左归疏肝汤加减治疗多囊卵巢综合征不孕症的临床疗效研究

摘要

目的 探讨左归疏肝汤加减治疗多囊卵巢综合征(PCOS)不孕症的临床疗效.方法 选取2014年6月-2016年3月在浙江中医药大学附属第二医院妇科门诊首次就诊的PCOS患者150例,采用随机数字表法分为对照组和试验组各75例.对照组患者采用克罗米芬治疗,试验组患者在对照组的治疗基础上服用左归疏肝汤加减治疗,当直径>1.4 cm的卵泡数≥3个时停止治疗,两组的治疗和观察周期不超过6个月.比较两组患者的血清内分泌生殖激素水平、排卵和妊娠情况、临床疗效及不良反应发生率.结果 治疗前两组患者血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)水平比较,差异无统计学意义(P>0.05);治疗后试验组患者血清LH、FSH、T水平低于对照组,差异有统计学意义(P<0.05).治疗后对照组患者血清LH、FSH水平低于治疗前,试验组患者血清LH、FSH、T水平低于治疗前,差异有统计学意义(P<0.05);而对照组患者血清T水平与治疗前比较,差异无统计学意义(P>0.05).试验组患者优势卵泡出现率、排卵率、临床妊娠率高于对照组,差异有统计学意义(P<0.05);两组患者早期流产率比较,差异无统计学意义(P>0.05).试验组患者临床疗效优于对照组,差异有统计学意义(P<0.05).两组患者子宫内膜变薄、卵巢过度刺激综合征发生率比较,差异无统计学意义(P>0.05).结论 在服用克罗米芬的基础上采用左归疏肝汤加减治疗,可以有效降低PCOS不孕症患者的内分泌生殖激素水平,提高优势卵泡出现率、排卵率及临床妊娠率,疗效确切.%Objective To explore the clinical effects of zuogui soothing liver decoction on polycystic ovary syndrome(PCOS) infertility.Methods A total of 150 patients with PCOS in Gynecology Outpatient Clinic of in the Second Affiliated Hospital of the Second Affiliated Hospital of Zhejiang Chinese Medicine University for the first visit from June 2014 to March 2016 were selected.The random number table method was used to divide the subjects into control group and experiment group,each had 75 patients.The patients in the control group were treated with clomiphene,based on which the patients in the experiment group were treated with zuogui soothing liver decoction.When the number follicle≥ 3 with diameter> 1.4 cm,treatment would be stopped,and the treatment and observation period of the two groups should be within 6 months.The serum endocrine and reproductive hormone levels,ovulation and pregnancy status,clinical efficacy and the incidence of adverse reactions were compared between two groups.Results There was no significant difference in serum levels of luteinizing hormone(LH),follicle stimulating hormone(FSH) and testosterone(T) between two groups before treatment(P>0.05).The levels of serum LH,FSH and T of patients in experiment group after treatment were significantly lower than those in control group(P<0.05).After treatment,the levels of serum LH and FSH in control group were significantly lower than those before treatment,and the levels of serum LH,FSH and T in the experiment group were significantly lower than those before treatment(P<0.05).There was no significant difference in T levels in the control group before and after treatment(P>0.05).The prevalence of dominant follicle,ovulation rate and clinical pregnancy rate in the experiment group were significantly higher than those in the control group(P<0.05).There was no significant difference in the early abortion rate between two groups(P>0.05).The clinical curative effect of the experiment group was significantly better than that of the control group(P<0.05).There was no significant difference in the incidence of endometrial thinning and ovarian hyperstimulation syndrome between two groups(P>0.05).Conclusion The use of zuogui soothing liver decoction based on taking clomiphene can effectively lower the endocrine reproductive hormone level of patients with PCOS infertility and improve the rate of dominant follicles,ovulation rate and clinical pregnancy rate.Thus it has exact effects.