针药二段调周法干预肾虚型卵巢储备功能减退的临床研究OA
Clinical Research on the Treatment of Diminished Ovarian Reserve with Kidney Deficiency Pattern Intervened with Two-Stage Therapy of Acupuncture and Medication to Regulate the Menstrual Cycle
目的 评价针药二段调周法对肾虚型卵巢储备功能减退(DOR)的干预效果,观察其改善中医症状、调节卵巢功能指标(FSH、E2、AMH、AFC)的效果及安全性.方法 选取符合纳入标准的60例肾虚型DOR患者,依据随机数字表法随机分为对照组与治疗组,每组30例.对照组给予芬吗通规范周期治疗,治疗组采用针药二段调周法干预(归肾丸/二仙汤加减联合滋阴/温阳针刺),两组均治疗3个月经周期.比较治疗前后中医证候积分、血清FSH、E2、AMH水平及AFC含量,并监测安全性.结果 治疗后,两组中医证候积分、FSH均显著下降(P<0.01),E2、AMH水平及AFC计数均显著升高(P<0.01);与对照组治疗后比较,治疗组中医证候积分明显降低(P<0.05),AFC计数均显著升高(P<0.05).治疗组临床总有效率86.7%(26/30),明显高于对照组临床总有效率73.3%(22/30)(P<0.05).安全性方面,对照组有2例乳房胀痛,1例轻微恶心,治疗组有1例轻微腹胀,均未停药;两组血常规、肝肾功能等无异常.结论 针药二段调周法能有效改善肾虚型DOR患者卵巢功能与症状,效果优于单一激素替代方案,且安全性良好,机制可能与调节HPO轴、促进卵泡发育有关.
Objective To evaluate the intervention effect of two-stage therapy of acupuncture and medication to regulate the menstrual cycle on diminished ovarian reserve(DOR)with kidney deficiency pattern,and to observe its effects on improving traditional Chinese medicine(TCM)syndromes,regulating ovarian function indicators(FSH,E2,AMH,and AFC),and its safety.Methods 60 patients of DOR with kidney deficiency pattern who met the inclusion criteria were randomly divided into a control group and a treatment group using a random number table method,with 30 cases in each group.The control group received standard cyclic therapy with Femoston,the treatment group was intervened with two-stage therapy of acupuncture and medication to regulate the menstrual cycle(modified Guishen Pills/Erxian Decoction combined with nourishing yin/warming yang acupuncture).Both groups were treated for 3 menstrual cycles.TCM syndrome scores,serum FSH,E2,AMH levels,and AFC counts were compared before and after treatment,along with safety monitoring.Results After treatment,compared with before the treatment,both groups demonstrated a significant reduction in TCM syndrome scores and FSH levels(P<0.01),and a significant increase in E2,AMH levels and AFC counts in both groups(P<0.01).Compared with the control group after treatment,the treatment group showed a significantly lower TCM syndrome score(P<0.05),while AFC counts were significantly higher(P<0.05).The total clinical effective rate in the treatment group was 86.7%(26/30),which was significantly higher than 73.3%(22/30)in the control group(P<0.05).In terms of safety,2 cases in the control group had breast distension and 1 case had mild nausea,while 1 case in the treatment group had mild abdominal tenderness,and all did not stop the treatment.There were no abnormalities in blood routine,liver and kidney function,etc.in either group.Conclusion The two-stage therapy of acupuncture and medication to regulate the menstrual cycle can effectively improve ovarian function and symptoms in patients of DOR with kidney deficiency pattern.Its effect is better than the single hormone replacement therapy,with a favorable safety profile.The mechanism may be related to regulating the HPO axis and promoting follicular development.
孙昕;王英淑;张翔昱
山东中医药大学,山东 济南 250014威海市中医院,山东 威海 264200威海市中医院,山东 威海 264200
卵巢储备功能减退肾虚针药并用二段调周法滋阴温阳归肾丸二仙汤
Diminished ovarian reserveKidney deficiencyCombined acupuncture and herbal medicineTwo-stage therapy of regulating the menstrual cycleNourishing yinWarming yangGuishen PillErxian Decoction
《中医药信息》 2026 (4)
57-61,5
2024年度威海市中医药科技项目(2024I-2)
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