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目的:探讨补肾调经汤对多囊卵巢综合征不孕(PCOS)促排卵作用及对胰岛素抵抗(IR)和血清瘦素(LP)的影响。方法:将114例患者随机按数字表法分为对照组和观察组各57例。对照组采用炔雌醇环丙孕酮片和枸橼酸氯米芬片治疗。观察组在对照组治疗的基础上加用补肾调经汤。两组疗程均为3个月经周期。观察子宫内膜厚度、子宫内膜类型(A,B,C型)、宫颈黏液评分、排卵数、月经恢复、妊娠;检测胰岛素抵抗指数(HOMA-IR),瘦素(LP),黄体生成素(LH),血清睾酮(T),雌二醇(E2)水平和卵泡刺激素(FSH)的水平。结果:治疗后观察组子宫内膜厚度和宫颈黏液评分优于对照组(P<0.01),治疗后观察组子宫内膜A型比例多于对照组(P<0.05);治疗后观察组月经恢复、排卵、妊娠患者例数多于对照组(P<0.05);治疗后观察组T和LH水平低于对照组(P<0.01);观察组治疗后HOMA-IR和LP低于对照组(P<0.01)。结论:结合西医的治疗,补肾调经汤能改善子宫内膜厚度、改善内膜形态,促进月经恢复,促使排卵,提高妊娠,其作用机制可能与调节内分泌和代谢有关。
Objective: To investigate the effect of Bushen Tiaojing Decoction on ovulation induction and insulin resistance (IR) and serum leptin (LP) in women with PCOS. Methods: 114 patients were randomly divided into control group and observation group according to the digital table method in 57 cases. The control group ethinyl estradiol cyproterone tablets and clomiphene citrate tablets treatment. Observation group in the control group based on the treatment with Bushen Tiaojing Tang. Two groups of treatment are 3 menstrual cycle. The thickness of endometrium, type of endometrium (type A, B and C), cervical mucus score, number of ovulation, menstrual recovery and pregnancy were observed. The levels of insulin resistance index (HOMA-IR), leptin (LP), luteinizing hormone (LH), serum testosterone (T), estradiol (E2) and follicle stimulating hormone (FSH). Results: After treatment, the endometrial thickness and cervical mucus score of the observation group were better than those of the control group (P <0.01). After treatment, the proportion of type A endometrium in the observation group was more than that of the control group (P <0.05) (P <0.05). The levels of T and LH in the observation group were lower than those in the control group (P <0.01). The HOMA-IR and LP in the observation group were lower than those in the control group <0.01). Conclusion: According to the treatment of Western medicine, Bushen Tiaojing Decoction can improve the thickness of endometrium, improve the morphology of endometrium, promote the recovery of menstruation, promote ovulation and improve the pregnancy. Its mechanism may be related to the regulation of endocrine and metabolism.