| 引用本文:李娟，张燕，丁志云.基于“心-肾-子宫轴”理论探讨清心滋肾汤对心肾不交型早发性卵巢功能不全的疗效及部分作用机制[J].世界中医药,2019,(09):. |
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| 基于“心-肾-子宫轴”理论探讨清心滋肾汤对心肾不交型早发性卵巢功能不全的疗效及部分作用机制 |
| Exploration on the Efficacy and Partial Mechanism of Qingxin Zishen Decoction in Premature Ovarian Insufficiency of Heart-kidney Non-interaction Type Based on the Theory of “Heart-kidney-uterus Axis” |
| 投稿时间：2018-11-29 |
| DOI：10.3969/j.issn.1673-7202.2019.09.027 |
| 中文关键词: 心肾不交型 早发性卵巢功能不全 心-肾-子宫轴 清心滋肾汤 性激素 卵巢尺寸 生命质量评分 临床疗效 |
| English Keywords:Heart-kidney non-interaction type Premature ovarian insufficiency Heart-kidney-uterus axis Qingxin Zishen Decoction Sex hormone Ovarian size Score of life quality Clinical efficacy |
| 基金项目:江苏省卫生计生委2015年度青年科研课题（H201512） |
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| 中文摘要: |
| 目的：探究“心-肾-子宫轴”理论指导下应用清心滋肾汤治疗心肾不交型早发性卵巢功能不全的临床疗效及作用机制。方法：选取2017年4月至2018年4月昆山市中医医院收治符合纳入条件心肾不交型早发性卵巢功能不全患者88例作为研究对象，按照就诊顺序编号随机分为对照组和观察组，每组44例。对照组予雌孕激素周期序贯治疗，观察组在对照组基础上在“心-肾-子宫轴”理论指导下应用清心滋肾汤加减治疗，2组均连续治疗3个月。观察2组治疗前、治疗末性激素、抗苗勒氏激素（AMH）水平变化并比较；观察治疗前、治疗末在超声下卵巢平均直径、卵巢面积、窦卵泡数情况。观察治疗前、治疗末生命质量变化并比较。治疗过程中进行不良反应比较，并对症治疗。治疗结束后进行疗效判断。结果：1)2组患者治疗前血清卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、AMH比较，差异无统计学意义（P>0.05），治疗末2组FSH、LH较治疗前均显著下降，E2、AMH较治疗前显著升高（P<0.05），治疗末观察组患者以上指标显著优于对照组（P<0.05）;2)2组患者治疗前卵巢平均直径、卵巢面积、窦卵泡数指标比较，差异无统计学意义（P>0.05），治疗末以上指标较2组较治疗前均显著上升（P<0.05），治疗末观察组患者以上指标显著高于对照组（P<0.05）;3)2组患者治疗前生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康比较，差异无统计学意义（P>0.05），治疗后以上指标2组较治疗前均显著升高（P<0.05），且观察组患者以上指标显著高于对照组（P<0.05）;4)完成治疗后观察组患者治愈率、总有效率明显高于对照组(P<0.05);5)2组不良反应发生率上比较，差异无统计学意义（P>0.05）。结论：“心-肾-子宫轴”理论指导下应用清心滋肾汤治疗心肾不交型早发性卵巢功能不全疗效满意，能提高雌激素水平，优化卵巢功能，改善生命质量。 |
| English Summary: |
| To explore clinical efficacy and mechanism of Qingxin Zishen Decoction in premature ovarian insufficiency(POI)of heart-kidney non-interaction type under the guidance of “heart-kidney-uterus axis” theory.Methods:A total of 88 patients with POI of heart-kidney non-interaction type who were eligible in the Kunshan Traditional Chinese Medicine Hospital from April 2017 to April 2018 were selected as research objects and randomly divided into a control group(44 cases)and an observation group(44 cases)according to the order of treatment.The control group was given cyclic sequential treatment of estrogen and progesterone.The observation group was additionally treated with modified Qingxin Zishen Decoction under the guidance of “heart-kidney-uterus axis” theory on the treatment basis of the control group.Both groups were treated continuously for 3 months.Levels of sex hormone and anti-Mullerian hormone(AMH)before and after the treatment were observed and compared between the 2 groups.Average diameter of ovary, ovarian area and antral follicle count in B-ultrasound before and after the treatment were observed.Changes of life quality before and after the treatment were observed and compared.During the treatment, adverse reactions were compared and symptomatic treatment was performed.The efficacy was judged after the treatment.Results:1)There was no significant difference in the levels of FSH, LH, E2 and AMH between the 2 groups before the treatment(P>0.05).The levels of FSH and LH in the end of the treatment were significantly lower than those before the treatment, while the levels of E2 and AMH were significantly higher than those before the treatment(P<0.05).And the above indexes in the observation group were significantly better than those in the control group(P<0.05).2)There was no significant difference in the average diameter of ovary, ovarian area and antral follicle count before the treatment between the 2 groups(P>0.05).At the end of treatment, the above indexes were significantly increased in the 2 groups compared with those before the treatment(P<0.05).And the above indexes in the observation group were significantly better than those in the control group(P<0.05).3)There was no significant difference in physiological function, physical function, somatic pain, general health, vitality, social function, emotional function and mental health between the 2 groups before the treatment(P>0.05).After the treatment, the above indexes in the 2 groups were significantly higher than those before the treatment(P<0.05), and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).4)After the treatment, the cure rate and total effective rate in the observation group were significantly higher than those in the control group(P<0.05).5)There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion:Qingxin Zishen Decoction in treatment of POI can improve the estrogen level, optimize ovarian function and improve the quality of life under the guidance of the theory of “heart-kidney-uterus axis”, with satisfying efficacy. |
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