女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探

doi:10.3969/j.issn.1006-7795.2019.03.007

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (3): 358-362.doi: 10.3969/j.issn.1006-7795.2019.03.007

女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探

杨维, 李玛建, 何军琴

首都医科大学附属北京妇产医院中医科, 北京 100006

收稿日期:2019-03-15 出版日期:2019-05-21 发布日期:2019-06-13
通讯作者: 杨维 E-mail:bjyangwei@126.com
基金资助:
北京市医院管理局培育项目（PZ2017005），北京市中医管理局北京中医药传承"双百工程"项目。

Primary investigation on clinical of Nuzhen decoction on diminished ovarian reserve in type of internal heat due to yin deficiency

Yang Wei, Li Majian, He Junqin

Department of Traditional Chinese Medicine, Beijing Gynaecology and Obstetrics Hospital, Capital Medical University, Beijing 100006, China

Received:2019-03-15 Online:2019-05-21 Published:2019-06-13
Supported by:
This study was supported by Beijing Municipal Administration of Hospital (PZ2017005),Beijing Administration of Traditional Chinese Medicine.

摘要/Abstract

摘要： 目的探讨女禛汤治疗阴虚内热型卵巢储备功能下降（diminished ovarian reserve，DOR）的临床疗效。方法 70例DOR患者，用EXCEL软件生成随机序列数，按照1：1的比例，分为女禛汤治疗组和坤泰胶囊对照组。两组均从月经第5天开始服药，至下次月经来潮第一天停药。3个月为一个疗程。随访6个月。治疗前后监测中医证候评分及血清内分泌指标[血清卵泡刺激素（follicle-stimulating hormone，FSH）、黄体生成素（luteinizing hormone，LH）、雌二醇（estradiol，E₂）、抗苗勒管激素（anti-Mullerian hormone，AMH）和抑制素B （inhibin B，INHB）浓度]、窦卵泡计数（antral follicle count，AFC）等。结果两组均可有效改善阴虚内热型卵巢储备功能下降患者的中医证候，降低中医证候评分，降低月经第2~4 d血清FSH、FSH/LH浓度，提高血清AMH浓度和AFC数量，女禛汤治疗组优于坤泰胶囊对照组。结论女禛汤可以通过提高卵巢反应性，从而改善卵巢储备功能。

关键词: 卵巢储备功能下降, 阴虚内热, 女禛汤

Abstract: Objective To observe the clinical effect of Nuzhen decoction on diminished ovarian reserve (DOR) belonged to the type of internal heat due to yin deficiency. Methods Totally 70 patients of DOR were randomly divided into two groups using EXCEL software. The treatment group was given Nuzhen decoction and the control group was treated with Kuntai capsule. Both groups started taking medicine on the fifth day of menstruation and stopped taking medicine on the first day of the next menstruation. The treatment lasted for three months for a course. The follow-up period was 6 months. All patients were evaluated at traditional Chinese medicine (TCM) syndrome evaluation, serum endocrine index follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), anti-Mullerian hormone (AMH), inhibin B (INHB),antral follicle count(AFC).Results For both groups the TCM syndromes were effectively improved and the scores of TCM syndromes were reduced. The levels of FSH and FSH/LH in serum on the 2 nd to 4 th day of menstruation were reduced and the levels of AMH in serum and AFC were increased. These changes in the treatment group were superior to that in the control group. Conclusion Nuzhen decoction can improve ovarian reserve function by improving ovarian responsiveness.

Key words: diminished ovarian reserve, internal heat due to yin deficiency, Nuzhen decoction

中图分类号:

R271

杨维, 李玛建, 何军琴. 女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探[J]. 首都医科大学学报, 2019, 40(3): 358-362.

Yang Wei, Li Majian, He Junqin. Primary investigation on clinical of Nuzhen decoction on diminished ovarian reserve in type of internal heat due to yin deficiency[J]. Journal of Capital Medical University, 2019, 40(3): 358-362.

参考文献

[1] Li J,Yuan H,Chen Y,et al.A meta-analysis of dehydroepiandrosterone supplementation among women with diminished ovarian reserve undergoing in vitro fertilization or intracytoplasmic sperm injection[J].Int J Gynaecol Obstet,2015,131(3):240-245.
[2] 韩莹,张云山.卵巢储备功能下降相关因素的logistic回归分析[J].现代妇产科进展,2015,24(2):109-111.
[3] 曹海龙,王慧.不孕症患者卵巢储备功能下降的影响因素分析[J].现代仪器与医疗,2018,24(1):120-122.
[4] 贾丹,李娜,陈璐,等.肾虚血瘀型多囊卵巢综合征、复发性流产、不孕症的治疗研究进展[J].中医药学报,2017,45(2):128-130.
[5] 冯晓玲,刘庆丽.肾虚血瘀型月经过少-月经后期-闭经研究进展[J].辽宁中医药大学学报,2017,19(1):8-10.
[6] Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve:a committee opinion[J].Fertil Steril,2012,98(6):1407-1415.
[7] 曹泽毅.中华妇产科学[M].北京:人民卫生出版社,2004:356.
[8] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:388.
[9] 马宝璋.中医妇科学[M].北京:中国中医药出版社,2016:75,89,226.
[10] 杨冬梅,朱立春,张学新.子午流注法择时口服中药对卵巢储备功能下降月经周期延长的影响[J].中国中医基础医学杂志,2013,19(10):1159-1161.
[11] 王芳,吴步钧.补肾养精汤与活血汤周期疗法治疗肾虚血瘀型多囊卵巢综合征疗效及对血清促卵泡激素的影响[J].现代中西医结合杂志,2017,26(2):152-154.
[12] Verhagen T E,Hendriks D J,Bancsi L F,et al.The accuracy ofmultivariate models predicting ovarian reserve and pregnancy afterin vitro fertilization:a meta-analysis[J].Hum Reprod/pdata,2008,14(2):95-100.
[13] Sauer M V. Reproduction at an advanced maternal age and maternal health[J]. Fertil Steril, 2015, 103(5):136-143.
[14] 韩莹,张云山.卵巢储备功能检测的研究进展[J].实用医学杂志,2015,31(4):523-525.
[15] 高静,李佶,陈应超,等.补肾活血方治疗卵巢储备功能下降的临床观察[J].上海中医药杂志,2014,48(7):62-64.
[16] 丛建华.FSH/LH比值在评价围绝经期卵巢功能中的价值探讨[J].国际检验医学杂志,2014,35(23):3171-3172,3175.
[17] 杨冬梓,何钻玉. 卵泡刺激素/黄体生成素比值与卵巢反应性的关系[J].生殖医学杂志,2012,21(2):133-136.
[18] 何雪梅,李萍,卢晓娴,等. 基础FSH/LH比值评估年轻女性卵巢功能的价值[J].中国妇幼保健,2018,33(24):5902-5904.
[19] 沈苏琴, 刘康生. 血清抗苗勒管激素(AMH)在卵巢早衰患者中的预测价值[J].微量元素与健康研究, 2017, 34(2):28-29.
[20] 梁艳,张媛媛.血清抗苗勒管激素在预测卵巢功能中的应用[J]. 实用妇科内分泌杂志,2018,5(28):94,96.
[21] 刘迎萍,陈玉庆,黄腾辉,等.安坤种子丸对卵巢储备功能下降闭经FSH、LH、E2、AMH的影响[J].中国中医药现代远程教育,2018,16(1):106-108.
[22] Tremellen K, ZandER-Fox D. Serum anti-Mullerian hormone assessment of ovarian reserve and polycystic ovary syndrome status over the reproductive lifespan[J]. Aust N Z J Obstet Gynaecol,2015, 55(4):384-389.
[23] 杨琪,夏天,李爽,等. 血清抑制素B对女性生殖功能的临床诊断价值[J].中国妇产科临床杂志,2016,17(2):187-189.
[24] 莫爱萍.抑制素A和抑制素B对卵巢早衰的诊断价值研究[J].海南医学院学报,2011,17:1239-1241.

女禛汤治疗阴虚内热型卵巢储备功能下降临证经验初探

Primary investigation on clinical of Nuzhen decoction on diminished ovarian reserve in type of internal heat due to yin deficiency

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