滋水清肝饮加味治疗围绝经期肾虚肝郁型患者的效果及对相关指标的影响

目的 探讨滋水清肝饮加味对(肾虚肝郁型)围绝经期综合征(perimenopausal syndrome，MPS)的疗效。 方法 选取2016年10月—2018年10月期间丽水市中医院收治的64例围绝经期综合征患者，按随机数字表法分为对照组(32例)和观察组(32例)。对照组采用常规干预措施，观察组在对照组治疗的基础上采用滋水清肝饮加味治疗，1剂/d，2次/d。2组连续治疗3个月。比较2组肾虚肝郁证和Kupperman指数(Kupperman index，KI)评分、血脂、疗效、血管内皮功能以及血清脂联素、Kisspeptin-10、雌二醇水平。 结果 治疗后观察组肾虚肝郁证和KI评分、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)明显低于对照组，高密度脂蛋白胆固醇(HDL-C)显著高于对照组(均P＜0.01)；观察组总有效率显著高于对照组(96.9% vs. 75.0%，P＜0.05)；观察组血清血管性血友病因子(vWF)和内皮素-1(ET-1)水平显著低于对照组，血清脂联素、Kisspeptin-10、雌二醇(8.69±0.92)mg/L、(2.31±0.27)ng/mL、(72.45±8.90)pmol/L]水平高于对照组(均P＜0.01)。 结论 滋水清肝饮加味治疗(肾虚肝郁型)围绝经期患者的疗效明显，上调血清脂联素、Kisspeptin-10、雌二醇水平可能是其疗效途径之一。 

Efficacy of Zishui Qinggan Decoction in treatment of perimenopause women with syndrome of renal deficiency and hepatic stagnation and impact on relevant indexes

Objective To investigate the effect of Zishui Qinggan decoction on perimenopausal syndrome (MPS) women with syndrome of renal deficiency and hepatic stagnation. Methods Sixty-four MPS cases were selected in our hospital and divided into the control group and the observation group with 32 cases in each according to random number table method. Control group was treated with the routine therapy according to the guideline. On basis of control group, the observation group was treated with Zishui Qinggan decoction (1 dose / d and 2 times / d). Both groups were treated for 3 months. Scores of symptoms of syndrome of renal deficiency and hepatic stagnation and Kupperman index (KI), blood lipid levels, the efficacy, vascular endothelial function, and serum levels of adiponectin, Kisspeptin-10, and estradiol were compared between two groups. Results After 3 months treatment, scores of symptoms of syndrome of renal deficiency and KI, levels of triglyceride (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (LDL-C) were significantly lower than those of the control group, while high-density lipoprotein cholesterol (HDL-C) were significantly higher than the control group (all P<0.01). Total effective rate of observation group (96.88%) was obviously higher than the control group (75.00%) , P<0.05. Serum levels of vascular hemophilia factor (vWF) and endothelin-1 (ET-1) in the observation group were significantly lower than those in the control group (P<0.01). Serum levels of adiponectin, Kisspeptin-10, and estradiol (8.69±0.92) mg/L, (2.31±0.27) ng / L, (72.45±8.9) pmol/L] in the observation group were higher than those in the control group (all P<0.01). Conclusion The efficacy of Zishui Qinggan decoction in the treatment of perimenopause female patients with kidney deficiency and hepatic stagnation is significant. Up-regulation of serum levels of adiponectin, Kisspeptin-10, and estradiol may be one of the effective ways.