补肾调周法对不同表型多囊卵巢综合征高雄激素血症的临床疗效观察
发布时间：2018-11-25 17:34
【摘要】：目的：观察补肾调周法治疗不同表型(肥胖和非肥胖)多囊卵巢综合征(PCOS)患者高雄激素血症的临床疗效,探讨其作用机理,为临床治疗提供理论依据和治疗方法。 方法：选取符合纳入标准的肾虚型PCOS高雄激素血症患者作为研究对象,根据体重指数(BMI)分为肥胖组和非肥胖组各30例。均给予补肾调周中药治疗3个月。观察治疗前后患者月经情况、肾虚证候、多毛及痤疮、B超卵巢多囊及基础体温(BBT)的改善情况,测量并计算治疗前后的BMI。分别于治疗前后测定血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、空腹胰岛素(FINS)水平。同时比较两组治疗前的内分泌激素情况。所得数据经统计学方法处理后判定疗效。 结果：①补肾调周法治疗肥胖型和非肥胖型PCOS高雄激素血症患者总有效率分别为70.00%,73.33%。两组有效率无明显差异(P0.05)。②自身对照：治疗后两组患者的月经周期、多毛、痤疮、肾虚证候、窦卵泡数均得到明显改善(P0.01)。改善肥胖组及非肥胖组BBT的有效率为56.67%、60.00%。还能降低肥胖组患者的BMI(P0.01)。治疗后两组的血T、LH、LH/FSH、DHEAS值均较治疗前有所下降,血E2、SHBG值上升,肥胖组FINS值降低。 ③组间对照：两组患者治疗前的T值无明显差异(P0.05),非肥胖组PCOS患者LH、LH/FSH均高于肥胖组,而肥胖组患者的FINS高于非肥胖组。两组治疗后的T、LH、 LH/FSH、DHEAS、E2、SHBG水平均无明显差异(P0.05),两组治疗后月经周期、多毛、痤疮、肾虚证候、窦卵泡数、BBT情况无明显差异(P0.05),治疗效果相近。 结论：两组患者内分泌特征有差别：非肥胖组患者LH、LH/FSH水平均高于肥胖组,而肥胖组患者的FINS水平高于非肥胖组。补肾调周法对不同表型PCOS高雄激素血症患者临床疗效肯定,两组疗效相近,可通过调节下丘脑-垂体-卵巢轴的功能来改善患者临床症状及体征：纠正月经失调,改善痤疮、多毛及肾虚证候,降低体重,改善卵巢多囊状态及BBT；可调节内分泌代谢紊乱：降低T、LH、LH/FSH、DHEAS,升高SHBG、E2,降低肥胖型患者FINS。
[Abstract]:Objective: to observe the clinical effect of tonifying kidney and regulating week on hyperandrogenemia in patients with polycystic ovary syndrome (PCOS) with different phenotypes (obesity and non-obesity), and to explore its mechanism, and to provide theoretical basis and treatment methods for clinical treatment. Methods: patients with PCOS hyperandrogenemia according to the inclusion criteria were selected and divided into obese group (30 cases) and non obese group (30 cases) according to body mass index (BMI). All of them were treated with tonifying kidney and regulating week Chinese medicine for 3 months. To observe the improvement of menstruation, kidney deficiency syndrome, hirsutism and acne, (BBT) of ovarian polycystic and basal body temperature before and after treatment, and to measure and calculate BMI. before and after treatment. Serum testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2) and dehydroepiandrosterone (DHEAS), sex hormone binding globulin (SHBG), fasting insulin (FINS) were measured before and after treatment. At the same time, the endocrine hormones before treatment were compared between the two groups. The data were processed by statistical method to determine the curative effect. Results: 1 the total effective rate of tonifying kidney and regulating week therapy for obese and non-obese PCOS patients with hyperandrogenemia was 70.000 and 73.33, respectively. There was no significant difference in the effective rate between the two groups (P0.05). 2 Self-control: after treatment, the menstrual cycle, hirsutism, acne, kidney deficiency syndrome and the number of antral follicles were significantly improved in the two groups (P0.01). The effective rate of improving BBT in obese and non obese groups was 56.67 and 60.00. It also reduced the BMI of obese patients (P0.01). After treatment, the blood TLHH / FSHH / FSHHEAS values of both groups were lower than those before treatment, and the serum E2SHBG values increased, and the FINS values of obesity group decreased. There was no significant difference in T value between the two groups before treatment (P0.05). The LH,LH/FSH of PCOS patients in non-obese group was higher than that of obese group, while the FINS of obese group was higher than that of non-obese group. There was no significant difference in the levels of LH/FSH,DHEAS,E2,SHBG and LH/FSH,DHEAS,E2,SHBG between the two groups after treatment (P0.05). There was no significant difference in menstrual cycle, hirsutism, acne, kidney deficiency syndrome, number of antral follicles and BBT after treatment between the two groups (P0.05). The therapeutic effect was similar. Conclusion: there are differences in endocrine characteristics between the two groups: the level of LH,LH/FSH in non-obese group is higher than that in obese group, while the FINS level in obese group is higher than that in non-obese group. The clinical effect of tonifying kidney and regulating week method on patients with different phenotypes of PCOS hyperandrogenemia was confirmed. The two groups had similar curative effects. They could improve the clinical symptoms and signs by regulating the function of hypothalamus-pituitary-ovary axis: correcting menstrual disorders and improving acne. Multiple hair and Kidney deficiency Syndrome, reduce body weight, improve Ovarian Polycystic State and BBT; Adjustable Endocrine Metabolism Disorder: reduce Thyristor LH / FSHDHEASA, increase SHBG,E2, and reduce FINS. in obese patients
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.75
[Abstract]:Objective: to observe the clinical effect of tonifying kidney and regulating week on hyperandrogenemia in patients with polycystic ovary syndrome (PCOS) with different phenotypes (obesity and non-obesity), and to explore its mechanism, and to provide theoretical basis and treatment methods for clinical treatment. Methods: patients with PCOS hyperandrogenemia according to the inclusion criteria were selected and divided into obese group (30 cases) and non obese group (30 cases) according to body mass index (BMI). All of them were treated with tonifying kidney and regulating week Chinese medicine for 3 months. To observe the improvement of menstruation, kidney deficiency syndrome, hirsutism and acne, (BBT) of ovarian polycystic and basal body temperature before and after treatment, and to measure and calculate BMI. before and after treatment. Serum testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2) and dehydroepiandrosterone (DHEAS), sex hormone binding globulin (SHBG), fasting insulin (FINS) were measured before and after treatment. At the same time, the endocrine hormones before treatment were compared between the two groups. The data were processed by statistical method to determine the curative effect. Results: 1 the total effective rate of tonifying kidney and regulating week therapy for obese and non-obese PCOS patients with hyperandrogenemia was 70.000 and 73.33, respectively. There was no significant difference in the effective rate between the two groups (P0.05). 2 Self-control: after treatment, the menstrual cycle, hirsutism, acne, kidney deficiency syndrome and the number of antral follicles were significantly improved in the two groups (P0.01). The effective rate of improving BBT in obese and non obese groups was 56.67 and 60.00. It also reduced the BMI of obese patients (P0.01). After treatment, the blood TLHH / FSHH / FSHHEAS values of both groups were lower than those before treatment, and the serum E2SHBG values increased, and the FINS values of obesity group decreased. There was no significant difference in T value between the two groups before treatment (P0.05). The LH,LH/FSH of PCOS patients in non-obese group was higher than that of obese group, while the FINS of obese group was higher than that of non-obese group. There was no significant difference in the levels of LH/FSH,DHEAS,E2,SHBG and LH/FSH,DHEAS,E2,SHBG between the two groups after treatment (P0.05). There was no significant difference in menstrual cycle, hirsutism, acne, kidney deficiency syndrome, number of antral follicles and BBT after treatment between the two groups (P0.05). The therapeutic effect was similar. Conclusion: there are differences in endocrine characteristics between the two groups: the level of LH,LH/FSH in non-obese group is higher than that in obese group, while the FINS level in obese group is higher than that in non-obese group. The clinical effect of tonifying kidney and regulating week method on patients with different phenotypes of PCOS hyperandrogenemia was confirmed. The two groups had similar curative effects. They could improve the clinical symptoms and signs by regulating the function of hypothalamus-pituitary-ovary axis: correcting menstrual disorders and improving acne. Multiple hair and Kidney deficiency Syndrome, reduce body weight, improve Ovarian Polycystic State and BBT; Adjustable Endocrine Metabolism Disorder: reduce Thyristor LH / FSHDHEASA, increase SHBG,E2, and reduce FINS. in obese patients
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.75
【参考文献】
相关期刊论文 前10条
1 华苓;;柴松岩治疗多囊卵巢综合征经验[J];北京中医药;2011年07期
2 雷露;张文艳;吉秀家;吴克明;;吴克明教授运用新加苁蓉菟丝丸治疗多囊卵巢综合征的经验[J];广西中医药;2012年05期
3 高金金;侯丽辉;孙淼;;肥胖对多囊卵巢综合征表现的差异影响[J];长春中医药大学学报;2013年01期
4 何淑莹,申玉华,尤昭玲;多囊卵巢综合症LH及FSH的研究现状[J];中医药导报;2005年08期
5 文炯;杨正望;;补肾化瘀法治疗多囊卵巢综合征的研究进展[J];中医药导报;2008年03期
6 夏桂成;;用动静观指导滋阴补肾调治多囊卵巢综合征[J];江苏中医药;2006年03期
7 付志红;周琼;胡著云;;薏苡仁治疗妇科疾病的药理机制研究[J];江西中医药;2011年04期
8 代玉;陈莹;;论中医药治疗多囊卵巢综合征[J];辽宁中医药大学学报;2013年01期
9 郭银华;邱，
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