加减龙胆泻肝汤对肝经郁火型多囊卵巢综合征患者高雄激素血症的影响

目的 观察加减龙胆泻肝汤治疗肝经郁火型多囊卵巢综合征（PCOS）患者的临床疗效，并探讨其对高雄激素血症的影响。方法 48例患者分为中药组（25例，服用加减龙胆泻肝汤）和达英组（23例，服用Diane-35），记录患者治疗前、治疗3个月和治疗后第1个月经周期的月经、痤疮、多毛情况，测定基础体温（BBT）等。检测治疗前后血清促黄体激素（LH）、促卵泡激素（FSH）、泌乳素（PRL）、游离睾酮（FT）、雄烯二酮（A）；同时观察不良反应情况。结果（1）月经异常、痤疮、BBT、单相两组治疗后比治疗前均明显改善（P〈0．05）。（2）血清LH、LH／FSH、FT、A值两组治疗后较治疗前明显降低（P〈0．05）；PRL中药组治疗后较治疗前明显降低（P〈0．05）；两组治疗后LH、FSH、LH／FSH、FT、A值比较差异无显著性（P〉0．05），中药组PRL显著低于达英组（P〈0．05）。（3）达英组不规则阴道出血3例，恶心呕吐5例；中药组未见不良反应。结论 加减龙胆泻肝汤可有效地改善肝经郁火型PCOS患者高雄激素血症的情况。

Effects of Modified Longdan Xiegan Decoction on Hyperandrogenism in Patients with Polycystic Ovary Syndrome of Stagnant Fire in Gan Channel Type

ObjectiveTo observe the therapeutic effect of modified Longdan Xiegan Decoction (LXD) on hyperandrogenism in patients with polycystic ovary syndrome (POS) of stagnant fire in Gan channel type. MethodsForty-eight patients were divided into two groups: the LXD group (25 cases) treated with LXD for 3 months, and the Diane-35 group (23 cases) with Diane-35. Condition of menstruation, acne, hairiness were observed, basal body temperature (BBT) was measured, and the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), free testosterone (FT), and androstenedione (A) were detected before and after 3 months' treatment. Meanwhile, adverse reaction was observed. Results After treatment, the condition of menstrual disorder, acne and single-phase BBT were improved significantly, and serum levels of LH, LH/FSH, FT and A decreased in both groups (P<0.05), showed insignificant difference between them (P>0.05). The PRL level dropped in the LXD group (P< 0.05), which significantly lower than that in the Diane-35 group (P<0.05). There were 3 cases with adverse reaction of irregular colporrhagia and 5 cases with nausea and vomiting in the Diane-35 group, while no adverse reaction in the LXD group occurred. Conclusion Modified LXD could significantly improve the condition in hyperandrogenism patients with POS of stagnant fire in Gan channel type.