丹栀逍遥丸对肝郁化火型多囊卵巢综合征促排卵疗效的影响

目的观察丹栀逍遥丸对肝郁化火型多囊卵巢综合征（polycystic ovary syndrome，PCOS）合并胰岛素抵抗（insulin resistance，IR）的无排卵型不孕症患者促排卵的疗效。方法 60例患者随机分为中西医组和西医组，每组30例。两组口服二甲双胍+复方醋酸环丙孕酮片，中西医组加服丹栀逍遥丸，疗程均为3个月经周期。治疗后口服来曲唑或注射尿促性素（HMG）诱发排卵，比较两组患者临床疗效。结果治疗后两组胰岛素水平、促黄体生成素水平、睾酮值均较治疗前明显降低（P<0.05），治疗后两组比较差异无统计学意义。两组治疗前后体重指数比较差异无统计学意义（P>0.05）。中西医组在改善烦躁易怒、胸胁胀满、经前乳房胀痛、口苦口干、月经稀发、月经色量异常、舌脉方面效果显著（P<0.05，P<0.01）。中西医组排卵率（86.1%，93/108）明显高于西医组（65.5%，74/113），临床妊娠率（60.0%，18/30）明显高于西医组（36.7%，11/30），差异有统计学意义（P<0.05）。结论丹栀逍遥丸可提高PCOS伴IR无排卵型不孕患者排卵率及妊娠率，并可显著改善中医证候，较单用西药具有明显优势。

英文摘要:

Objective To observe the efficacy of Danzhi Xiaoyao Pill （DXP） in anovulation infertility patients with polycystic ovary syndrome （PCOS） of pathogenic fire derived from stagnation of Gan qi （PFDSG） complicated insulin resistance （IR）. Methods Sixty PCOS patients were randomly assigned to two group， the integrative medical treatment group （Group A） and the Western medical treatment group （Group B）， 30 cases in each group. All patients took Metformin and Diane 35. Those in Group A took DXP additionally. The therapeutic course for all was 3 menstrual cycles. After treatment the ovulation was induced by oral administration of letrozole or injection of menotropins （HMG）. The therapeutic efficacy was compared between the two groups. Results The levels of insulin， luteinizing hormone， and testosterone were obviously lower after treatment than before treatment in the two groups （P<0.05）. There was no statistical difference between the two groups after treatment. There was no statistical difference in body mass index （BMI） between the two groups before and after treatment （P>0.05）. Better effects were obtained in Group A in improving symptoms such as agitation and irritability， fullness in the chest and hypochondrium， swollen pain in the breast before menstruation， bitter and dry mouth， oligomenorrhea， abnormal color and amount of menstruation， and pulse and tongue （P<0.05， P<0.01）. The ovulation rate was 86.1% （93/108 cases） in Group A， obviously higher than that in Group B （65.5%，74/113 cases）. The clinical pregnancy rate was 60.0% （18/30 cases） in Group A， obviously higher than that in Group B （36.7%，11/30 cases）， showing statistical difference （P<0.05）. Conclusions DXP could improve the ovulation rate and the pregnancy rate in anovulation infertility patients with PCOS complicated IR. It also could significantly improve Chinese medical syndromes， showing obvious advantages over using Western medicine alone.

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