补肾化痰治疗多囊卵巢综合征中对下丘脑—垂体—卵巢功能的调节

Regulating Effect on Hypothalamic-Pituitary-Ovarian Axis Observed During the Process of Treating Polycystic Ovarian Disease by Tonifying the Kidney and Resolving Phlegm

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中文关键词: 多囊卵巢综合征补肾化痰下丘脑卵巢功能高催乳素血症促排卵无排卵治疗后排卵周期垂体

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基金项目:

作者	单位
俞瑾	上海医科大学妇产科医院
孙月丽	上海医科大学妇产科医院
邵公权	上海医科大学妇产科医院
邴圣民	上海医科大学妇产科研究所
李超荆	上海医科大学妇产科研究所

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中文摘要:

本文观察多囊卵巢综合征患者在补肾化痰治疗前后血清中性激素的变化。治疗90天中9例共来月经22次,其中6例计9个周期出现排卵,这9个周期在治疗中血FSH 值和 E₂值均有上升,LH/FSH 比值先下降,后 IgT/IgE₂比值下降而排卵。13个无排卵周期无此现象,其中9个血 PRL 值过高,2个经清肝补肾治疗后血 PRL 降为正常而排卵。提示补肾化痰是调节下丘脑—垂体—卵巢轴而促排卵,但对高催乳素血症者需清肝补肾治疗有效,为古人"肝肾同源"提供了科学证据。

英文摘要:

For studying the effect of tonifying the kindney and resolving phlegm on polycystic ovarian disease （PCOD）,serum FSH,LH,E₂,T,PRL,C,assays were taken prior to and in 90-days’ treatment for 9 typical cases diagnosed by hormonal assay,D and C,laparoscopy and ovarian biopsy.In the 90-day’s treatment,9 cases had menstruated 22 times,6 cases with 9 cycles showed ovulation and 3 of the 4 infertile women became pregnant in 6 months. All their basal hormonal values were similar to those of PCOD reported.LH/FSH ratio was higher than 3,and IgT/IgE₂ ratio was higher than 0.91.Of the 9 cases,5 had markedly higher PRL levels.As for basal values,no difference was observed between the groups which resulted in ovulation and anovulation, but PRL levels were higher in the group resulting in anovulating.During the treatment,serum FSH and E₂ tended to be elevated in the ovulatory group（p<0.05）,and not in the anovulatory group.Other hormones tested did not show any statistical change.It appeared that in the ovulatory group LH/FSH ratio dropped first then IgT/IgE₂ ratio declined through the treatment,at last basal body temperature rose,which suggested that induction of ovulation by tonifying the kidney and resolving phlegm was actually via a regulatory effect on hypothalamic-pituitary-ovarian axis.9 higher PRL cycles concentrated in 13 anovulatory cycles did not show any effect on HPO axis,2 cases with higher PRL had their PRL become normal,and at that time ovulation occurred after changing the treatment into quenching"fire"in the liver and tonifying the kindey.This fact might give a scientific explanation of"the liver and the kidney have a common source"— an important theory in traditional Chinese medicine.

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