补肾活血方联合雌孕激素治疗卵巢早衰的临床研究

目的观察补肾活血方联合雌孕激素治疗卵巢早衰（POF）的疗效，探索中西医结合治疗POF的有效方法。方法 265例POF患者随机分为Ⅰ组（86例，补肾活血方治疗）、Ⅱ组（88例，结合雌激素加醋酸甲羟孕酮治疗）和Ⅲ组（91例，采用Ⅰ组和Ⅱ组药物联合治疗），每组疗程均为6个月，于治疗结束时和结束后6个月，比较3组治疗前后主要症状（月经周期、潮热、盗汗、阴道干涩和性欲低下）、实验室检测指标［卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）和抑制素B（INH-B）］、超声检查指标（子宫内膜厚度、卵巢体积和窦卵泡数）以及不良反应情况。结果与治疗前比较，治疗结束时及结束后6个月3组主要症状、实验室指标及超声检查结果均显著改善（P<0.05，P<0.01）；在改善月经周期、阴道干涩和性欲低下等症状，降低FSH、LH水平，提高E2、INH-B水平，改善子宫内膜厚度、卵巢体积和窦卵泡数等方面，Ⅲ组优于Ⅰ组或Ⅱ组（P<0.05， P<0.01）。3组均未见明显不良反应。结论补肾活血方联合雌孕激素治疗POF疗效优于单纯补肾活血方或雌孕激素治疗，提示补肾活血方联合雌孕激素是治疗POF有效的方法。

英文摘要:

Objective To observe the clinical efficacy of Bushen Huoxue Recipe （BHR） combined estrogen and progesterone in treating premature ovarian failure （POF）， and to explore an effective treatment program of POF by integrative medicine. Methods Totally 265 POF patients were randomly assigned to 3 groups， i.e.， Group Ⅰ （86 cases，treated by BHR），Group Ⅱ （88 cases，treated by conjugated estrogens and medroxyprogesterone acetate），and Group Ⅲ （91 cases，treated by BHR+conjugated estrogens and medroxyprogesterone acetate）. The therapeutic course for each group was 6 months. The main symptoms （including menstrual cycle， hectic fever， night sweat， vaginal dryness， and low libido）， laboratory indices ［including follicle stimulating hormone （FSH）， luteotropic hormone （LH）， estradiol （E2）， and inhibin B （INH-B）］， B-ultrasound indicators （including endometrial thickness， ovarian volume， and antral follicle count）， and adverse reactions were observed in the three groups at the end of treatment and 6 months after treatment. Results Compared with before treatment， the main symptoms， laboratory indices， and B-ultrasound indicators were statistically improved in the three groups at the end of treatment and 6 months after treatment （P<0.05， P<0.01）. Better effects were obtained in Group Ⅲ in improving symptoms of the menstrual cycle， vaginal dryness， and low libido， lowering levels of FSH and LH， elevating levels of E2 and INH-B， and ameliorating the endometrial thickness， the ovarian volume， and the antral follicle count （P<0.05， P<0.01）. No obvious adverse reaction occurred in the three groups. Conclusion BHR combined estrogen and progesterone showed better clinical efficacy than use of BHR or estrogen/progesterone alone， indicating it was an effective treatment program for POF.

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