摘要
目的:观察防风通圣散联合二甲双胍治疗肥胖型多囊卵巢综合征(PCOS)的临床疗效。方法:采用随机数字表法将140例肥胖型PCOS患者分为对照组、观察组各70例。对照组采用二甲双胍治疗,观察组采用防风通圣散联合二甲双胍治疗。比较2组治疗前后痤疮严重程度评分、中医证候积分、体质量指数(BMI)、卵巢体积、糖代谢指标、血脂代谢指标、性激素指标;比较2组治疗1个月、3个月后基础体温(BBT);比较2组临床疗效及不良反应发生率。结果:研究期间,对照组剔除3例,脱落4例;观察组剔除3例,脱落4例,2组各完成研究63例。观察组总有效率92.06%,高于对照组79.37%(P<0.05)。2组治疗后痤疮严重程度评分、中医证候积分、BMI、卵巢体积低于治疗前(P<0.05),且观察组治疗后上述指标低于对照组(P<0.05)。2组治疗后卵泡刺激素(FSH)、抗苗勒管激素(AMH)、雌二醇(E_(2))、黄体生成素(LH)、孕酮(P)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FBG)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(HOMA-IR)均较治疗前降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)升高(P<0.05);观察组治疗后性激素、糖代谢指标及LDL-C、TC、TG水平低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。2组治疗3个月后BBT单相占比低于治疗1个月后(P<0.05),BBT偶有双相、BBT双相占比高于治疗1个月后(P<0.05),且观察组治疗3个月后BBT单相占比、BBT偶有双相占比低于对照组(P<0.05),BBT双相占比高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:防风通圣散联合二甲双胍治疗肥胖型PCOS疗效确切,能降低患者体质量,改善糖脂代谢功能,调节性激素水平,安全性较高。
Objective:To observe the clinical effect of Fangfeng Tongsheng Powder combined with Metformin for obese polycystic ovary syndrome(PCOS).Methods:A total of 140 cases of patients with obese PCOS were divided into the control group and the observation group according to the random number table method,with 70 cases in each group.The control group was treated with Metformin,and the observation group was treated with Fangfeng Tongsheng Powder combined with Metformin.Before and after treatment,the severity scores of acne,traditional Chinese medicine(TCM)syndrome scores,body mass index(BMI),ovarian volume,glucose metabolism,lipid metabolism and sex hormone indexes were compared between the two groups.Basal body temperature(BBT)in the two groups was compared after 1 month and 3 months of treatment.The clinical effects and the incidence of adverse reactions were compared between the two groups.Results:During the study period,3 cases were removed and 4 cases dropped out in the control group;3 cases were removed and 4 cases dropped out in the observation group;a total of 63 cases were completed in each group.The total effective rate was 92.06%in the observation group,higher than that of 79.37%in the control group(P<0.05).The severity scores of acne,TCM syndrome scores,BMI,and ovarian volume in the the two groups were lower than those before treatment(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of follicle stimulating hormone(FSH),anti-mullerian hormone(AMH),estradiol(E_(2)),luteinizing hormone(LH),progesterone(P),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG),and fasting insulin(FINS),and Homeostatic Model Assessment of Insulin Resistance(HOMA-IR)in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of high-density lipoprotein cholesterol(HDL-C)were increased(P<0.05).After treatment,the levels of sex hormone,glucose metabolism indexes,LDL-C,TC,and TG in the observation group were lower than those in the control group(P<0.05),and the level of HDL-C was higher than that in the control group(P<0.05).After 3 months of treatment,the proportion of single-phase BBT in the two groups was lower than that after 1 months of treatment(P<0.05),and the proportions of occasional dual-phase BBT and dual-phase BBT were higher than those after 1 months of treatment(P<0.05);the proportion of single-phase BBT and occasional dual-phase BBT in the observation group was lower than that in the control group(P<0.05),and the proportions of dual-phase BBT were higher than those in the control group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Fangfeng Tongsheng Powder combined with Metformin has a definite curative effect in treating obese PCOS,which can reduce the body mass of patients,improve the function of glucose and lipid metabolism and regulate the levels of sex hormones,with high safety.
作者
仲英华
毛芳
曹晓春
ZHONG Yinghua;MAO Fang;CAO Xiaochun(Department of Gynecology,Hangzhou Linping Tradition Chinese Medicine Hospital,Hangzhou Zhejiang 311106,China)
出处
《新中医》
CAS
2023年第17期56-61,共6页
New Chinese Medicine
基金
杭州市科技计划引导项目(20211231Y152)。
关键词
多囊卵巢综合征
肥胖
防风通圣散
二甲双胍
糖脂代谢
性激素
Polycystic ovary syndrome
Obesity
Fangfeng Tongsheng Powder
Metformin
Glucose and lipid metabolism
Sex hormones
作者简介
仲英华(1981-),女,硕士,副主任中医师,E-mail:mpxcml@163.com。
