资坤汤治疗卵巢储备功能下降月经后期阴虚血燥证的临床观察

目的:观察资坤汤治疗卵巢储备功能下降(decreasing ovarian reservation,DOR)月经后期阴虚血燥证的临床疗效。方法:将60例DOR月经后期阴虚血燥证患者按照随机数字表法分为对照组和观察组,各30例。对照组予雌二醇片/雌二醇地屈孕酮片治疗,观察组予资坤汤治疗。对照组从月经第1天开始服药,连服28 d,观察组从月经第5天开始服药,至下次月经来潮第1天停药。停药后随访3个月经周期。并观察两组治疗前后月经周期、中医证候积分改善情况,窦卵泡数(antral follicle count,AFC)以及血清卵泡刺激素(follicle stimulating hormone,FSH),黄体生成激素(luteinizing hormone,LH),雌二醇(estradiol,E2),抗苗勒管激素(anti-müllerian hormone,AMH),抑制素B(inhibin B,INHB)水平及FSH/LH。结果:治疗后观察组临床有效率与对照组比较,差异无统计学意义,但观察组患者中医证候积分明显低于对照组(P<0.05),观察组患者INHB明显升高(P<0.05),不良反应发生率低于对照组(P<0.05)。与本组治疗前比较,治疗后两组患者FSH,FSH/LH水平均明显降低(P<0.05);两组患者AMH水平均明显升高(P<0.05),AFC数量明显增加(P<0.05)。结论:资坤汤治疗卵巢储备功能下降月经后期阴虚血燥证具有较好的临床疗效,可改善患者性激素水平,增加窦卵泡数,改善卵巢储备功能,促进月经来潮。

Clinical Observation of Zikun Decoction in Treatment of Syndrome of Yin Deficiency and Blood Dryness in Delayed Menorrhea Cycle Due to Decreasing Ovarian Reservation

Objective: To observe the effect of Zikun decoction(ZKD)in treatment of Yin deficiency and blood dryness in delayed menorrhea due to decreasing ovarian reservation. Method: A total of 60 cases were randomly divided into two groups. The observation group was given ZKD orally,and the control group was treated with complex packing estradiol tablets/estradiol and dydrogestero for three months. The control group began to take medicine on the first day of menstruation for 28 days,while the observation group began to take medicine on the fifth day of menstruation,and stopped taking medicine on the first day of the next menstruation. Three menstrual cycles were followed up. The clinical syndrome scores,follicle-stimulating hormone(FSH),luteinizing hormone(LH),inhibin B(INHB),FSH/LH,Estradiol(E2),anti-müllerian hormone(AMH),and antral follicle count(AFC) scores of the patients before and after treatment were compared. Result: After treatment, there was no significant difference in clinical efficiency between observation group and control group,but the traditional Chinese medicine syndrome score of observation group was significantly reduced(P<0. 05),observation group and control group had the same curative effect in improvement of FSH,FSH/LH,AMH and AFC(P<0. 05),but ZKD was better than complex packing estradiol tablets/estradiol and dydrogestero in improvement of INHB. Conclusion: ZKD has a good treatment effect in the treatment of DOR. It can effectively improve patients’ sex hormone levels,increase antral follicle count,improve the ovarian reserve function and promote menstruation.