补肾益气活血方治疗卵巢储备功能低下的临床疗效

Jing ZHOU; Xin-yao PAN; Jin LIN; Qi ZHOU; Li-kun LAN; Jun ZHU; Ru DUAN; Lan WANG; Yan SUN; Ling WANG

doi:10.1007/s11655-020-3484-x

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补肾益气活血方治疗卵巢储备功能低下的临床疗效

Original Article | Updated：2022-03-18

- 补肾益气活血方治疗卵巢储备功能低下的临床疗效
- Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve:A Randomized Controlled Trial
- Chinese Journal of Integrative Medicine 2022年28卷第3期页码：195-201
- Affiliations：
  
  1.Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College,Fudan University, Shanghai (200000), China
  2.Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai (200000), China
  3.Academy of Integrative Medicine of Fudan University, Shanghai (200000), China
  4.Yangpu Hospital of Traditional Chinese Medicine, Shanghai(200000), China
  5.Second Affiliated Hospital of Hexi University,Zhangye, Gansu Province (743000), China
  6.Department of Obstetrics and Gynecology, Wenling People's Hospital,Wenzhou Medical University, Wenzhou, Zhejiang Province(325000), China
  7.Regulatory Commission Office of the New Cooperative Medical Scheme, Eryuan County, Dali, Yunnan Province (671000), China
- Author bio：
  
  Prof. WANG Ling, E-mail: dr.wangling@fudan.edu.cn
- Funds：
  
  the 2018 Program to Guide Medicine of the Shanghai Municipal Science and Technology Commission(18401902200);Special Project of the China Resources Sanjiu Medical and Pharmaceutical Co. and the Obstetrics &Gynecology Special Committee, the Chinese Association for the Integration of Traditional and Western Medicine(CR1901FC01)
- DOI：10.1007/s11655-020-3484-x
  中图分类号：
- 纸质出版日期：2022-03-01，
  
  网络出版日期：2021-01-09，
  
  录用日期：2020-03-23
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Jing ZHOU, Xin-yao PAN, Jin LIN, 等. 补肾益气活血方治疗卵巢储备功能低下的临床疗效[J]. Chinese Journal of Integrative Medicine, 2022,28(3):195-201.

Jing ZHOU, Xin-yao PAN, Jin LIN, et al. Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve:A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(3):195-201.
Jing ZHOU, Xin-yao PAN, Jin LIN, 等. 补肾益气活血方治疗卵巢储备功能低下的临床疗效[J]. Chinese Journal of Integrative Medicine, 2022,28(3):195-201. DOI： 10.1007/s11655-020-3484-x.

Jing ZHOU, Xin-yao PAN, Jin LIN, et al. Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve:A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(3):195-201. DOI： 10.1007/s11655-020-3484-x.

摘要

目的:

探索补肾益气活血方治疗卵巢储备功能低下的临床疗效.

方法:

将2013年12月至2014年12月被诊断为卵巢储备功能低下的180例患者纳入本临床研究

分为补佳乐+达芙通 (E+D) 组 (n=60) 、左归丸组 (n=60) 和补肾益气活血方 (BYHD) 组 (n=60)

每组患者分别予补佳乐联合达芙通、左归丸、补肾益气活血方治疗12个月. 比较并分析三组患者治疗前后的卵泡刺激素 (FSH) 、黄体生成素 (LH) 、雌二醇 (E

) 、抗缪勒氏管激素 (AMH) 、窦卵泡数 (AFC) 、卵巢体积、子宫内膜厚度以及子宫和卵巢动脉血流阻力.

结果:

9例病例在研究过程中脱落 (E+D组4例

左归丸组3例

BYHD组2例) . 分别将三组患者治疗6个月和12个月后与治疗前的指标对比

左归丸组和BYHD组均出现了显著疗效

表现为FSH、LH降低

子宫内膜厚度、AMH增加 (

0.01) . BYHD组还较治疗前具有显著的E

升高、卵巢体积增大、卵巢动脉血流阻力降低 (

0.05) 以及窦卵泡数增加 (

0.01) . 治疗12个月后

BYHD组较左归丸组具有更显著的疗效

表现为FSH降低

卵巢体积和子宫内膜厚度增加 (

0.01)

但三组患者间的子宫动脉血流阻力没有明显差异; 此外

E+D组在治疗过程中仅显著增厚了患者的子宫内膜厚度 (

0.01) .

结论:

补肾益气活血方对卵巢储备功能低下的患者具有显著的临床疗效

其机制可能与调节内分泌激素水平、改善排卵以及影响子宫内膜功能有关. 在中医治疗中

补肾、益气、活血同时应用对治疗卵巢储备功能低下具有良好效果.

Abstract

Objective:

To explore the therapeutic effect of Bushen Yiqi Huoxue Decoction BYHD) in patients with diminished ovarian reserve (DOR).

Methods:

A total of 180 patients with DOR diagnosed from December 2013 to December 2014 were equally assigned into progynova and duphaston (E+D) group

Zuogui Pill group and BYHD group with 60 cases in each by computerized randomization. Patients received E+D

Zuogui Pill or BYHD for 12 months

respectively. Follicle stimulating hormone (FSH)

luteinizing hormone (LH)

estradiol (E

)

anti-Müllerian hormone (AMH)

antral follicle count (AFC)

ovarian volume

endometrial thickness

and the resistance indices (RIs) of ovarian arteries and uterine arteries were observed before and after treatment.

Results:

Nine women (4 from the E+D group

3 from the Zuogui Pill group

and 2 from the BYHD group) withdrew from the study. After 6 months

Zuogui Pill and BYHD significantly decreased FSH and LH and increased endometrial thickness and AMH (all

0.01). BYHD also resulted in E

elevation (

0.05)

ovary enlargement (

0.05)

AFC increase (

0.01)

and RI of ovarian arteries decrease (

0.05). After 12 months

further improvements were observed in the Zuogui Pill and BYHD groups (all

0.01)

but BYHD showed better outcomes

with lower FSH

larger ovaries and a thicker endometrium compared with the Zuogui Pill group (all

0.01). However

E+D only significantly increased endometrial thickness (

0.01) and no significant improvements were observed in the RI of uterine arteries in the three groups.

Conclusions:

BYHD had a favorable therapeutic effect in patients with DOR by rebalancing hormone levels

promoting ovulation

and repairing the thin endometrium. The combination of tonifying Shen (Kidney)

benefiting qi and activating blood circulation may be a promising therapeutic strategy for DOR.

关键词

Keywords

Bushen Yiqi Huoxue Decoctiondiminished ovarian reserverandomized controlled trialChinese medicine

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