补肾化痰汤对多囊卵巢综合征不孕患者
卵巢功能及性激素水平的影响

doi:10.3760/cma.j.cn441417-20240702-01004

摘要/Abstract

摘要：

目的　观察补肾化痰汤对多囊卵巢综合征（PCOS）不孕患者卵巢功能及性激素水平的影响。方法　本研究为随机对照试验。选取陕西省中医医院2023年9月至2024年6月收治的PCOS不孕患者114例，按随机数字表法分研究组与对照组各57例。研究组年龄（27.91±3.15）岁；体重指数（BMI）（25.47±2.59）kg/m²；不孕时间（3.57±0.62）年；初潮年龄（13.86±1.15）岁。对照组年龄（28.14±3.25）岁；BMI（25.88±2.64）kg/m²；不孕时间（3.45±0.71）年；初潮年龄（14.03±1.06）岁。对照组口服氯米芬，50 mg/次，1次/d，月经周期第5天开始服用，连服5 d。研究组加用补肾化痰汤（200 ml药汁分早晚两次服下，每日一剂），月经结束后第1天连续服用至下次月经。两组均连续治疗3个月经周期。治疗后评估两组疗效；治疗前后，比较两组中医证候积分、卵巢功能［卵巢体积、卵泡数量、抗米勒管激素（AMH）、子宫内膜厚度］、性激素［促黄体生成素（LH）、睾酮（T）、雌二醇（E₂）、促卵泡生成素（FSH）］；统计两组不良反应发生情况。采用t检验、χ²检验进行统计学分析。结果　研究组总有效率高于对照组［91.23%（52/57）比75.44%（43/57）］（P<0.05）。治疗后，两组各项中医证候积分均下降，且研究组低于对照组（均P<0.05）。治疗后，两组卵巢体积、卵泡个数、AMH均下降，且研究组［（10.53±2.46）cm³、（6.71±0.95）个、（7.13±2.08）μg/L］低于对照组［（13.94±3.02）cm³、（9.03±1.02）个、（9.05±4.33）μg/L］；两组子宫内膜厚度均上升，且研究组［（9.83±0.64）mm］高于对照组［（9.05±0.62）mm］（均P<0.05）。治疗后，两组LH、T均下降，且研究组［（6.24±1.79）mIU/ml、（1.42±0.29）nmol/L］低于对照组［（9.05±2.16）mIU/ml、（1.93±0.34）nmol/L］；E₂均上升，且研究组［（182.16±15.98）ng/L］高于对照组［（166.72±14.03）ng/L］（均P<0.05）；两组FSH无显著变化（均P>0.05）。两组不良反应总发生率差异无统计学意义（P>0.05）。结论　补肾化痰汤对PCOS不孕患者疗效较佳，可有效减轻患者症状，改善卵巢功能及性激素紊乱，且安全性较高。

关键词: 多囊卵巢综合征, 不孕, 补肾化痰汤, 卵巢功能, 性激素

Abstract:

Objective　To observe the effects of Bushen Huatan Decoction on ovarian function and sex hormone level in infertile patients with polycystic ovary syndrome (PCOS). Methods　This study was a randomized controlled trial. A total of 114 infertile patients with PCOS admitted to Shaanxi Provincial Hospital of Traditional Chinese Medicine from September 2023 to June 2024 were selected, and were divided into a study group and a control group by the random number table method with 57 cases in each group. The study group was (27.91±3.15) years old, the body mass index (BMI) was (25.47±2.59) kg/m², the infertility time was (3.57±0.62) years, and the age of menarche was (13.86±1.15) years old. The control group was (28.14±3.25) years old, the BMI was (25.88±2.64) kg/m², the infertility time was (3.45±0.71) years, and the age of menarche was (14.03±1.06) years old. The control group took clomiphene orally, 50 mg/time, once a day, starting from the 5th day of the menstrual cycle, and continuously taking for 5 days. The study group received an additional treatment of Bushen Huatan Decoction (200 ml of Chinese medicine juice was taken twice in the morning and evening, one dose daily), continuously taking from the 1st day after the end of menstruation to the next period. Both groups were continuously treated for 3 menstrual cycles. The efficacy of the two groups was evaluated after treatment. Before and after treatment, the traditional Chinese medicine (TCM) syndrome scores, ovarian function [ovarian volume, number of follicles, anti-Müllerian hormone (AMH), and endometrial thickness], and sex hormones [luteinizing hormone (LH), testosterone (T), estradiol (E₂), and follicle-stimulating hormone (FSH)] of the two groups were compared. The occurrence of adverse reactions was counted in the two groups. t test and χ² test were used for statistical analysis. Results　The total effective rate of the study group was higher than that of the control group [91.23% (52/57) vs. 75.44% (43/57)] (P<0.05). After treatment, the scores of TCM syndromes were decreased in both groups, and those in the study group were lower than those in the control group (all P<0.05). After treatment, the ovarian volume, number of follicles, and AMH were decreased in both groups, and those in the study group [(10.53±2.46) cm³, 6.71±0.95, and (7.13±2.08) μg/L] were lower than those in the control group [(13.94±3.02) cm³, 9.03±1.02, and (9.05±4.33) μg/L]; the endometrial thickness was increased in both groups, and that in the study group [(9.83±0.64) mm] was higher than that in the control group [(9.05±0.62) mm] (all P<0.05). After treatment, the levels of LH and T were decreased in both groups, and those in the study group [(6.24±1.79) mIU/ml and (1.42±0.29) nmol/L] were lower than those in the control group [(9.05±2.16) mIU/ml and (1.93±0.34) nmol/L]; the level of E₂ was increased in both groups, and that in the study group [(182.16±15.98) ng/L] was higher than that in the control group [(166.72±14.03) ng/L] (all P<0.05); there was no significant change in the level of FSH in both groups (both P>0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　Bushen Huatan Decoction has good effect on PCOS infertile patients, which can effectively alleviate the patients' symptoms, improve the ovarian function and sex hormone disorders, and has high safety.

Key words: Polycystic ovary syndrome, Infertility, Bushen Huatan Decoction, Ovarian function, Sex hormone

王瑛胡梦迪. 补肾化痰汤对多囊卵巢综合征不孕患者卵巢功能及性激素水平的影响[J]. 国际医药卫生导报, 2025, 31(1): 16-20.

Wang Ying, Hu Mengdi. Effects of Bushen Huatan Decoction on ovarian function and sex hormone level in infertile patients with polycystic ovary syndrome [J]. International Medicine and Health Guidance News, 2025, 31(1): 16-20.

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