Article(id=1322924023943930327, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.039, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339266048, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339266048, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339266048, creator=13701087609, updateTime=1793339266048, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=192, endPage=195, ext={EN=ArticleExt(id=1322924024266891736, articleId=1322924023943930327, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Prospective Study of Huayu Xiaozhi Decoction(化瘀消癥汤)in Treatment of Polycystic Ovary Syndrome with Hyperandrogenemia, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the curative effect of Huayu Xiaozhi Decoction(化瘀消癥汤)on polycystic ovary syndrome with hyperandrogenemia prospectively.

Methods

From October 2022 to October 2023,86 patients with hyperandrogenemia of polycystic ovary syndrome of The First Affiliated Hospital of Zhengzhou University were divided into the control group(43 cases)and the combination group(43 cases)randomly.The control group was treated with drospirenone ethinylestradiol tablets(Ⅱ),and the combination group was treated with drospirenone ethinylestradiol tablets(Ⅱ)combined with Huayu Xiaoshi Decoction for 3 menstrual cycles.The efficacy of the two groups after 3 menstrual cycles,glucose and lipid metabolism,reproductive hormone,ovarian function before and after 3 menstrual cycles,and the occurrence of adverse reactions during treatment were compared.

Results

After 3 menstrual cycles,the total effective rate(90.70%,39/43)in the combination group was higher(P<0.05).Compared with those before treatment,menstrual cycle score,ovarian follicle number,ovarian volume,the levels of serum luteinizing hormone(LH),estrogen(E2),testosterone(T),androstenedione(ASD),fasting blood glucose(FPG),fasting insulin(FINS),triglyceride(TG)and total cholesterol(TC)decreased in both groups after 3 menstrual cycles,and the difference between two groups was lower than that in the combination group(P<0.05).The incidence of adverse reactions was similar between the two groups[9.30%(4/43)vs 4.65%(2/43),P>0.05].

Conclusion

Huayu Xiaoshi Decoction in the treatment of polycystic ovary syndrome with hyperandrogenemia could regulate the secretion of reproductive hormone,improve the ovarian function,control the abnormal glucose and lipid metabolism,improve the efficacy and has good safety.

, authors=Jinying JIA, Mingzhu LIU, Xiaoyan GUO, authorsList=Jinying JIA, Mingzhu LIU, Xiaoyan GUO, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924026833805794, articleId=1322924023943930327, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的前瞻性研究, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

前瞻性研究化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的疗效。

方法

2022年10月—2023年10月郑州大学第一附属医院收治的多囊卵巢综合征高雄激素血症患者86例,随机纳入对照组(43例)与联合组(43例)。对照组予以屈螺酮炔雌醇片(Ⅱ)治疗,联合组采用屈螺酮炔雌醇片(Ⅱ)联合化瘀消癥汤治疗,均治疗3个月经周期。比较两组治疗3个月经周期后疗效,治疗前、治疗3个月经周期后糖脂代谢、生殖激素、卵巢功能,治疗期间不良反应发生情况。

结果

治疗3个月经周期后,联合组总有效率90.70%(39/43)相较对照组的总有效率72.09%(31/43)更高(P<0.05)。与治疗前比较,治疗3个月经周期后两组雄烯二酮(androstenedione,ASD)、空腹血糖(fasting blood glucose,FPG)、月经周期评分、卵巢内卵泡数量、卵巢体积,血清促黄体生成素(luteinizing hormone,LH)、总胆固醇(total cholesterol,TC)、睾酮(testosterone,T)、空腹胰岛素(fasting insulin,FINS)、雌激素(estrogen,E2)、甘油三酯(triglyceride,TG)水平均降低,且组间比较联合组更低(P<0.05)。两组不良反应发生率接近[9.30%(4/43)vs4.65%(2/43),P>0.05]。

结论

化瘀消癥汤治疗多囊卵巢综合征高雄激素血症,可调节生殖激素分泌,改善卵巢功能,控制糖脂代谢异常,提高疗效,安全性良好。

, authors=贾金英, 刘明珠, 郭晓燕, authorsList=贾金英, 刘明珠, 郭晓燕, authorCompany=null, correspAuthors=null, authorNote=

贾金英(1966-),女,河南郑州人,副主任医师,学士,研究方向:中西医结合妇科、肿瘤放化疗后不良反应的中医治疗。

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贾金英(1966-),女,河南郑州人,副主任医师,学士,研究方向:中西医结合妇科、肿瘤放化疗后不良反应的中医治疗。

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贾金英(1966-),女,河南郑州人,副主任医师,学士,研究方向:中西医结合妇科、肿瘤放化疗后不良反应的中医治疗。

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refType=null, unstructuredReference=李陈雪,杨玉赫,冷德生,等. 枳壳化学成分及药理作用研究进展[J]. 辽宁中医药大学学报,2019,21(2):158-161., articleTitle=枳壳化学成分及药理作用研究进展, refAbstract=null), Reference(id=1322924033725047337, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, doi=null, pmid=null, pmcid=null, year=2019, volume=17, issue=8, pageStart=1162, pageEnd=1165, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=赵晶珊, 侯雅竹, 王贤良, journalName=中西医结合心脑血管病杂志, refType=null, unstructuredReference=赵晶珊,侯雅竹,王贤良,等. 中药枳壳治疗心血管疾病的药理学作用研究进展[J]. 中西医结合心脑血管病杂志,2019,17(8):1162-1165., articleTitle=中药枳壳治疗心血管疾病的药理学作用研究进展, refAbstract=null)], funds=[Fund(id=1322924031548203531, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, awardId=24A360024, language=CN, fundingSource=河南省高等学校重点科研计划项目(24A360024), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322924027702026723, tenantId=1146029695717560320, journalId=1255847919539208197, 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组别例数治愈显效有效无效总有效
联合组438(18.60)17(39.53)14(32.56)4(9.30)39(90.70)
对照组434(9.30)12(27.91)15(34.88)12(27.91)31(72.09)
χ2值4.914
P值0.027
), ArticleFig(id=1322924030986166788, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=CN, label=表1, caption=

两组多囊卵巢综合征高雄激素血症患者治疗3个月经周期后疗效比较

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组别例数治愈显效有效无效总有效
联合组438(18.60)17(39.53)14(32.56)4(9.30)39(90.70)
对照组434(9.30)12(27.91)15(34.88)12(27.91)31(72.09)
χ2值4.914
P值0.027
), ArticleFig(id=1322924031057469957, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间卵巢体积/(cm3)卵巢内卵泡数量/(个)月经周期评分/(分)
左侧右侧
联合组43治疗前10.95±1.7311.19±1.6513.77±1.892.56±0.57
对照组4311.02±1.8810.74±1.8614.11±1.952.43±0.46
t值0.1801.1870.8211.164
P值0.8580.2390.4140.248
联合组43治疗3个月经周期后6.86±1.61*7.02±0.75*6.07±1.01*0.57±0.15*
对照组437.62±1.56*7.94±0.81*8.43±1.23*0.96±0.19*
t值2.2235.4659.72410.565
P值0.0290.0000.0000.000
), ArticleFig(id=1322924031149744646, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=CN, label=表2, caption=

两组多囊卵巢综合征高雄激素血症患者治疗前、治疗3个月经周期后卵巢功能比较(±s)

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组别例数时间卵巢体积/(cm3)卵巢内卵泡数量/(个)月经周期评分/(分)
左侧右侧
联合组43治疗前10.95±1.7311.19±1.6513.77±1.892.56±0.57
对照组4311.02±1.8810.74±1.8614.11±1.952.43±0.46
t值0.1801.1870.8211.164
P值0.8580.2390.4140.248
联合组43治疗3个月经周期后6.86±1.61*7.02±0.75*6.07±1.01*0.57±0.15*
对照组437.62±1.56*7.94±0.81*8.43±1.23*0.96±0.19*
t值2.2235.4659.72410.565
P值0.0290.0000.0000.000
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组别例数时间T/(ng/mL)ASD/(nmol/L)LH/(IU/L)E2/(pg/mL)
联合组43治疗前0.82±0.154.67±1.1115.86±2.4362.79±6.68
对照组430.80±0.164.65±1.0716.15±2.5263.83±7.26
t值0.5980.0850.5430.691
P值0.5510.9320.5880.491
联合组43治疗3个月经周期后0.41±0.13*2.07±0.52*10.76±1.43*31.26±4.36*
对照组430.57±0.15*3.12±0.59*13.39±1.56*48.09±4.57*
t值5.2868.7558.14917.473
P值0.0000.0000.0000.006
), ArticleFig(id=1322924031279768072, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=CN, label=表3, caption=

两组多囊卵巢综合征高雄激素血症患者治疗前、治疗3个月经周期后生殖激素比较(±s)

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组别例数时间T/(ng/mL)ASD/(nmol/L)LH/(IU/L)E2/(pg/mL)
联合组43治疗前0.82±0.154.67±1.1115.86±2.4362.79±6.68
对照组430.80±0.164.65±1.0716.15±2.5263.83±7.26
t值0.5980.0850.5430.691
P值0.5510.9320.5880.491
联合组43治疗3个月经周期后0.41±0.13*2.07±0.52*10.76±1.43*31.26±4.36*
对照组430.57±0.15*3.12±0.59*13.39±1.56*48.09±4.57*
t值5.2868.7558.14917.473
P值0.0000.0000.0000.006
), ArticleFig(id=1322924031372042761, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间FPG/(mmol/L)FINS/(μU/mL)TG/(mmol/L)TC/(mmol/L)
联合组43治疗前6.47±0.8321.43(3.541.73±0.174.56±0.52
对照组436.31±0.9222.04(3.221.69±0.184.40±0.54
t值0.8470.8361.0591.400
P值0.4000.4060.2920.165
联合组43治疗3个月经周期后5.13±0.75*8.36±1.11*1.20±0.19*3.83±0.43*
对照组435.84±0.82*13.84±2.26*1.39±0.18*4.10±0.41*
t值4.19014.2724.7602.980
P值0.0000.0000.0000.004
), ArticleFig(id=1322924031443345930, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924023943930327, language=CN, label=表4, caption=

两组多囊卵巢综合征高雄激素血症患者治疗前、治疗3个月经周期后糖脂代谢比较(±s)

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组别例数时间FPG/(mmol/L)FINS/(μU/mL)TG/(mmol/L)TC/(mmol/L)
联合组43治疗前6.47±0.8321.43(3.541.73±0.174.56±0.52
对照组436.31±0.9222.04(3.221.69±0.184.40±0.54
t值0.8470.8361.0591.400
P值0.4000.4060.2920.165
联合组43治疗3个月经周期后5.13±0.75*8.36±1.11*1.20±0.19*3.83±0.43*
对照组435.84±0.82*13.84±2.26*1.39±0.18*4.10±0.41*
t值4.19014.2724.7602.980
P值0.0000.0000.0000.004
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化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的前瞻性研究
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贾金英 , 刘明珠 , 郭晓燕
中华中医药学刊 | 省级项目平台 2025,43(6): 192-195
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中华中医药学刊 |省级项目平台 2025 , 43 (6) : 192 -195
化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的前瞻性研究
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贾金英, 刘明珠, 郭晓燕
作者信息
  • 郑州大学第一附属医院,河南 郑州 450052
作者简介:

贾金英(1966-),女,河南郑州人,副主任医师,学士,研究方向:中西医结合妇科、肿瘤放化疗后不良反应的中医治疗。

Prospective Study of Huayu Xiaozhi Decoction(化瘀消癥汤)in Treatment of Polycystic Ovary Syndrome with Hyperandrogenemia
Jinying JIA, Mingzhu LIU, Xiaoyan GUO
Affiliations
  • The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.039
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目的

前瞻性研究化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的疗效。

方法

2022年10月—2023年10月郑州大学第一附属医院收治的多囊卵巢综合征高雄激素血症患者86例,随机纳入对照组(43例)与联合组(43例)。对照组予以屈螺酮炔雌醇片(Ⅱ)治疗,联合组采用屈螺酮炔雌醇片(Ⅱ)联合化瘀消癥汤治疗,均治疗3个月经周期。比较两组治疗3个月经周期后疗效,治疗前、治疗3个月经周期后糖脂代谢、生殖激素、卵巢功能,治疗期间不良反应发生情况。

结果

治疗3个月经周期后,联合组总有效率90.70%(39/43)相较对照组的总有效率72.09%(31/43)更高(P<0.05)。与治疗前比较,治疗3个月经周期后两组雄烯二酮(androstenedione,ASD)、空腹血糖(fasting blood glucose,FPG)、月经周期评分、卵巢内卵泡数量、卵巢体积,血清促黄体生成素(luteinizing hormone,LH)、总胆固醇(total cholesterol,TC)、睾酮(testosterone,T)、空腹胰岛素(fasting insulin,FINS)、雌激素(estrogen,E2)、甘油三酯(triglyceride,TG)水平均降低,且组间比较联合组更低(P<0.05)。两组不良反应发生率接近[9.30%(4/43)vs4.65%(2/43),P>0.05]。

结论

化瘀消癥汤治疗多囊卵巢综合征高雄激素血症,可调节生殖激素分泌,改善卵巢功能,控制糖脂代谢异常,提高疗效,安全性良好。

多囊卵巢综合征  /  高雄激素血症  /  化瘀消癥汤  /  生殖激素  /  卵巢功能  /  糖脂代谢  /  安全性
Objective

To investigate the curative effect of Huayu Xiaozhi Decoction(化瘀消癥汤)on polycystic ovary syndrome with hyperandrogenemia prospectively.

Methods

From October 2022 to October 2023,86 patients with hyperandrogenemia of polycystic ovary syndrome of The First Affiliated Hospital of Zhengzhou University were divided into the control group(43 cases)and the combination group(43 cases)randomly.The control group was treated with drospirenone ethinylestradiol tablets(Ⅱ),and the combination group was treated with drospirenone ethinylestradiol tablets(Ⅱ)combined with Huayu Xiaoshi Decoction for 3 menstrual cycles.The efficacy of the two groups after 3 menstrual cycles,glucose and lipid metabolism,reproductive hormone,ovarian function before and after 3 menstrual cycles,and the occurrence of adverse reactions during treatment were compared.

Results

After 3 menstrual cycles,the total effective rate(90.70%,39/43)in the combination group was higher(P<0.05).Compared with those before treatment,menstrual cycle score,ovarian follicle number,ovarian volume,the levels of serum luteinizing hormone(LH),estrogen(E2),testosterone(T),androstenedione(ASD),fasting blood glucose(FPG),fasting insulin(FINS),triglyceride(TG)and total cholesterol(TC)decreased in both groups after 3 menstrual cycles,and the difference between two groups was lower than that in the combination group(P<0.05).The incidence of adverse reactions was similar between the two groups[9.30%(4/43)vs 4.65%(2/43),P>0.05].

Conclusion

Huayu Xiaoshi Decoction in the treatment of polycystic ovary syndrome with hyperandrogenemia could regulate the secretion of reproductive hormone,improve the ovarian function,control the abnormal glucose and lipid metabolism,improve the efficacy and has good safety.

polycystic ovary syndrome  /  hyperandrogenemia  /  Huayu Xiaozhi Decoction(化瘀消癥汤)  /  reproductive hormone  /  ovarian  /  glycolipid metabolism  /  security
贾金英, 刘明珠, 郭晓燕. 化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的前瞻性研究. 中华中医药学刊, 2025 , 43 (6) : 192 -195 . DOI: 10.13193/j.issn.1673-7717.2025.06.039
Jinying JIA, Mingzhu LIU, Xiaoyan GUO. Prospective Study of Huayu Xiaozhi Decoction(化瘀消癥汤)in Treatment of Polycystic Ovary Syndrome with Hyperandrogenemia[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 192 -195 . DOI: 10.13193/j.issn.1673-7717.2025.06.039
多囊卵巢综合征高雄激素血症为临床常见生殖系统疾病,群体患病率为6% ~20%,多发于育龄妇女,主要发病机制为内分泌与代谢异常,疾病表现为卵巢功能紊乱,从而引发排卵异常、月经稀发或闭经,可严重影响女性整体健康[1-2]。屈螺酮炔雌醇片(Ⅱ)为生殖系统的性激素调节剂,在多囊卵巢综合征高雄激素血症中应用广泛,但不良反应较多,且停药后易复发[3-4]。多囊卵巢综合征高雄激素血症中医学中病机为“痰挟瘀血,遂成窠囊”,痰凝血瘀,冲任失调为其主要病机,被纳入“月经后期”“闭经”“不孕”等范畴,化瘀血、祛痰湿为其治疗宗旨[5]。化瘀消癥汤出自《名医治验良方》,由周霭祥教授制定,有活血化瘀之效,多应用于子宫肌瘤、子宫内膜异位合并不孕的治疗,但目前化瘀消癥汤治疗多囊卵巢综合征高雄激素血症患者疗效及机制尚未完全明确。本研究纳入多囊卵巢综合征高雄激素血症患者86例,旨在研究化瘀消癥汤治疗多囊卵巢综合征高雄激素血症的效果,报道如下。
2022年10月—2023年10月郑州大学第一附属医院收治的多囊卵巢综合征高雄激素血症患者86例,以随机数字表为依据纳入对照组(43例)与联合组(43例)。联合组年龄21~40岁,平均(28.13±1.63)岁;病程6~34个月,平均(24.85±3.23)个月;已婚30例,未婚13例;身体质量指数(body mass index,BMI)19~29 kg/m2,平均(25.04±1.13)kg/m2。对照组年龄20~40岁,平均(27.89±1.87)岁;病程6~35个月,平均(25.02±3.15)个月;已婚28例,未婚15例;BMI 19~27 kg/m2,平均(24.92±1.25)kg/m2。联合组、对照组一般资料均衡可比(P>0.05)。临床试验方案经本院医院伦理委员会审核批准(伦理批号:2022-KY-1140-002)。
西医诊断符合《多囊卵巢综合征中国诊疗指南》[6]中多囊卵巢综合征相关诊断标准,排卵减少,并经超声检测确诊,临床和(或)生化有高雄激素血症表现,同时未合并其他可能产生高雄激素血症疾病。
符合《中医病证诊断疗效标准》[7]中“痰瘀互结证”标准,主症必备,包括月经推迟,或量少,色黯或夹有血块,或闭经,或婚久不孕,或胸胁满闷、神疲嗜睡;次症具备1项以上,包括经行小腹胀痛拒按,块下痛减,多毛、痤疮。舌黯红边有瘀点,脉弦细。
符合以上中西医诊断者;无子宫手术史者;初治多囊卵巢综合征高雄激素血症者;18~40岁者;签署知情同意书者等。
重要脏器功能障碍者;甲状腺、肾上腺疾患及糖尿病者;合并生殖道结构异常、染色体异常者;合并恶液质者;精神病者;严重血栓风险或病史者;对本研究用药不耐受者等。
予以屈螺酮炔雌醇片(Ⅱ)(Bayer Weimar GmbH und Co.KG,进口药品注册证号H20140972,成分:24片含有激素的浅粉色薄膜包衣片:每片含有0.02 mg炔雌醇和3 mg屈螺酮,4片不含激素的白色薄膜包衣片)。在月经来潮的第1天开始服用,1片/d,连续给药28 d为1个周期,连续给药3个月经周期。
采用屈螺酮炔雌醇片(Ⅱ)联合化瘀消癥汤治疗,屈螺酮炔雌醇片(Ⅱ)应用方法同对照组,化瘀消癥汤方剂用中药配方颗粒(广州一方药业)组成:桃仁6 g,枳壳9 g,红花12 g,制香附6 g,玄参15 g,三棱5 g,莪术5 g,川牛膝15 g,山药15 g,土鳖虫6 g,半枝莲12 g,鸡内金6 g,水蛭5 g。加入开水搅拌溶解,分早、晚两次饭后1 h左右服用,1剂/d。两组均治疗3个月经周期。
治疗3个月经周期后,参照《中医病证诊断疗效标准》评价疗效,总有效率(%)=(1-无效例数/总例数)×100%。治愈:月经推迟,或量少,色黯、多毛,痤疮等症状消失,月经周期、生殖激素复常,或患者已受孕;显效:月经推迟,或量少,色黯、多毛,痤疮等症状明显改善,月经周期、生殖激素基本恢复正常,或恢复排卵;有效:月经推迟,或量少,色黯、多毛,痤疮等症状改善不明显,排卵不正常,月经可自主来潮(但未持续3个月),未见妊娠;无效:症状无改善,排卵及月经未恢复。
卵巢形态采用GE-E10型超声仪(美国GE公司),选择月经干净2~5 d检查,已婚者经阴道超声,未婚者经直肠超声,闭经者口服黄体酮撤药出血后检查[黄体酮胶囊(国药准字H20041902,浙江仙琚制药股份有限公司,50 mg/粒)100 mg/次,2次/d,连服5 d]分析卵巢体积、卵巢内卵泡数量。通过月经周期评分评估卵巢周期性变化,得分范围为0~8分,得分越高患者月经周期越长[8]。治疗前、治疗3个月经周期后各检测1次。
取患者空腹静脉血3 mL,3500 r/min离心10 min,得血清,通过酶联免疫化学发光检测促黄体生成素(luteinizing hormone,LH)、血清睾酮(testosterone,T)、雌激素(estrogen,E2)水平(美国贝克曼库尔特公司),化学发光试剂盒检测雄烯二酮(androstenedione,ASD)水平(美国西门子医疗系统股份有限公司)。治疗前、治疗3个月经周期后各检测1次。
通过罗氏Cobas8000型全自动生化免疫分析仪检测空腹血糖(fasting blood glucose,FPG)水平、血清甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)水平(德国罗氏公司);通过化学发光微粒子免疫检测法检测空腹胰岛素(fasting insulin,FINS)水平(美国西门子医疗系统股份有限公司)。治疗前、治疗3个月经周期后各检测1次。
比较治疗期间不良反应发生情况。
使用SPSS26.0统计软件进行分析。计数、计量资料以例(%)、表示,χ2/校正χ2检验、配对/独立样本t检验比较。P<0.05,表示差异具有统计学意义。
治疗3个月经周期后,联合组总有效率90.70%相较对照组的总有效率72.09%更高(P<0.05)。见表1。
与治疗前比较,治疗3个月经周期后两组月经周期评分、卵巢内卵泡数量、卵巢体积均降低,且组间比较联合组更低(P<0.05)。见表2。
与治疗前比较,治疗3个月经周期后两组血清T、ASD、LH、E2水平降低,且组间比较联合组更低(P<0.05)。见表3。
与治疗前比较,治疗3个月经周期后,两组血清FPG、FINS、TG、TC水平降低,且组间比较联合组更低(P<0.05)。见表4。
治疗期间,两组产生不良的反应均未影响治疗的进行,联合组出现胃肠道反应2例、胸闷1例、皮疹0例、口干1例,对照组出现胃肠道反应1例、胸闷0例、皮疹0例、口干1例,两组不良反应发生率接近(9.30% vs 4.65%,校正χ2 =0.179,P=0.672)。
随着饮食结构改变及生活压力增加,多囊卵巢综合征高雄激素血症发病率有上升的倾向,目前临床发病率可达到5%,发病机制为人体内雄性激素分泌过多,可使得患者出现脱发、痔疮及多毛等情况;改善卵泡质量,建立正常月经周期,为多囊卵巢综合征高雄激素血症临床治疗的宗旨[9-11]。目前多囊卵巢综合征高雄激素血症多采用能够阻断雄激素受体并减少雄激素合成的药物治疗,如屈螺酮炔雌醇片(Ⅱ),但患者治疗周期较长,且长期应用后容易出现雄激素波动、肝毒性等情况,临床亟需探究更为有效治疗方案[12-14]。本研究将化瘀消癥汤应用于多囊卵巢综合征高雄激素血症的治疗,取得一定成果。
多囊卵巢综合征高雄激素血症在中医理论中无对应病名,多认为其发病与肾虚、肝郁、脾虚密切相关,痰浊、瘀血为其主要病理产物,痰浊及瘀血壅塞胞宫胞脉,血海蓄溢受阻而见月经后期或停闭,痰浊及瘀血皆为阴邪,又互为因果,治疗要以化瘀、祛湿及补肾为主[15-17]。化瘀消癥汤方中三棱止痛消积、行气破血,莪术止痛破瘀、解郁行气,共为君药,相须为用,可强化其消癥化瘀、行气止痛的效果;红花通经活血,桃仁祛瘀活血,土鳖虫逐瘀破血,水蛭消积聚、祛肿散湿,共为臣药,可助君药化瘀消癥,又有软坚散结、活血通络之效;制香附止痛调经,玄参散结解毒,川牛膝补肝肾,半枝莲祛瘀活血,众多化瘀药同服,又恐伤胃气,加枳壳消胀行滞、山药解毒清热、鸡内金健脾益气,以上共为佐药,化瘀解毒而不伤正气,全方共奏消癥软坚、化瘀活血之效,可祛除患者瘀血、痰湿,改善卵巢异常增大,促进月经周期恢复[18-20]。本研究中,化瘀消癥汤治疗多囊卵巢综合征高雄激素血症,改善卵巢功能,可提高疗效,安全性良好。幸星婷等[21]研究亦指出,加用中药并未增加多囊卵巢综合征高雄激素血症不良反应,且可提高治疗效果,与本研究结果相互印证。糖脂代谢异常及下丘脑-垂体-卵巢轴调节功能异常为多囊卵巢综合征高雄激素血症发生的基础病因[22-23]。本研究中,化瘀消癥汤治疗多囊卵巢综合征高雄激素血症,可调节生殖激素分泌,控制糖脂代谢异常。分析其原因为,三棱-莪术药为临床常用活血化瘀类药对,含有挥发油及皂苷类成分,可抗血栓,抑制血液高凝状态的作用,促进血液循环,还具有抗雌激素依赖的效果,能有效抑制结缔组织再生[24-25];山药所含肽及蛋白质,具有增强机体抗氧化能力,进而调控下丘脑-垂体-肾上腺素轴,影响雌激素转化,调节性激素分泌[26-27];枳壳中的黄酮苷类物质可抑制脂质过氧化,抑制脂肪生成相关的基因,调节脂质代谢、逆转高脂饮食导致的肠道菌群失调,进而调节糖脂代谢,最终改善多囊卵巢综合征高雄激素血症病情进展[28-30]。
综上,化瘀消癥汤治疗多囊卵巢综合征高雄激素血症,可调节生殖激素分泌,改善卵巢功能,控制糖脂代谢异常,提高疗效,安全性良好。但本研究纳入研究对象均为本院患者,且为近期疗效观察研究,未进行随访观察,临床可行进一步研究分析化瘀消癥汤治疗多囊卵巢综合征高雄激素血症患者的效果。
  • 河南省高等学校重点科研计划项目(24A360024)
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doi: 10.13193/j.issn.1673-7717.2025.06.039
  • 首发时间:2026-10-30
  • 出版时间:2025-06-10
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河南省高等学校重点科研计划项目(24A360024)
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    郑州大学第一附属医院,河南 郑州 450052
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2种不同金属材料的力学参数
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genus
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species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
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Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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