甘麦大枣汤加减对围绝经期综合征患者性激素水平和生活质量的影响OA
Effects of Modified Licorice-Wheat-Jujube Decoction on Sex Hormone Levels and Quality of Life in Patients with Perimenopausal Syndrome
目的:观察甘麦大枣汤加减治疗围绝经期综合征的临床疗效及其对患者性激素水平和生活质量的影响.方法:将192 例围绝经期综合征患者按照随机数字表法分为西药组和联合组,每组各96 例.西药组采用雌孕激素序贯疗法,联合组在西药组治疗的基础上加用甘麦大枣汤加减.比较两组患者的临床疗效、不良反应发生情况及治疗前后中医证候积分、血清性激素水平[雌二醇(estradiol,E2)、卵泡刺激素(follicle-stimulating hormone,FSH)及黄体生成素(luteinizing hormone,LH)]、改良 Kup-perman 评分(modified Kupperman index,mKI)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、更年期生存质量量表(menopause-specific quality of life questionnaire,MENQOL)评分变化情况.结果:西药组有效率为 70.83%,联合组有效率为89.58%,两组患者有效率比较,差异具有统计学意义(P<0.05).两组患者治疗后腰膝酸软、心烦、失眠、口咽干燥等中医证候积分低于本组治疗前,且治疗后联合组低于西药组,差异具有统计学意义(P<0.05).两组患者治疗后 E2 水平高于本组治疗前,FSH、LH 水平低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05).两组患者治疗后 mKI、PSQI 评分低于本组治疗前,且治疗后联合组低于西药组,差异具有统计学意义(P<0.05).两组患者治疗前后心理状态评分比较,差异无统计学意义(P>0.05);两组患者治疗后血管舒缩症状、生理状态、性生活评分低于本组治疗前,且治疗后联合组低于西药组,差异具有统计学意义(P<0.05).两组不良反应发生情况比较,差异无统计学意义(P>0.05).结论:甘麦大枣汤加减治疗围绝经期综合征,可调节患者的激素水平,改善临床症状及睡眠质量,提高生活质量.
Objective:To observe the clinical efficacy of Modified Licorice-Wheat-Jujube Decoction in the treatment of perimenopausal syndrome(PMS)and its effects on sex hormone levels and quality of life in patients.Methods:A total of 192 patients with PMS were randomly divided into the Western medicine group and the combined group using the random number table method,with 96 cases in each group.The Western medicine group received sequential estrogen-progesterone therapy,while the combined group received Modified Licorice-Wheat-Jujube Decoction in addition to the Western medicine treatment.The clinical efficacy,incidence of adverse reactions,and changes in TCM syndrome scores,serum sex hormone levels[estradiol(E2),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)],modified Kupperman index(mKI),Pittsburgh sleep quality index(PSQI),and menopause-specific Quality of Life Questionnaire(MENQOL)scores before and after treatment were compared between the two groups.Results:The effective rate was 70.83%in the Western medicine group and 89.58%in the combined group,with a statistically significant difference(P<0.05).After treatment,both groups showed lower TCM syndrome scores for symptoms such as soreness and weakness of the waist and knees,irritabil-ity,insomnia,and dry mouth and throat compared to before treatment,and the above scores in the combined group were lower than in the Western medicine group,with statistically significant differences(P<0.05).E2 levels were higher while FSH and LH levels were lower than those before treatment in both groups,with significant differences between the two groups(P<0.05).Both groups presented re-duced mKI and PSQI scores after treatment,and the combined group had lower scores than the Western medicine group,with statistically significant differences(P<0.05).However,there was no significant difference in psychological status scores between the two groups before and after treatment(P>0.05).After treatment,scores of vasomotor symptoms,physical status and sexual function decreased in both groups.These scores were lower in the combined group than in the Western medicine group,with statistically significant differences(P<0.05).No significant difference was found in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Licorice-Wheat-Jujube Decoction can regulate sex hormone levels,improve clinical symptoms,sleep quality and quality of life in patients with PMS.
李颖真;史婷;张亚丽
河南中医药大学第三附属医院,河南 郑州 450008河南中医药大学第三附属医院,河南 郑州 450008河南中医药大学第三附属医院,河南 郑州 450008
医药卫生
围绝经期综合征心肾不交证甘麦大枣汤戊酸雌二醇地屈孕酮雌孕激素序贯疗法中西医结合疗法《金匮要略》张仲景
《河南中医》 2026 (10)
1501-1506,6
河南省自然科学基金项目(252300420626)
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