王慧 陈小平 谢波

摘要 目的：分析針灸联合复方左归胶囊治疗卵巢储备功能低下（DOR）的临床疗效。方法：选取2018年3月至2018年10月广东省第二中医院收治的DOR患者50例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组25例。对照组采用戊酸雌二醇+黄体酮胶丸治疗，观察组采用针灸联合复方左归胶囊治疗。2组患者均连续治疗3个月。比较2组治疗后3个月、6个月、9个月的中医症状积分变化，临床疗效、血清促卵泡成熟激素（FSH）、黄体生成激素（LH）、雌二醇（E2）、生命质量评分（SF-36）以及药物不良反应比较。结果：2组患者治疗后中医症状积分、FSH、L均较治疗前下降，观察组下降趋势较对照组明显，差异有统计学意义（P<0.05）;观察组临床治疗有效率均高于对照组，差异有统计学意义（P<0.05）;治疗后9个月2组患者E2、SF-36各维度评分均较治疗前升高，且观察组优于对照组，差异有统计学意义（P<0.05）。2组患者治疗过程中均无严重药物不良反应，观察组患者一般不良反应率低于对照组，差异有统计学意义（P<0.05）。结论：针灸联合复方左归胶囊可有效治疗DOR，且不良反应少，明显提升患者生命质量。

关键词 卵巢储备功能低下;针灸;复方左归胶囊;肾虚证;健康宣教;性激素水平;临床症状积分;生命质量评分;不良反应

Abstract Objective：To analyze the clinical efficacy of acupuncture combined with compound Zuogui Capsules in the treatment of low ovarian reserve function（DOR）.Methods：A total of 50 patients with DOR admitted to the Guangdong Second Traditional Chinese Medicine Hospital from March 2018 to October 2018 were selected as the research objects， and were randomly divided into a control group（n=25）and an observation group（n=25）.The control group was treated with estradiol valerate plus progesterone Capsule， and the observation group was treated with acupuncture combined with compound Zuogui Capsules.Patients in both groups were treated continuously for 3 months.The changes of TCM syndrome score， clinical efficacy， serum FSH， LH， E2， quality of life score（SF-36）and adverse drug reactions were compared between the 2 groups at 3 months， 6 months and 9 months after treatment.Results：After treatment， the scores of TCM symptoms， FSH and LH in the observation group were significantly lower than those in the control group.The decreasing trend of the observation group was more obvious than that of the control group（P<0.05）;the total effective rate of clinical treatment in the observation group was higher than that in the control group， and the dimensional scores of E2 and SF-36 in the 2 groups were higher 9 months after treatment， and the observation group was better than the control group（P<0.05）.There were no serious adverse drug reactions in both groups， and the general adverse reaction rate in the observation group was lower than that in the control group（P<0.05）.Conclusion：Acupuncture combined with compound Zuogui Capsule can effectively treat DOR， with less adverse reactions and can significantly improve the quality of life of patients.

Keywords Low ovarian reserve function; Acupuncture; Compound Zuogui Capsule; Kidney deficiency syndrome; Health education; Sex hormone level; Clinical symptom score; Quality of life score; Adverse reactions

卵巢储备功能（Ovarian Reserve，OR）是卵巢皮质区存留卵泡生长、发育、形成受精卵的能力。OR是育龄女性维持正常生殖功能的基础。卵巢储备功能低下（Diminished Ovarian Reserve，DOR）对女性的生殖功能、激素水平、身心状况将会产生不利的影响[1]。临床表现为月经异常（主要是频次稀少、经量少甚至闭经）、小腹胀痛、腰骶酸痛、神疲乏力、头晕眼花、耳鸣耳聋等一系列临床症状，给患者的身心造成严重负面影响。卵巢储备功能低下目前的发病机制尚不完全明确[2]，对于DOR的治疗以激素治療方案为主，治疗周期长，药物不良反应多，疗效因患者个体情况的不同存在较大差异。中医从整体论、系统论的角度分析研究疾病，在治疗复杂病因的疾病方面颇有建树[3-4]。……