化浊解毒养心方联合屈螺酮炔雌醇片(Ⅱ)治疗多囊卵巢综合征伴焦虑抑郁状态的临床研究OA
Efficacy of decoction for resolving turbidity,removing toxin and nourishing heart combined with drospirenone and ethinylestradiol tablets(Ⅱ)on polycystic ovary syndrome with anxiety and depression
目的 观察化浊解毒养心方联合屈螺酮炔雌醇片(Ⅱ)治疗多囊卵巢综合征伴焦虑抑郁状态的临床疗效.方法 选取2022 年12 月—2023 年12 月就诊于河北省中医院妇科门诊并诊断为多囊卵巢综合征伴焦虑抑郁状态的60 例患者,随机分为观察组和对照组,每组30 例.对照组患者给予屈螺酮炔雌醇片(Ⅱ)口服,观察组患者在对照组治疗基础上予化浊解毒养心方口服,2组均治疗3 个月经周期.评估2 组临床疗效,比较 2 组患者治疗前后中医证候积分,血清性激素[促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、抗缪勒管激素(AMH)、LH/FSH]水平,糖脂代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)]水平,焦虑自评量表评分(SAS)、抑郁自评量表(SDS)评分及多囊卵巢综合征患者生存质量问卷修订版(MPCOSQ)评分.结果 治疗 3 个月经周期后,观察组总有效率明显高于对照组[90.0%(27/30)比76.7%(23/30),P<0.05];2 组患者治疗后中医证候积分及 SAS、SDS 评分均较治疗前明显降低(P 均<0.05),且观察组均明显低于对照组(P 均<0.05);2 组患者治疗后性激素水平均较治疗前明显改善(P 均<0.05),且观察组 LH、T、AMH 水平及 LH/FSH 均明显低于对照组(P 均<0.05);2 组患者治疗后糖脂代谢指标均较治疗前明显降低(P 均<0.05),且观察组各指标水平均明显低于对照组(P 均<0.05);2 组患者 MPCOSQ 评分均较治疗前明显提高(P 均<0.05),且观察组明显高于对照组(P<0.05).结论 化浊解毒养心方联合屈螺酮炔雌醇片(Ⅱ)可改善多囊卵巢综合征合并焦虑抑郁状态患者血清性激素水平及糖脂代谢紊乱,减轻焦虑抑郁情绪和相关中医证候,提高生活质量.
Objective It is to observe the clinical efficacy of decoction for resolving turbidity,removing toxin and nour-ishing heart combined with drospirenone and ethinylestradiol tablets(Ⅱ)in the treatment of polycystic ovary syndrome with anxiety and depression.Methods Sixty patients diagnosed as polycystic ovary syndrome with anxiety and depression at the gynecology clinic of Hebei Provincial Hospital of Traditional Chinese Medicine from December 2022 to December 2023 were selected and randomly divided into observation group and control group,with 30 cases in each group.The patients in the control group were orally treated with drospirenone and ethinylestradiol tablets(Ⅱ),and those in the observation group were orally treated with decoction for resolving turbidity,removing toxin and nourishing heart based on the therapy in the control group,both groups were treated for 3 menstrual cycles.The scores of traditional Chinese medicine syndrome,serum levels of sex hormones[luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),anti-Müllerian hormone(AMH),LH/FSH],glucose and lipid metabolism indicators[total cholesterol(TC),triglycerides(TG),fast-ing plasma glucose(FPG),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)],scores of the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and modified polycystic ovary syn-drome health-related quality of life questionnaire(MPCOSQ)of patients in the two groups were compared before and after treatment.Results After treatment for 3 menstrual cycles,the overall effective rate in the observation group was significant-ly higher than that in the control group[90.0%(27/30)vs 76.7%(23/30),P<0.05].The traditional Chinese medi-cine syndrome scores,SAS and SDS scores of patients in the two groups were significantly lower after treatment than those before treatment(all P<0.05),and the scores in the observation group were significantly lower than those in the control group(all P<0.05);the sex hormone levels of patients in the two groups were improved significantly after treatment com-pared with before treatment(all P<0.05),and the levels of LH,T and AMH,as well as the LH/FSH ratio in the obser-vation group were significantly lower than those in the control group(all P<0.05);the levels of glucose and lipid metabo-lism indicators after treatment were significantly lower than those before treatment in the two groups(all P<0.05),and all indicators in the observation group were significantly lower than those in the control group(all P<0.05);the MPCOSQ scores after treatment were significantly higher than those before treatment(all P<0.05),and the scores in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Decoction for resolving turbidity,removing toxin and nourishing heart combined with drospirenone and ethinylestradiol tablets(Ⅱ)can improve serum levels of hormone and glucose and lipid metabolism disorders,alleviate anxiety and depressive emotions and related traditional Chinese medicine syndromes and improve quality of life in patients with polycystic ovary syndrome with anxiety and depres-sion.
张珊;牛冰倩;陈慧娟
河北中医药大学,河北 石家庄 050091河北中医药大学,河北 石家庄 050091河北省中医院,河北 石家庄 050011||河北省浊毒证重点实验室,河北 石家庄 050011
医药卫生
多囊卵巢综合征焦虑抑郁化浊解毒养心方心之浊毒屈螺酮炔雌醇片(Ⅱ)浊毒理论
polycystic ovary syndromedecoction for resolving turbidity,removing toxin and nourishing heartturbidity and toxin of the heartdrospirenone and ethinylestradiol tablets(Ⅱ)theory of turbidity and toxin
《现代中西医结合杂志》 2026 (3)
320-325,6
河北省中医药管理局科研计划项目(2021060)
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