陈氏调经汤联合芬吗通治疗肝肾阴虚型卵巢早衰的临床疗效观察

张文瑜; 吴欢

doi:10.16766/j.cnki.issn.1674-4152.002739

陈氏调经汤联合芬吗通治疗肝肾阴虚型卵巢早衰的临床疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002739

张文瑜^1, ,,
吴欢²

1.
浙江中医药大学附属第三医院妇科，浙江杭州 310005
2.
浙江中医药大学附属第三医院超声科

基金项目:

浙江省教育厅一般科研项目 Y201942331

浙江省中医药科技计划项目 2019ZB066

详细信息

通讯作者:
张文瑜, E-mail: zhangwenyulby@sina.com

中图分类号: R242 R271
计量
- 文章访问数: 276
- HTML全文浏览量: 155
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2021-12-29
- 网络出版日期: 2022-12-30

Clinical observation of Chen' s Menstrual Conditioning Soup combined with femostone on premature ovarian failure of liver and kidney Yin deficiency syndrome

ZHANG Wen-yu^{1
, ,},
WU Huan²

1.
Department of Gynecology, the Third Affiliated Hospital of Zhejiang University of Traditional Chinese

摘要

摘要: 目的回顾性分析陈氏调经汤联合芬吗通治疗肝肾阴虚型卵巢早衰的临床疗效。方法对2019年1月—2021年1月浙江中医药大学附属第三医院收治的40例肝肾阴虚型卵巢早衰患者进行回顾性分析，根据治疗方法分为芬吗通治疗组(对照组，17例)及芬吗通联合陈氏调经汤治疗组(观察组，23例)，6个月后观察治疗效果。结果治疗后，观察组各项中医证候积分均低于对照组(均P＜0.05)；观察组治疗效果优于对照组(Z=-2.455，P＜0.05)；观察组血清促卵泡生成素(FSH)、黄体生成素(LH)水平[(19.21±4.57)IU/L、(20.44±3.10)IU/L]低于对照组[(22.78±4.69)IU/L、(23.17±3.44)IU/L, 均P＜0.05]；观察组雌二醇(E₂)水平为(69.22±12.39)pmol/L，高于对照组[(60.98±11.22)pmol/L, P＜0.05]；观察组卵巢体积、窦卵泡数(AFC)、卵巢动脉收缩期峰值血流速度(PSV)高于对照组，阻力指数(RI)、加速时间(TA)低于对照组(均P＜0.05)。结论陈氏调经汤联合芬吗通治疗肝肾阴虚型卵巢早衰疗效显著，可有效缓解临床症状，促进性激素水平恢复，改善卵巢功能。
- 陈氏调经汤 /
- 芬吗通 /
- 肝肾阴虚型卵巢早衰 /
- 性激素水平
Abstract: Objective To retrospectively analyses the clinical curative effect of Chen' s Menstrual Conditioning Soup combined with femoston on premature ovarian failure of liver and kidney Yin deficiency syndrome. Methods Forty cases of premature ovarian failure with Yin deficiency of liver and kidney in the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine were retrospectively analysed from January 2019 to January 2021. According to the treatment methods, they were divided into femoston treatment group (control group, n=17) and femoston combined with Chen' s Menstrual Conditioning Soup treatment group (observation group, n=23). The treatment effect was observed after 6 months. Results After treatment, the scores of TCM syndromes in the observation group were lower than those in the control group (all P < 0.05). The therapeutic effect of the observation group was better than that of the control group (Z=-2.455, P < 0.05). The levels of serum follicle stimulating hormone and luteinizing hormone in the observation group were (19.21±4.57) IU/L and (20.44±3.10) IU/L, respectively, which were lower than those in the control group [(22.78±4.69) IU/L, (23.17±3.44) IU/L, all P < 0.05]. The level of estradiol (E₂) in the observation group was (69.22±12.39) pmol/L, which was higher than that in the control group [(60.98±11.22) pmol/L, P < 0.05]. The mean ovarian volume, number of antral follicles and peak systolic blood flow velocity of ovarian artery in the observation group were higher than those in the control group, and the resistance index and acceleration time were lower than those in the control group (all P < 0.05). Conclusion Chen' s Menstrual Conditioning Soup combined with femostone has a remarkable effect on premature ovarian failure of liver and kidney Yin deficiency syndrome, and it can effectively alleviate clinical symptoms, promote the recovery of sex hormone level and improve ovarian function.
- Chen' s Menstrual Conditioning Soup /
- Femoston /
- Premature ovarian failure of liver and kidney Yin deficiency syndrome /
- Sex hormone levels

HTML全文

表 1 2组肝肾阴虚型卵巢早衰患者基线资料比较(x±s)

Table 1. Comparison of baseline data of patients with Hepatorenal Yin deficiency premature ovarian failure between the two groups (x±s)

组别	例数	年龄(岁)	BMI	病程(月)	孕次(次)
对照组	17	33.15±5.22	23.46±2.14	16.83±5.18	1.46±0.81
观察组	23	33.06±4.18	23.28±2.22	16.30±5.34	1.50±0.79
t值		0.061	0.257	0.314	0.157
P值		0.952	0.798	0.755	0.876

下载: 导出CSV

表 2 2组肝肾阴虚型卵巢早衰患者中医证候积分比较(x±s，分)

Table 2. Comparison of TCM syndrome scores of patients with Liver and Kidney Yin deficiency type premature ovarian failure between the two groups (x±s, points)

组别	例数	潮热汗出		腰膝酸软		阴道干涩		口干咽燥
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	17	2.20±0.34	1.51±0.22^a	1.96±0.25	1.44±0.20^a	1.80±0.27	1.25±0.19^a	2.14±0.22	1.31±0.15^a
观察组	23	2.21±0.30	1.18±0.20^a	1.98±0.23	1.26±0.17^a	1.76±0.25	1.13±0.10^a	2.10±0.23	1.20±0.11^a
t值		0.098	4.945	0.262	3.071	0.488	2.590	0.554	2.679
P值		0.922	< 0.001	0.795	0.004	0.631	0.014	0.583	0.011

组别	例数	头晕耳鸣		五心烦热		食欲不振		毛发脱落
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	17	1.67±0.24	1.14±0.17^a	1.98±0.18	1.22±0.13^a	1.68±0.18	1.36±0.11^a	1.50±0.16	1.22±0.14^a
观察组	23	1.71±0.23	0.91±0.13^a	2.04±0.21	1.04±0.08^a	1.66±0.15	1.18±0.10^a	1.48±0.11	1.09±0.08^a
t值		0.534	4.853	0.948	5.410	0.383	5.394	0.469	3.717
P值		0.597	< 0.001	0.349	< 0.001	0.704	< 0.001	0.642	0.001
注：与同组治疗前比较，^aP < 0.05。

下载: 导出CSV

表 3 2组肝肾阴虚型卵巢早衰患者治疗效果比较[例(%)]

Table 3. Comparison of therapeutic effect between the two groups of patients with Hepatorenal Yin deficiency type premature ovarian failure [cases (%)]

组别	例数	显效	有效	无效	有效率
对照组	17	6(35.29)	8(47.06)	3(17.65)	14(82.35)
观察组	23	17(73.91)	5(21.74)	1(4.35)	22(95.65)
统计量			-2.455^a		1.921^b
P值			0.030		0.166
注：^a为Z值，^b为χ²值。

下载: 导出CSV

表 4 2组肝肾阴虚型卵巢早衰患者性激素水平比较(x±s)

Table 4. Comparison of sex hormone levels in patients with Hepatorenal Yin deficiency premature ovarian failure between the two groups (x±s)

组别	例数	FSH(IU/L)		LH(IU/L)		E₂(pmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	17	40.60±9.24	22.78±4.69^a	30.48±6.52	23.17±3.44^a	40.77±10.16	60.98±11.22^a
观察组	23	40.15±10.08	19.21±4.57^a	30.80±6.33	20.44±3.10^a	41.23±10.59	69.22±12.39^a
t值		0.145	2.415	0.156	2.628	0.138	2.163
P值		0.886	0.021	0.877	0.012	0.891	0.037
注：与同组治疗前比较，^aP < 0.05。

下载: 导出CSV

表 5 2组肝肾阴虚型卵巢早衰患者卵巢体积及卵巢血流动力学参数比较(x±s)

Table 5. Comparison of ovarian volume and hemodynamic parameters of the two groups of patients with hepatorenal Yin deficiency premature ovarian failure (x±s)

组别	例数	卵巢体积(cm³)		AFC(个)		PSV(m/s)		RI		TA(s)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	17	2.35±0.55	5.33±1.65^a	4.43±1.18	6.92±1.66^a	6.24±1.90	8.09±2.46^a	0.73±0.15	0.66±0.09^a	0.11±0.03	0.07±0.02^a
观察组	23	2.37±0.58	6.44±1.78^a	4.29±1.22	8.55±1.80^a	6.33±2.21	9.78±2.69^a	0.72±0.17	0.60±0.08^a	0.12±0.03	0.05±0.01^a
t值		0.110	2.010	0.364	2.925	0.135	2.036	0.193	2.224	1.042	4.157
P值		0.913	0.052	0.718	0.006	0.893	0.049	0.848	0.032	0.304	< 0.001
注：与同组治疗前比较，^aP < 0.05。

下载: 导出CSV

参考文献(20)

[1]	曾若男, 乔美玲, 尹巧芝. 从"二阳之病发心脾"论治卵巢早衰[J]. 四川中医, 2020, 38(5): 57-60. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202005020.htm ZENG R N, QIAO M L, YIN Q Z. Differentiation and treatment of premature ovarian failure from"Disorder of Stomach Maybe Affected by Disorders of Heart or Spleen"[J]. Journal of Sichuan of Traditional Chinese Medicine, 2020, 38(5): 57-60. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202005020.htm
[2]	胥风华, 侯亚宁, 葛鹏玲, 等. 卵巢早衰中医治疗特色[J]. 辽宁中医药大学学报, 2020, 22(1): 25-28. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202001009.htm XU F H, HOU Y N, GE P L, et al. Characteristic treatment of traditional chinese medicine on premature ovarian failure[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2020, 22(1): 25-28. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202001009.htm
[3]	张晓静, 丁峰, 李海娇. 适龄女性发生卵巢早衰的危险因素分析[J]. 河北医学, 2018, 24(9): 1574-1577. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX201809045.htm ZHANG X J, DING F, LI H J. Analysis on risk factors of premature ovarian failure in women of middle age[J]. Hebei Medicine, 2018, 24(9): 1574-1577. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX201809045.htm
[4]	林露, 徐向进. 女性绝经期激素替代治疗的争议和共识[J]. 国际内分泌代谢杂志, 2021, 41(6): 565-568. LIN L, XU X J. Controversies and consensus on menopause hormone therapy in women during menopause[J]. International Journal of Endocrinology and Metabolism, 2021, 41(6): 565-568.
[5]	郭梦云, 傅金英, 李瑞丽, 等. 中西医结合防治卵巢早衰的研究进展[J]. 世界最新医学信息文摘(连续型电子期刊), 2021, 21(8): 172-173. GUO M Y, FU J Y, LI R L, et al. Research progress of prevention and treatment of premature ovarian failure by integrated Chinese and Western medicine[J]. World Latest Medicine Information, 2021, 21(8): 172-173.
[6]	董亚兰, 董莉. 补肾活血方治疗卵巢早衰的临床观察及其对ANA-ACA-AOA通路的影响[J]. 上海中医药杂志, 2020, 54(8): 61-65. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ202008017.htm DONG Y L, DONG L. Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway[J]. Shanghai Journal of Traditional Chinese Medicine, 2020, 54(8): 61-65. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ202008017.htm
[7]	陈体辉, 贾维宁, 钟雪梅, 等. 中药分期疗法治疗卵巢早衰疗效及对患者中医症候和血清FSH、LH、E₂水平的影响[J]. 四川中医, 2021, 39(5): 155-159. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202105047.htm CHEN T H, JIA W N, ZHONG X M, et al. Curative effect of applying traditional chinese medicine staging therapy in the treatment of premature ovarian failure and its influences on traditional chinese medicine symptoms, serum FSH, LH and E2 Levels[J]. Journal of Sichuan of Traditional Chinese Medicine, 2021, 39(5): 155-159. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202105047.htm
[8]	梁玉玲. 中医综合护理干预对卵巢早衰不孕的效果[J]. 实用中医内科杂志, 2021, 35(9): 66-68. https://www.cnki.com.cn/Article/CJFDTOTAL-SYZY202109020.htm LIANG Y L. Nursing effect of traditional chinese medicine comprehensive nursing intervention on infertile patients with premature ovarian failure[J]. Journal of Practical Traditional Chinese Internal Medicine, 2021, 35(9): 66-68. https://www.cnki.com.cn/Article/CJFDTOTAL-SYZY202109020.htm
[9]	张兵, 刘金星. 卵巢早衰的中西医临床研究及治疗进展[J]. 现代中西医结合杂志, 2020, 29(32): 3643-3648. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH202032026.htm ZHANG B, LIU J X. Clinical research and treatment progress of premature ovarian failure in traditional Chinese and western medicine[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2020, 29(32): 3643-3648. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH202032026.htm
[10]	杨华娣, 邵一峰, 单双双, 等. 金匮温经汤联合芬吗通治疗化疗源性卵巢早衰的临床疗效[J]. 中成药, 2019, 41(5): 1197-1199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYA201905054.htm YANG H D, SHAO Y F, SHAN S S, et al. Clinical effect of Jinguiwenjing Decoction combined with Fendong in the treatment of chemotherapy-induced premature ovarian failure[J]. Chinese Traditional Patent Medicine, 2019, 41(5): 1197-1199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYA201905054.htm
[11]	杨敬红, 唐丽华, 未欢, 等. 滋肾育胎丸联合戊酸雌二醇治疗女性卵巢早衰的疗效及其对血清雌激素水平的影响[J]. 重庆医学, 2020, 49(22): 3803-3806. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202022027.htm YANG J H, TANG L H, WEI H, et al. Efficacy of kidney nourishing pills combined with estradiol valerate in the treatment of women with premature ovarian failure and its effect on serum estrogens levels[J]. Chongqing Medicine, 2020, 49(22): 3803-3806. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202022027.htm
[12]	韩锐, 万丹, 刘琳, 等. 芬吗通治疗绝经综合征患者疗效及对血清性激素水平和子宫内膜厚度的影响[J]. 中国妇产科临床杂志, 2021, 22(5): 477-479. https://www.cnki.com.cn/Article/CJFDTOTAL-FKLC202105010.htm HAN R, WAN D, LIU L, et al. Curative effect of femoston on menopausal syndrome and the influence on serum sex hormone levels and endometrial thickness[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2021, 22(5): 477-479. https://www.cnki.com.cn/Article/CJFDTOTAL-FKLC202105010.htm
[13]	严航, 王璐, 陈学奇. 陈学奇治疗产后身痛验案[J]. 浙江中医杂志, 2021, 56(7): 532. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZZ202107050.htm YAN H, WANG L, CHEN X Q. Chen Xueqi treated postpartum body pain[J]. Zhejiang Journal of Traditional Chinese Medicine, 2021, 56(7): 532. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZZ202107050.htm
[14]	李芹, 汤劲松, 仇姝, 等. 六味地黄丸联合克龄蒙治疗卵巢早衰临床疗效观察[J]. 河北医学, 2016, 22(2): 339-341. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX201602061.htm LI Q, TANG J S, QIU S, et al. The clinical effect of drug combination by liuwei dihuang pills and climen in treatment of POF[J]. Hebei Medicine, 2016, 22(2): 339-341. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX201602061.htm
[15]	崔永魁, 吴晓婕, 潘晓华. 激素替代疗法联合坤泰胶囊治疗卵巢早衰的临床疗效[J]. 川北医学院学报, 2021, 36(4): 517-520. https://www.cnki.com.cn/Article/CJFDTOTAL-NOTH202104026.htm CUI Y K, WU X J, PAN X H. Clinical effect of hormone replacement therapy combined with Kuntai capsule on premature ovarian failure[J]. Journal of North Sichuan Medical College, 2021, 36(4): 517-520. https://www.cnki.com.cn/Article/CJFDTOTAL-NOTH202104026.htm
[16]	万妮娅, 李素芳, 孙洪东, 等. 温针灸联合当归桂枝汤治疗卵巢早衰临床疗效及对卵巢血流状态的影响[J]. 湖北中医药大学学报, 2021, 23(3): 87-89. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX202103024.htm WAN N Y, LI S F, SUN H D, et al. Efficacy of Danggui Guizhi Decoction combined with thermol needling mo-xibustion on premature ovarian failure and its influence on ovarian blood flow[J]. Journal of Hubei University of Chinese Medicine, 2021, 23(3): 87-89. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX202103024.htm
[17]	李慧, 杨华娣, 邵一峰, 等. 加味桂仙汤联合芬吗通治疗肾虚肝郁型卵巢早衰临床研究[J]. 新中医, 2020, 52(1): 115-118. https://www.cnki.com.cn/Article/CJFDTOTAL-REND202001035.htm LI H, YANG H D, SHAO Y F, et al. Clinical study on modified Guixian Tang combined with femonston for premature ovarian failure of kidney deficiency and liver depression type[J]. Journal of New Chinese Medicine, 2020, 52(1): 115-118. https://www.cnki.com.cn/Article/CJFDTOTAL-REND202001035.htm
[18]	骆文仙, 许明军, 朱雪萍, 等. 穴位埋线联合坤泰胶囊治疗卵巢早衰的临床观察[J]. 川北医学院学报, 2020, 35(2): 264-266, 270. https://www.cnki.com.cn/Article/CJFDTOTAL-NOTH202002022.htm LUO W X, XU M J, ZHU X P, et al. The clinical observation of acupoint embedding and Kuntai capsule in the treatment of premature ovarian failure[J]. Journal of North Sichuan Medical College, 2020, 35(2): 264-266, 270. https://www.cnki.com.cn/Article/CJFDTOTAL-NOTH202002022.htm
[19]	高宁珂, 王克华, 闫姝. 免疫性卵巢早衰中西医诊疗进展[J]. 陕西中医, 2021, 42(10): 1480-1482. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202110041.htm GAO N K, WANG K H, YAN S. Progress of TCM and Western medicine in the diagnosis and treatment of immune premature ovarian failure[J]. Shaanxi Journal of Traditional Chinese Medicine, 2021, 42(10): 1480-1482. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202110041.htm
[20]	胡菊兰, 肖少芳, 朱丽娟. 补肾滋肝中药联合针刺及性激素序贯疗法治疗卵巢早衰的临床效果分析[J]. 江西中医药, 2021, 52(5): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-JXZY202105020.htm HU J L, XIAO S F, ZHU L J. Clinical effect analysis of Bushen Zigan Traditional Chinese Medicine combined with acupuncture and sex hormone sequential therapy in the treatment of premature ovarian failure[J]. Jiangxi Journal of Traditional Chinese Medicine, 2021, 52(5): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-JXZY202105020.htm