大补阴丸加减联合克龄蒙对卵巢早衰患者卵巢储备功能和免疫功能的影响

发布时间：2018-07-25 09:12

【摘要】：目的:观察大补阴丸加减联合克龄蒙(戊酸雌二醇片、雌二醇环丙孕酮片)治疗卵巢早衰肾阴虚证的临床疗效及对巢储备功能和免疫功能的影响。方法:将120例患者随机分为对照组和观察组,每组60例。对照组采用克龄蒙(戊酸雌二醇片、雌二醇环丙孕酮片)治疗,观察组在对照组治疗基础上加用大补阴丸加减汤(熟地黄30 g,知母15 g,黄柏10 g,龟板30 g,女贞子20 g,北沙参20 g,淫羊藿15 g,丹参20 g,桑葚子20 g,夜交藤30 g,山萸肉10 g,黄精30 g)治疗。两组患者均以2个月经周期为1个疗程,共治疗2个疗程。两组患者均进行治疗前后Kupperman评分和肾阴虚证评分,检测治疗前后促卵泡激素(follicle stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)水平;进行治疗前后妇科彩超检查,记录卵巢最大平面的平均卵巢直径(mean ovarian diameter,MOD)、卵巢动脉收缩期峰值流速(peak systolic velocity,PSV)和子宫内膜厚度;检测治疗前后CD3+、CD4+和CD8+水平,并进行安全性评价。结果:治疗后两组患者Kupperman评分和肾阴虚证评分均显著下降,差异有统计学意义(P0.01),治疗后观察组Kupperman评分和肾阴虚证评分均低于对照组,差异有统计学意义(P0.01);治疗后观察组FSH和LH水平低于对照组,差异有统计学意义(P0.01),E2水平高于对照组,差异有统计学意义(P0.01);治疗后两组患者MOD和子宫内膜厚度均较治疗前增加,观察组增加更为显著,两组比较,差异有统计学意义(P0.01),治疗后两组患者PSV较治疗前增多,治疗后观察组PSV多于对照组,差异有统计学意义(P0.01);治疗后观察组CD3+和CD4+水平高于对照组,CD8+水平低于对照组,差异有统计学意义(P0.01);未发现与中药相关不良反应,两组均没有严重不良事件发生。结论:大补阴丸加减方联合克龄蒙治疗卵巢早衰肾阴虚证患者,能改善症状,纠正性激素的紊乱,促进卵巢功能恢复,调节机体免疫机能,且安全性好。
[Abstract]:Objective: to observe the clinical effect of Dabuyin pills combined with estradiol valerate tablets (estradiol cycloproprogesterone tablets) in the treatment of kidney yin deficiency syndrome of premature ovarian failure and its effect on nesting reserve function and immune function. Methods: 120 patients were randomly divided into control group and observation group with 60 cases in each group. The control group was treated with kereng (estradiol valerate tablets and cycloproprogesterone estradiol tablets). Observation group in the control group on the basis of treatment plus add and subtract decoction (cooked Rehmannia glutinosa 30 g, Anemarrhena affinis 15 g, yellow cypress 10 g, tortoise plate 30 g, Ligustrum lucidum 20 g, Herba epimedium 15 g, Salvia miltiorrhiza 20 g, mulberry 20 g, night-red vine 30 g, Cornel Meat 10 g, yellow essence 30 g). The two groups were treated with 2 menstrual cycles as a course of treatment. Before and after treatment, Kupperman score and kidney yin deficiency syndrome score were used to detect the levels of follicle stimulating hormone (follicle stimulating), luteinizing hormone LH and estradiol E 2 before and after treatment, and the gynecologic color Doppler examination before and after treatment. The mean ovarian diameter (mean ovarian diameterus), peak systolic velocity of ovarian artery (peak systolic velocityv) and endometrial thickness were recorded, and the levels of CD3 CD4 and CD8 were measured before and after treatment, and the safety was evaluated. Results: after treatment, the Kupperman score and the kidney yin deficiency syndrome score of the two groups were significantly decreased (P0.01). After treatment, the Kupperman score and the kidney yin deficiency syndrome score in the observation group were lower than those in the control group. After treatment, the levels of FSH and LH in the observation group were lower than those in the control group (P0.01), the difference was statistically significant (P0.01), and the difference was statistically significant (P0.01). The increase of PSV in the observation group was more significant than that in the control group (P0.01). After treatment, the PSV of the two groups was higher than that of the control group, and the PSV of the observation group was more than that of the control group after treatment. After treatment, the levels of CD3 and CD4 in the observation group were significantly higher than those in the control group (P0.01), and the difference was statistically significant (P0.01). Conclusion: the combination of Da Bu Yin Pill and Ke Ling Meng can improve the symptoms, correct the disorder of sex hormone, promote the recovery of ovarian function, regulate the immune function of the body, and have good safety in treating the patients with kidney yin deficiency syndrome of premature ovarian failure.
【作者单位】：咸宁市中心医院;广西中医药大学第一附属医院;
【基金】：广西中医药民族医药继承创新工程立项课题(GZZJ13-071)
【分类号】：R711.75

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