丹栀逍遥散结合炔雌醇环丙孕酮治疗女大学生多囊卵巢综合征的效果.docx

    丹栀逍遥散结合炔雌醇环丙孕酮治疗女大学生多囊卵巢综合征的效果    谢莉 王娟 赵井苓 李成银[Summary]目的探討使用丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）治疗在校女大学生肝郁血热型多囊卵巢综合征（PCOS）的持续性疗效方法选取2018年12月至2020年1月于湖北中医药大学黄家湖医院妇科就诊的符合肝郁血热型 PCOS 在校女大学生60例作为研究对象，随机分为西药组（30例）和中西药组（30例）西药组采用口服炔雌醇环丙孕酮片（Diane-35），中西药组采用口服丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）3个月经周期为1个疗程观察两组满1个疗程停药后第1个月经周期和第3个月经周期的月经正常率、中医症状及内分泌水平的变化，并观察安全性结果停药后第1个月经周期，两组月经周期正常率比较，差异无统计学意义（P >0.05）;停药后第3个月经周期，中西药组的月经周期正常率高于西药组（P <0.05）停药第1个及第3个月经周期，中西药组部分中医临床症状改善情况高于西药组（P <0.05）停药后第1个月经周期，两组血清促卵泡激素（FSH）均升高，且中西药组的 FSH 低于西药组，差异有统计学意义（P <0.05）;两组血清性激素促黄体激素（LH）、LH/FSH、睾酮（T）均下降，且中西药组的 LH、LH/FSH、T 高于西药组，差异有统计学意义（P <0.05）。

停药后第3个月经周期，中西药组的血清性激素 LH、LH/FSH、T 均低于西药组， FSH 高于西药组，差异有统计学意义（ P <0.05）两组血常规、肝肾功能、凝血功能未见明显异常，且无明显过敏反应结论丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）治疗女大学生肝郁血热型 PCOS，不仅能显著改善患者肝郁血热的中医症状、恢复月经周期，还能降低性激素水平，具有较高的临床应用价值，值得在临床上推广应用[Key]丹栀逍遥散;炔雌醇环丙孕酮片（Diane-35）;多囊卵巢综合征;内分泌;肝郁血热型[] R711.75  [] A   []2095-0616（2022）08-0092-05Efficacy of DanzhiXiaoyao Powder combined with ethinylestradiol and cyproterone acetate in the treatment ofPCOS in female collegestudentsXIE  Li    WANG  JuanZHAO  Jingling1LI  Chengyin31. Department of Gynecology， Huangjiahu Hospital of Hubei University of Chinese Medicine， Hubei， Wuhan 430065， China;2. Department of Obstetrics and Gynecology， Hubei Provincial Armed Police Corps Hospital， Hubei， Wuhan 430061， China;3. Department of Oncology， Hubei Provincial Hospital of Traditional Chinese Medicine， Hubei， Wuhan 430061， China[Abstract] Objective To investigate the sustained efficacy of DanzhiXiaoyao Powder combined with ethinylestradiol and cyproterone acetate tablets （Diane-35） in the treatment of polycystic ovary syndrome （PCOS） of liver-depression and blood-heat type in in-school female college students. Methods A total of 60 in-school female college students with PCOS of liver-depression and blood-heat type who attended the Department of Gynecology at Huangjiahu Hospital of Hubei University of Chinese Medicine from December 2018 to January 2020 were selected as study subjects and randomly divided into the western medicine group （n=30） and the Chinese and western medicine group （n=30）. The western medicine group was treated with oral ethinylestradiol and cyproterone acetate tablets （Diane-35）， while the Chinese and western medicine group was treated with oral DanzhiXiaoyao Powder combined with ethinylestradiol and cyproterone acetate tablets （Diane-35）， both with 3 menstrual cycles are one course of treatment. The normal rate of menstrual cycle， changesinthe symptoms of traditional Chinese medicine （TCM） and endocrine level at the 1st and 3rd menstrual cycles after drug withdrawal for 1 course of treatment in both groups were observed， and observe the safety. Results In thefirst menstrual cycle after drug withdrawal， there was no significant difference in the normal rate of menstrual cycle between the two groups （P >0.05）. In the third menstrual cycle after drug withdrawal， the normal rate of menstrual cycle in the traditional Chinese and western medicine group was higher than that in the western medicine group （P <0.05）. In the first menstrual cycle after drug withdrawal， the follicular stimulating hormone （FSH） increased in both groups， and the FSH value in the traditional Chinese and western medicine group was lower than that in the western medicine group， and the difference was statistically significant （P <0.05）. The levels of serum sex hormones such as luteinizing hormone （LH），LH/FSH and testosterone （T） values all decreased， and the LH， LH/FSH and T values in the Chinese and Western medicine group were higher than those in the Western medicine group， and the difference was statistically significant （P <0.05）. In the third menstrual cycle after drug withdrawal， the serum sex hormone LH， LH/FSH and T values in the Chinese and Western medicine group were lower than those in the Western medicine group， the FSH value was higher than that in the Western medicine group group， the difference was statistically significant （P <0.05）. There was no obvious abnormality in blood routine， liver and kidney function， coagulation function， and no obvious allergic reaction in the two groups. Conclusion In the treatment of female college students with PCOS of the liver-depression and blood- heat type， DanzhiXiaoyao Powder combined with ethinylestradiol and cyproterone acetate tablets （Diane-35） can not only significantly improve the TCM symptoms of liver-depression and blood-heat of patients and restore menstrual cycle， but also reduce the levels of sex hormones， which is of high application value and is worthy of promotion in clinical practice.[Key words] DanzhiXiaoyao Powder; Ethinylestradiol and cyproterone acetate tablets （Diane-35）; Polycystic ovary syndrome; Endocrine; Liver-depression and blood-heat type多囊卵巢综合征（polycystic ovarian syndrome， PCOS）是青春期和育龄女性中最多见的内分泌疾病之一，主要由排卵障碍引起月经紊乱、闭经甚至不孕[1]。

以经期紊乱、肥胖、不孕等为主要临床表现，对患者的身心健康、生活质量产生较大影响目前临床上尚未完全明确 PCOS 的发病机制，但认为其与胰岛素抵抗、高雄激素血症等相关中医将 PCOS 纳入“闭经。