雌孕激素替代治疗联合六味地黄丸在肾阴虚型卵巢早衰治疗中的作用

目的探讨雌孕激素替代治疗联合六味地黄丸在肾阴虚型卵巢早衰治疗中的价值。方法选择肾阴虚型卵巢早衰病人164例，分为4组，A组41例，采用常规的雌孕激素替代治疗；B组43例，采用六味地黄丸治疗；C组40例，采用雌孕激素及六味地黄丸联合治疗；D组40例，不用药。分别于治疗或观察3个周期和6个周期后进行中医症候评分及血清卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)水平测定。结果A、B、C组在治疗3、6个周期后，与D组比较，FSH、LH水平均明显下降(P＜0.01)，E2水平明显升高(P＜0.01)，且与治疗前相比差异有统计学意义(P＜0.01)。A、B、C组在治疗3、6个周期后临床症状积分均较治疗前明显降低(P＜0.01)。D组在观察3、6个周期后FSH、LH的下降水平、E2上升水平及中医症候积分与观察前相比差异均无统计学意义(P>0.05)。A、B、C组在治疗后的总有效率均达到75%以上，明显高于D组的17.50%(P＜0.01)，C组在治疗后总有效率最高，达82.5%。结论雌孕激素与六味地黄丸均可有效改善肾阴虚型卵巢早衰病人的性激素水平和临床不适症状，两者联合效果更好，值得临床借鉴。

Value of estrogen and progesterone replacement therapy combined with Liuwei Dihuang pills in the treatment of kidney yin deficiency type premature ovarian failure

ObjectiveTo investigate the clinical significance of estrogen and progesterone replacement therapy combined with Liuwei Dihuang pills in the treatment of kidney yin deficiency type premature ovarian failure.MethodsOne hundred and sixty-four patients with kidney yin deficiency type premature ovarian failure were dividied into the A, B, C and D groups.The group A(41 cases) was treated with with conventional estrogen and progesterone replacement therapy, the group B(43 cases) was treated with Liuwei Dihuang pills, the group C(40 cases) was treated with estrogen and progesterone combined with Liuwei Dihuang pills, and the group D(40 cases) was treated with no drug.The TCM symptom scores, and serum levels of follicle stimulating hormone(FSH), luteinizing hormone(LH), estrogen(E2) were measured after 3 and 6 cycles of treatment or observation, respectively.ResultsAfter 3 and 6 cycles of treatment in A, B and C groups, the levels of FSH and LH significantly decreased compared with the group D(P＜0.01), the E2 levels significantly increased compared with the group D(P＜0.01), and the differences of the serum levels of FSH, LH and E2 in A, B and C groups between before and after treatment were statistically significant(P＜0.01).After 3 and 6 cycles of treatment in A, B and C groups, the TCM syndrome scores significantly decreased compared before treatment(P＜0.01).After 3 and 6 cycles of treatment in group D, the levels of FSH and LH decreased, the level of E2 increased, and the differences of the levels of FSH, LH and E2, and TCM syndrome scores between before and after treatment were not statistically significant(P>0.05).The total clinical effective rates in A, B and C groups(more than 75%) were significantly higher than that in group D(17.50%) (P＜0.01), the total effective rate in group C was the highest(82.5%).ConclusionsBoth estrogen and progesterone, and Liuwei Dihuang pills can effectively improve the sex hormone levels and symptoms of clinical discomfort in patients with kidney yin deficiency type premature ovarian failure, and the combined effect of the two is better, which is worthy of clinical reference.