定坤丹联合替勃龙治疗围绝经期综合征的临床研究

川贝母因其药用效果良好，被中国及世界上多个国家广泛应用于临床治疗中。但是随着川贝母药材资源需求量的急剧增长及其野生基原植物存在产量低，自然条件下种子数量少、发芽率及成活率极低等缺陷，使得川贝母野生基原植物资源处于濒危状态。以中国知网和Web of Science这两大数据库所发表的文章为基础，综述了川贝母本草学考证、野生基原植物资源分布状况及其影响因素、保育措施及利用内生真菌获得贝母类生物碱等方面的研究进展。以期从传统的保育措施及现阶段积极探索的微生物提取活性物质的角度为川贝母野生基原植物资源的保育提供发展思路，以期早日实现川贝母的供需平衡。

Clinical study on Dingkun Pills combined with tibolone in the treatment of perimenopausal syndrome

Objective To investigate the effect of Dingkun Pills combined with tibolone in the treatment of perimenopausal syndrome and its effects on sex hormones, lipid metabolism and immune function. Methods 82 Cases of postmenopausal osteoporosis patients diagnosed and treated in Xinzheng People''s Hospital from August 2018 to August 2019 were randomly divided into control group and treatment group, with 41 patients in each group. The control group was po administered with Tibolone Tablets, 2.5 mg/time, once daily. The treatment group was po administered with Dingkun Pills, 6 g/time, twice daily. All patients were treated for 3 months. The clinical efficacy of the two groups was compared, and hamilton anxiety scale (HAMA) scores, Hamilton depression scale (HAMD) scores, Kupperman postmenopausal index (KMI) score and serum estradiol (E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), gamma interferon (IFN-g), interleukin-2 (IL-2), IL-4, IL-10, levels of CD3⁺, CD4⁺ and CD8⁺ in two groups before and after treatment were observed. Results After treatment, the total effective rate in the treatment group was 95.12%, significantly higher than 80.49% in the control group (P<0.05). After treatment, HAMA score, HAMD score and KMI score in both groups were significantly lower than those in the same group before treatment (P<0.05). After treatment, these correlation scores of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, E₂ was significantly increased in both groups, while FSH and LH were significantly lower than those before treatment (P<0.05). After treatment, the hormone level of the treatment group was significantly better than that of the control group (P<0.05). After treatment, serum TG, TC and LDL-C levels in both groups were lower than those before treatment, but serum HDL-C levels were higher than those before treatment (P<0.05). After treatment, the blood lipid levels of the treatment group were better than those of the control group (P<0.05). After treatment, the levels of serum INF-g and IL-2 in both groups were lower than those before treatment, but the levels of serum IL-4 and IL-10 were higher than those before treatment (P<0.05). After treatment, the serum levels of these inflammatory factors in the treatment group were better than those in the control group (P<0.05). After treatment, CD3⁺ and CD4⁺ levels in both groups were higher than before treatment, but CD8⁺ levels were lower than before treatment (P<0.05). After treatment, the lymphocyte levels in the treatment group were better than those in the control group (P<0.05). Conclusion Dingkun Pills combined with tibolone has good clinical effect in the treatment of perimenopausal syndrome, and can effectively reduce patients'' negative emotions, and also can regulate estrogen levels, improve blood lipid metabolism and immune response ability, which has certain clinical application value.