋酸环丙孕酮片,治疗组在此基础上给予加味二陈汤,两组均进行3个月经周期的治疗,结束后对两组患者疗效、卵巢多囊样改变、内分泌功能、糖脂代谢及脂肪细胞因子进行比较。结果:治疗组患者总有效率为94.87%,对照组为81.01%,治疗组高于对照组(P0.05);经过治疗,两组患者均较治疗前双侧卵巢体积与卵泡数目明显降低,且治疗组低于对照组(P0.05);经过治疗后两组患者均较治疗前促黄体生成激素(luteotropic hormone,LH),卵泡刺激素(follicle-stimulating hormone,FSH)与卵泡刺激素(Testosterone,T)水平明显降低,雌二醇(estradiol,E2)水平明显升高,且治疗组患者效果优于对照组(P0.05);经过治疗,两组患者在治疗前糖脂代谢指标糖化血红蛋白(hemoglobin Alc,Hb A1c),空腹胰岛素(fasting insulin,FINS),胰岛素抵抗指数(insulin resistance index,HOMA-IR),总胆固醇(total cholesterol,TC),甘油三脂(triglycerid,TG)均较治疗前明显降低,且治疗后治疗组显著低于对照组(P0.05);通过治疗,两组患者均较治疗前内脂素(visfatin,VF),瘦素(leptin,LEP)水平明显降低,脂联素(adiponectin,APN)水平明显升高,且治疗组优于对照组(P0.05)。结论:加味二陈汤对肾虚痰湿型肥胖型PCOS具有积极的治疗效果,可以改善患者多囊样改变、内分泌功能以及糖脂代谢,值得在临床上推广。

Effect of Jiawei Erchentang on Polycystic Change, Endocrine and Metabolism in Patients with Polycystic Ovary Syndrome

Objective: To study the effect of Jiawei Erchentang polycystic change, endocrine and metabolism in patients with polycystic ovary syndrome (PCOS). Method: A total of 157 cases of PCOS patients treated in our hospital from March 2015 to March 2016 were selected in this study, and divided into two groups by the random number table, with 78 cases in clinical group and 79 in control group. Patients in control group were treated with cyproterone acetate tablets. In addition to the therapy of the control group, the clinical group was also given Jiawei Erchentang. Then efficacy, polycystic change, endocrine and metabolism were compared. Result: The total effective rate of control group was 81.01%, while that of clinical group was 94.87%, with a significant difference (P<0.05). Compared with before treatment, ovarian volume and ovarian follicle conditions of two groups after treatment decreased (P<0.05). Compared with control group, ovarian volume and ovarian follicle conditions of the experimental group were lower (P<0.05). Compared with before treatment, luteotropic hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) of two groups after treatment decreased, while estradiol (E₂) increased (P<0.05). Compared with control group, LH, FSH and T of the experimental group were lower after treatment, while E₂ was higher (P<0.05). Compared with before treatment, glucolipid metabolism indexes, including hemoglobin Alc (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), total cholesterol (TC), triglycerid (TG) of two groups after treatment decreased (P<0.05). Compared with before treatment, visfatin (VF) and leptin (LEP) of two groups after treatment decreased, while adiponectin (APN) increased (P<0.05). Compared with control group, VF and LEP of the experimental group were lower after treatment, while APN was higher (P<0.05). Conclusion: Jiawei Erchentang has a better effect on PCOS, and can significantly improve polycystic change, endocrine and metabolism, thus is worth clinical promotion.