广西医学

目的分析补肾化痰方联合二甲双胍治疗肾虚痰瘀型多囊卵巢综合征（PCOS）患者的临床效果及对内分泌、子宫内膜容受性的影响。方法将60例肾虚痰瘀型PCOS患者随机分为单药组和联合组，每组30例。单药组患者口服二甲双胍治疗，联合组患者口服补肾化痰方（新加启宫汤剂）及二甲双胍治疗。比较两组治疗3个月后的临床疗效，治疗前及治疗3个月后的中医证候积分、体质指数、性激素水平、胰岛素抵抗相关指标、子宫内膜容受性相关指标，以及治疗期间不良反应发生率。结果联合组患者总有效率高于单药组（分别为93.33%、73.33%，P＜0.05）。治疗后，两组的中医证候积分、体质指数、空腹血糖水平、空腹胰岛素水平、稳态模型胰岛素抵抗指数、子宫内膜螺旋动脉搏动指数和阻力指数，以及血清黄体生成素和睾酮水平低于治疗前，子宫内膜厚度,血清促卵泡激素和雌二醇水平高于治疗前（P＜0.05），联合组上述指标优于单药组（P＜0.05）。联合组治疗期间不良反应总发生率低于单药组（P＜0.05）。结论补肾化痰方联合二甲双胍治疗肾虚痰瘀型PCOS的疗效优于单一二甲双胍治疗，可更有效地改善此类患者的临床症状、性激素水平、内分泌水平及子宫内膜容受性。

ObjectiveTo analyze the clinical effect of Bushen Huatan Prescription combined with metformin for the treatment of patients with polycystic ovary syndrome (PCOS) in renal deficiency and sputum stagnation type, and its influence on endocrine and endometrial receptivity. MethodsA total of 60 PCOS patients in renal deficiency and sputum stagnation type were randomly assigned to single-drug group or combined group, with 30 cases in each group. The single-drug group was orally administrated with metformin, and the combine group was orally administrated with Bushen Huatan Prescription (Xinjia Qigong Decoction) and metformin. The 3-month post-treatment clinical efficacy, pre-treatment and 3-month post-treament Traditional Chinese Medicine symptom score, body mass index, sex hormone levels, indices related to insulin resistance, indices related to endometrial receptivity, and incidence rate of adverse reactions during treatment were compared between the two groups. ResultsThe total effective rate of the combined group (93.33%) was higher than that of the single-drug group (73.33%, P＜0.05). After treatment, the Traditional Chinese Medicine symptom score, body mass index, fasting blood glucose level, fasting insulin level, and homeostasis model assessment for insulin resistance index, endometrial spiral arterial pulsation and resistance indexes, as well as serum luteinizing hormone and testosterone levels in both groups were lower than those before treatment, whereas endometrial thickness, and serum follicle-stimulating hormone and estradiol levels were higher than those before treatment (P＜0.05); furthermore, the combined group exhibited superior indices as above to compared with the single-drug group (P＜0.05). The incidence rate of adverse reactions during treatment in the combined group was lower than that in the single-drug group (P＜0.05). ConclusionThe efficacy of Bushen Huatan Prescription combined with metformin for treating PCOS patients in renal deficiency and sputum stagnation type is superior to single metformin therapy, which can more effectively ameliorate these patients′ clinical symptoms, sex hormone levels, endocrine levels, and endometrial receptivity.