【摘要】：目的:觀察大補(bǔ)陰丸加減聯(lián)合克齡蒙(戊酸雌二醇片、雌二醇環(huán)丙孕酮片)治療卵巢早衰腎陰虛證的臨床療效及對(duì)巢儲(chǔ)備功能和免疫功能的影響。方法:將120例患者隨機(jī)分為對(duì)照組和觀察組,每組60例。對(duì)照組采用克齡蒙(戊酸雌二醇片、雌二醇環(huán)丙孕酮片)治療,觀察組在對(duì)照組治療基礎(chǔ)上加用大補(bǔ)陰丸加減湯(熟地黃30 g,知母15 g,黃柏10 g,龜板30 g,女貞子20 g,北沙參20 g,淫羊藿15 g,丹參20 g,桑葚子20 g,夜交藤30 g,山萸肉10 g,黃精30 g)治療。兩組患者均以2個(gè)月經(jīng)周期為1個(gè)療程,共治療2個(gè)療程。兩組患者均進(jìn)行治療前后Kupperman評(píng)分和腎陰虛證評(píng)分,檢測(cè)治療前后促卵泡激素(follicle stimulating hormone,FSH)、促黃體生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)水平;進(jìn)行治療前后婦科彩超檢查,記錄卵巢最大平面的平均卵巢直徑(mean ovarian diameter,MOD)、卵巢動(dòng)脈收縮期峰值流速(peak systolic velocity,PSV)和子宮內(nèi)膜厚度;檢測(cè)治療前后CD3+、CD4+和CD8+水平,并進(jìn)行安全性評(píng)價(jià)。結(jié)果:治療后兩組患者Kupperman評(píng)分和腎陰虛證評(píng)分均顯著下降,差異有統(tǒng)計(jì)學(xué)意義(P0.01),治療后觀察組Kupperman評(píng)分和腎陰虛證評(píng)分均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);治療后觀察組FSH和LH水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01),E2水平高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);治療后兩組患者M(jìn)OD和子宮內(nèi)膜厚度均較治療前增加,觀察組增加更為顯著,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01),治療后兩組患者PSV較治療前增多,治療后觀察組PSV多于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);治療后觀察組CD3+和CD4+水平高于對(duì)照組,CD8+水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);未發(fā)現(xiàn)與中藥相關(guān)不良反應(yīng),兩組均沒有嚴(yán)重不良事件發(fā)生。結(jié)論:大補(bǔ)陰丸加減方聯(lián)合克齡蒙治療卵巢早衰腎陰虛證患者,能改善癥狀,糾正性激素的紊亂,促進(jìn)卵巢功能恢復(fù),調(diào)節(jié)機(jī)體免疫機(jī)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.
【作者單位】： 咸寧市中心醫(yī)院;廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院;
【基金】：廣西中醫(yī)藥民族醫(yī)藥繼承創(chuàng)新工程立項(xiàng)課題(GZZJ13-071)
【分類號(hào)】：R711.75

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