地黄饮子合知柏地黄汤联合来曲唑治疗肾阴虚火型PCOS不孕症的疗效及对血清AMH、SHBG水平的影响OA
Effect of Dihuang Yinzi and Zhibai Dihuang decoction combined with Letrozole in the treatment of PCOS infertility with kidney Yin deficiency and fire and its influence on serum AMH and SHBG levels
目的 探讨地黄饮子合知柏地黄汤联合来曲唑治疗肾阴虚火旺型多囊卵巢综合征(PCOS)不孕症的疗效及对血清抗缪勒氏管激素(AMH)、性激素结合球蛋白(SHBG)水平的影响.方法 选取2023年10月至2024年11月该院收治的122例PCOS不孕症患者作为研究对象,采用随机数字表法分为对照组和试验组,每组61例.对照组在常规治疗的基础上采用来曲唑进行治疗,试验组在对照组的基础上联合地黄饮子合知柏地黄汤进行治疗.比较2组的临床疗效及性激素[促黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E2)、睾酮(T)]、AMH、SHBG水平,以及中医证候积分、子宫内膜厚度、优势卵泡个数、妊娠率、早期流产率及不良反应发生情况.结果 试验组总有效率为95.08%,高于对照组的83.61%,差异有统计学意义(P<0.05).治疗后,试验组FSH、E2、SHBG水平均高于对照组,LH、T、AMH水平及月经周期、月经量、胸闷纳呆、神疲乏力评分均低于对照组,差异均有统计学意义(P<0.05).治疗后,试验组子宫内膜厚度厚于对照组,优势卵泡个数多于对照组,差异均有统计学意义(P<0.05).试验组妊娠率高于对照组,差异有统计学意义(P<0.05).2组早期流产率及治疗期间不良反应发生率比较,差异均无统计学意义(P>0.05).结论 采用地黄饮子合知柏地黄汤联合来曲唑方案治疗PCOS所致不孕,能有效调节性激素与血清 AMH、SHBG水平,改善患者临床症状,且安全性良好,疗效显著.
Objective To investigate the efficacy of Dihuang Yinzi and Zhibai Dihuang decoction combined with Letrozole in the treatment of polycystic ovary syndrome(PCOS)infertility and its effect on serum anti-Mullerian hormone(AMH)and sex hormone binding globulin(SHBG)levels.Methods A total of 122 pa-tients with PCOS infertility admitted to the hospital from October 2023 to November 2024 were selected as the research objects,and they were divided into a control group and an experimental group by random number table method,with 61 cases in each group.The control group was treated with Letrozole on the basis of con-ventional treatment,and the experimental group was treated with Dihuang Yinzi and Zhibai Dihuang decoction on the basis of the control group.The clinical efficacy,sex hormone[luteinizing hormone(LH),follicle stimu-lating hormone(FSH),estradiol(E2),testosterone(T)],AMH and SHBG levels,TCM syndrome score,en-dometrial thickness,the number of dominant follicles,pregnancy rate,early abortion rate and adverse reactions were compared between the two groups.Results The total effective rate of the experimental group was 95.08%,which was higher than 83.61%of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of FSH,E2,and SHBG in the experimental group were higher than those in the control group,and the levels of LH,T,and AMH,menstrual cycle,menstrual volume,chest tight-ness,and fatigue scores in the experimental group were lower than those in the control group,and the differ-ences were statistically significant(P<0.05).After treatment,the endometrial thickness of the experimental group was thicker than that of the control group,and the number of dominant follicles was more than that of the control group,and the differences were statistically significant(P<0.05).The pregnancy rate of the ex-perimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the early abortion rate and the incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Dihuang Yinzi and Zhibai Dihuang decoc-tion combined with Letrozole in the treatment of infertility caused by PCOS can effectively regulate the levels of sex hormones,serum AMH and SHBG,improve the clinical symptoms of patients,with good safety and sig-nificant curative effect.
陈美娟;浦琼华;董志茹;陈孟娜;王丹华
江苏省无锡市锡山人民医院:妇产科,江苏 无锡 214100江苏省无锡市锡山人民医院:中医内科,江苏 无锡 214100江苏省无锡市锡山人民医院:妇产科,江苏 无锡 214100江苏省无锡市锡山人民医院:妇产科,江苏 无锡 214100江苏省无锡市锡山人民医院:妇产科,江苏 无锡 214100
医药卫生
地黄饮子合知柏地黄汤来曲唑多囊卵巢综合征不孕症抗缪勒氏管激素性激素结合球蛋白
Dihuang Yinzi and Zhibai Dihuang decoctionLetrozolepolycystic ovary syndromein-fertilityanti-mullerian hormonesex hormone binding globulin
《检验医学与临床》 2026 (11)
1474-1479,6
江苏省无锡市中医药管理局科技项目(ZYKJ202018)江苏省无锡市卫生健康委妇幼健康科研项目(FYKY202411).
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