健脾利湿益气养阴方治疗PCOS伴IR的临床观察

发布时间：2018-03-19 11:31

本文选题：健脾理湿益气养阴方　切入点：多囊卵巢综合征　出处：《黑龙江省中医药科学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:旨在观察健脾利湿益气养阴方对多囊卵巢伴有胰岛素抵抗的病患内分泌、代谢、排卵情况等影响,探讨其治疗多囊卵巢综合征伴有胰岛素抵抗疗效机理。方法:临床研究采用对照和随机的研究方法,将符合多囊卵巢综合征伴有胰岛素抵抗的病患,按1:1对照的原则,随机分为治疗组与对照组。在基础治疗之上,治疗组给予中药配方颗粒每日1剂,分早晚两次饭后服用;对照组给予二甲双胍500mg,每天2次,饭后服用。以1个月经周期为1个疗程,连续观察3个疗程。两组在治疗前后分别评价多囊卵巢伴有胰岛素抵抗的临床症状、其体征变化及实验室指标。全部数据都以SPSS16.0统计软件进行统计学的分析。结果:1.临床疗效方面:治疗组总有效率为93.33%。对照组总有效率为73.33%。治疗组优于对照组(P0.05)。2.中医症候方面:治疗组症候积分疗后较疗前明显下降(P0.01);对照组症候积分较治疗前无明显改变(P0.05),治疗组优于对照组(P0.01),疗后三个月治疗组优于对照组(P0.01)。3.临床症状及体征方面:(1)治疗后两组患者月经情况均有改善(P0.01),治疗组优于对照组(P0.05),疗后三个月月经改善稳定情况治疗组优于对照组(P0.05)。(2)治疗后两组患者BMI较治疗前均有所下降(P0.01),治疗组优于对照组(P0.05),疗后三个月治疗组优于对照组(P0.01)。(3)疗后、疗后三个月治疗组患者多毛情况、痤疮较治疗前有所改善(P0.01),对照组改善情况不明显(P0.05),治疗组优于对照组(P0.01)。(4)治疗后两组患者黑棘皮情况均有改善(P0.01),两组改善程度无差异(P0.05),疗后三个月治疗组优于对照组(P0.01)。4.性激素水平方面:(1)治疗后两组患者的T值均较治疗前有所下降(P0.05),治疗组雄激素下降程度优于对照组(P0.05)。(2)治疗后两组患者LH值、LH/FSH值较治疗前均有所下降(P0.01),且治疗组下降程度优于对照组(P0.05)。(3)治疗前后两组患者FSH值、E2值无明显差异(P0.05)。5.胰岛素相关指标方面:治疗后两组患者FINS值、ISI值较治疗前均有改善(P0.05),治疗组改善程度与对照组无差异(P0.05)。治疗前后两组患者FPG无明显差异。6.彩超影像学方面:治疗后两组患者窦卵泡数目较治疗前有所下降(P0.05),且治疗组窦卵泡数减少量优于对照组(P0.05)。7.排卵情况(基础体温测定)方面:疗后、疗后三个月两组患者基础体温双相率分别为40%、16.67%、33.33%、10%,治疗组效果优于对照组(P0.05)。8.安全性指标方面:治疗前后两组患者血、尿、便常规及肝、肾功能均在正常范围之内。两组均未见明显不良反应。结论:1.健脾利湿益气养阴方结合基础治疗可改善胰岛素抵抗(主要为降低FINS)。治疗效果与二甲双胍结合基础治疗相当。2.健脾利湿益气养阴方结合基础治疗可显著改善多囊卵巢综合征症候群,且疗后三个月复发率低。治疗效果优于二甲双胍结合基础治疗。
[Abstract]:Objective: to observe the effects of invigorating spleen, dampness and supplementing qi and nourishing yin on endocrine, metabolism and ovulation in patients with polycystic ovary accompanied by insulin resistance. Methods: control and randomized methods were used to treat patients with polycystic ovary syndrome with insulin resistance according to the principle of 1: 1 control. The treatment group was divided into treatment group and control group at random. On the basis of basic treatment, the treatment group was given 1 dose of traditional Chinese medicine prescription granule daily, taken after two meals in the morning and evening, while the control group was given metformin 500 mg twice a day, One menstrual cycle was used as a course of treatment, and three consecutive courses of treatment were observed. The clinical symptoms of polycystic ovary with insulin resistance were evaluated before and after treatment. All the data were analyzed statistically by SPSS16.0 software. Results: 1. Clinical efficacy: the total effective rate of the treatment group was 93.33. The total effective rate of the control group was 73.33. The treatment group was superior to the control group (P0.05. 2). The symptom score of the treatment group was significantly lower than that of the control group after treatment, while that of the control group had no significant change compared with that before treatment, the treatment group was superior to the control group, and the treatment group was superior to the control group three months after treatment. The clinical symptoms and signs of the treatment group were better than that of the control group. (1) after treatment, the menstrual status of the two groups was improved, the treatment group was superior to the control group (P 0.05), the treatment group was superior to the control group in improving menstrual stability three months after treatment, and the control group was superior to the control group (P 0.05). After treatment, the BMI of the two groups was lower than that of the control group (P 0.01), and the treatment group was better than that of the control group (P 0.01). The treatment group was superior to the control group (P 0.05), and the treatment group was superior to the control group (P 0.01) three months after treatment. Three months after treatment, the patients in the treatment group suffered from hirsutism. The acnes in the treatment group was better than that in the control group (P 0.01). There was no difference in the degree of improvement between the two groups. The treatment group was superior to the control group in three months after treatment, and the treatment group was superior to the control group. After the treatment, the T value of the two groups was lower than that before treatment. The decrease of androgen in the treatment group was better than that in the control group (P 0.05. 0. 2) after treatment, the LH value and the LH / FSH value of the two groups were lower than those before treatment, and the treatment group had a decrease in the value of LHP / FSH, and the treatment group had a lower value of LH / FSH than that of the control group (P < 0. 05, P < 0. 05, P < 0. 05). Before and after treatment, there was no significant difference in FSH value and E2 value between the two groups. Insulin related indexes: after treatment, the FINS value of the two groups was improved compared with that of the control group (P 0.05), and the improvement degree of the treatment group was higher than that of the control group. There was no significant difference in FPG between the two groups before and after treatment. 6. Color Doppler Imaging: the number of antral follicles in the two groups was lower than that before treatment, and the number of antral follicles in the treatment group was lower than that in the control group. Basic body temperature measurement): after treatment, Three months after treatment, the biphasic rates of basic body temperature in the two groups were 40 ~ 16.67 ~ 33.33 and 10, respectively. The effect of the treatment group was better than that of the control group (P 0.05) .8. the safety indexes were as follows: before and after treatment, the patients in the two groups had blood, urine, stool routine and liver. The renal function was within normal range. There were no obvious adverse reactions in the two groups. Conclusion 1. The combination of tonifying spleen, dampness and supplementing qi and nourishing yin can improve insulin resistance (mainly reducing FINSN). The therapeutic effect is based on metformin. 2. The combination of invigorating spleen, dampness and supplementing qi and nourishing yin can significantly improve the syndrome of polycystic ovary syndrome. The recurrence rate was low 3 months after treatment and the therapeutic effect was better than metformin combined with basic treatment.
【学位授予单位】：黑龙江省中医药科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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