章辉　宋爱清

[摘要] 目的 探讨补肾调经方联合地屈孕酮治疗多囊卵巢综合征的临床效果。 方法 根据纳入标准和排除标准选择62例多囊卵巢综合征患者，随机分为治疗组（32例）和对照组（30例）。治疗组在月经或撤药性出血干净后予补肾调经方口服，每日1剂，水煎两遍，分两次服用；同时在月经或撤药性出血第16天开始服用地屈孕酮，10 mg/次，2次/d，服10 d。对照组在月经周期第5天口服炔雌醇环丙孕酮片，每晚1片，共21 d。6个周期为1个疗程。两组均观察10个月。 结果 治疗组总有效率为90.62%，高于对照组的80.00%，差异有统计学意义（P<0.05）。两组治疗前后血清促卵泡生成素变化差异无统计学意义（P>0.05），促黄体生成素、雌二醇、睾酮治疗后较治疗前明显下降，差异有统计学意义（P<0.05）；治疗后两组间血清性激素比较，差异无统计学意义（P>0.05）。 结论 补肾调血方联合地屈孕酮治疗多囊卵巢综合征临床疗效优于炔雌醇环丙孕酮片。

[关键词] 补肾调经方；地屈孕酮；多囊卵巢综合征

[中图分类号] R271.9 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0136-03

[Abstract] Objective To explore the clinical effect of Bushen Tiaojing Decoction combined with dydrogesterone in the treatment of polycystic ovarian syndrome. Methods 62 cases of patients with polycystic ovarian syndrome were selected based on inclusion and exclusion criteria and randomly divided into treatment group （32 cases） and control group （30 cases）.The treatment group were orally given with Bushen Tiaojing Decoction after menstruation or drug withdrawal-induced bleeding.One dose was decocted twice with water and orally given twice a day；the patients were also given with dydrogesterone 10 mg every time from the sixteenth days after menstruation or drug withdrawal-induced bleeding，twice a day for 10 days.The control group were orally given with ethinylestradiol and cyproterone acetate tablets from the fifth day during the menstruation，one tablet every night for 21 days.A course of treatment lasted for six periods.The two groups were observed for 10 months. Results The total effective rate in the treatment group was 90.62%，higher than 80.00% in the control group，the difference was significant （P<0.05）.Changes of FSH in the two groups before and after treatment were not significant （P>0.05）；LH，E2 and T significantly reduced after treatment，and the differences were significant （P<0.05），but the difference between two groups was not significant （P>0.05）. Conclusion Bushen Tiaojing Decoction combined with dydrogesterone in the treatment of polycystic ovarian syndrome has a better clinical effect than ethinylestradiol and cyproterone acetate tablets.

[Key words] Bushen Tiaojing Decoction；Dydrogesterone；Polycystic ovarian syndrome

多囊卵巢综合征是妇科常见的内分泌疾病，育龄期妇女中发病率高达5%～10%[1-2]，是女性不孕症的主要病因之一。月经稀发或闭经是多囊卵巢综合征的主要临床表现，高雄激素血症是其重要的内分泌特征。多囊卵巢综合征不仅会引起女性月经失调，影响女性的生育功能，还会增加2型糖尿病、代谢综合征和心脑血管疾病等远期并发症的发病风险[3]。多囊卵巢综合征病因复杂。中医理论认为，肾主生殖，调节女性的生殖内分泌系统，因此肾虚是其根本。本文采用中西医结合疗法治疗多囊卵巢综合征，观察其临床疗效。……