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[摘要] 目的 觀察滋肾调肝活血调周法、二甲双胍及两者联合用药治疗多囊卵巢综合征（PCOS）的临床疗效。 方法 将114例符合诊断标准的PCOS患者随机分为三组，中药组37例，西药组38例，中西药组39例，三组患者无显著差异，具有可比性。治疗3个疗程，观察临床疗效及治疗前后三组患者的卵巢体积（V）、卵泡数目（Fn）、卵巢间质面积/卵巢总面积比（S/A）、子宫内膜厚度（双层，En）的变化。 结果 西药组、中药组、中西药组有效率呈依次增高。治疗后三组V、Fn、S/A、En各自与治疗前比较，差异均有统计学意义（P<0.05）；治疗后两两比较，中药组与西药组V、Fn、S/A差异均有统计学意义（P<0.05），En比较差异无统计学意义（P>0.05），中药组与中西药组V、Fn、S/A、En差异均有统计学意义（P<0.05），西药组与中西药组V、Fn、S/A、En差异均有统计学意义（P<0.05）。 结论 滋肾调肝活血调周法联合二甲双胍治疗PCOS可以取得较好疗效。

[关键词] 滋肾调肝活血调周法；二甲双胍；PCOS；中西医结合

[中图分类号] R711.75 [文献标识码] B [文章编号] 1673-9701（2018）10-0131-04

Preliminary study on the effect of Zishen Tiaogan Huoxue Tiaozhou recipe on ovarian morphology in patients with PCOS

YANG Zhi YE Liqun

Department of Gynecology， Ningbo Traditional Chinese Medicine Hospital， Ningbo 315000， China

[Abstract] Objective To observe the clinical effect of Zishen Tiaogan Huoxue Tiaozhou recipe， metformin and combination therapy on polycystic ovary syndrome（PCOS）. Methods 114 patients meeting the diagnostic criteria of PCOS were randomly divided into three groups， including 37 cases of traditional Chinese medicine group， 38 cases of western medicine group and 39 cases of integrated traditional Chinese and western medicine group. And there were no significant differences in the three groups of patients， which were comparable. The patients were treated for 3 courses. The clinical efficacy and the changes of ovarian volume （V）， follicles number（Fn）， ovarian interstitial area/total ovarian area ratio（S/A）， endometrial thickness（double layer， En） in the three groups before and after treatment were observed. Results The effective rate of western medicine group， traditional Chinese medicine group and integrated traditional Chinese and western medicine group was increased in turn. There were significant differences in V， Fn， S/A and En after the treatment compared with those before treatment in the three groups（P<0.05）. After treatment， pairwise comparison among the three groups was performed. The differences in V， Fn and S/A between the traditional Chinese medicine group and the western medicine group were statistically significant（P<0.05）， and there was no significant difference in En（P>0.05）. There were significant differences in V， Fn， S/A and En between traditional Chinese medicine group and integrated traditional Chinese and western medicine group（P<0.05）. There were significant differences in V， Fn， S/A and En between western medicine group and integrated traditional Chinese and western medicine（P<0.05）. Conclusion Zishen Tiaogan Huoxue Tiaozhou recipe combined with metformin in the treatment of PCOS can achieve better curative effect.

[Key words] Zishen Tiaogan Huoxue Tiaozhou recipe； Metformin； PCOS； Integrated traditional Chinese and western medicine

多囊卵巢综合征（PCOS）是一种以高雄激素、胰岛素抵抗和持续无排卵为基本特征的内分泌代谢疾病[1]，是女性最常见的内分泌紊乱性疾病，在手术中或在超声下可观察到该类患者卵巢呈多囊性形态学的改变[2]。2003年鹿特丹会议已将多囊卵巢的形态学描述纳入诊断标准，但现有探讨 PCOS患者对各种治疗方法的临床反应与卵巢形态学改变这两者相互关系的研究报道较少。本研究通过中药滋肾调肝活血调周法联合二甲双胍，周期序贯用药治疗PCOS，探讨该种治疗方法与卵巢形态改变的关系，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年1～10月期间在本院妇科门诊就诊并确诊的PCOS患者114例，均符合本研究所设定的中西医诊断标准及纳入标准，随机分为中药组37例，平均年龄（26.54±4.41）岁，平均病程（16.35±5.72）个月；……