从“实”论治多囊卵巢综合征30例的临床分析

【作者】 李文春；

【导师】 张庆文；

【作者基本信息】 成都中医药大学 ， 中医妇科学， 2010， 硕士

【摘要】 目的：通过“从实论治”多囊卵巢综合征,分析中医学“从实论治”多囊卵巢综合征的疗效。方法：以跟师于2007年9月—2010年3月在成都中医药大学附属医院门诊所治的多囊卵巢综合征患者30例为观察对象,对治疗前后患者月经情况、妊娠情况、卵巢及卵泡、生殖激素水平、胰岛素抵抗等进行观察,分析临床疗效。结果：1.一般情况：本组患者平均年龄(24.9±4.7)岁。病程在2年以上的有23例(77.0%)。患者发病年龄多在26岁以下26例(87.0%)。30例患者中有生育要求者12例(40.0%),未生育的有25例(83.3%)。本组就诊前有21例(70.0%)曾接受过激素治疗。初诊时月经周期≤35天者6例(20.0%),36-60天者14例(46.7%),61天以上者10例(33.3%)。体重指数23以上患者的有14例(46.7%)。伴见痤疮的16例(53.0%),多毛的10例(33.0%)。本组患者中痰湿型占14例(47.0%),瘀血型占16例(53.0%)。本组有17例在治疗前监测卵巢体积,卵巢体积大于8以上有5例(17.0%)。治疗前有28例患者作了卵泡监测,中有4例有优势卵泡,双侧卵巢有卵泡(2—9mm)数十个以上的有23例(77.0%)。本组治疗前有27例患者查了生殖激素,其中有7例T升高,15例LH/FSH≥2。本组治疗前有14例查过胰岛素水平,其中有13例为胰岛素抵抗。2、疗效1)本组患者末次就诊时月经周期有7(23.3%)月经正常(≤35天)。30例患者有3例治疗1个月,9例治疗2月,18例治疗3月,18例患者中治疗后月经周期小于35天有6例(33.3%),36-60天的有7例(38.9%),61天以上的有5例(27.8%),追踪停药3个周期后其中有4例(22.0%)患者有规律月经来潮。2) 18例患者中有生育要求的有9例,治疗后有3例(33.0%)成功妊娠。3)治疗前后16例患者B超监测卵巢示,治疗后8例患者左卵巢体积减小,7例患者右卵巢体积减小,左右卵巢体积均减小的有5例,治疗前后卵巢体积统计显示治疗后卵巢体积明显减小(P>0.05),差异具无显著性,只是显示治疗后卵巢体积有下降趋势。24例患者治疗前后作了卵泡监测：治疗前有4例患者有优势卵泡,治疗后有15例有优势卵泡。以上资料统计结果提示,差异有显著性(P<0.05),从“实”论治多囊卵巢综合征有促进卵泡发育趋势。4) 9例患者做了治疗前后生殖激素检查,治疗前4例LH/FSH≥2,2例T超过正常值。治疗后复查结果示2例患者LH/FSH恢复正常,T均降至正常。5) 3例患者治疗前后检查胰岛素水平比较,INS、1hINS、2hINS、3hINS均有下降趋势。结论：通过治疗前后观察比较,初步认为从“实”论治多囊卵巢综合征,对改善月经情况、促进卵泡发育及妊娠等都有一定疗效。更多还原

【Abstract】 objectiveTo study of Treatment of polycystic ovary syndrome From the reality Analysis efficacy of Treatment of polycystic ovary syndrome From the realityMethodsSelecting 30 patients with PCOS from clinic of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from September 2007 to March 2010, analysis of clinical efficacy through observing symptomatic variation of Menstruation, pregnancy conditions, ovary and follicle, reproductive hormone levels, insulin resistance before and after treatment。Results1 in general:The average age of patients in this group is(24.9±4.7) years,23 cases (77%) patients falled ill in 2 years or more, Age of onset in patients of 26 cases (87%) less than 25 years of age。12 cases (40%) of 30 patients have requested birth,21 cases (70%) of 30 patients had received hormone treatment, Usual menstrual cycle of 27 patients (90%) in 30 patients surpass 35 days,18 cases ((60%)of 30 patients have Body mass index (≥22),16 cases (53%) of 30 patients view With acne,10 cases (33%) of 30 patients have Hairy,14 cases (47%)of 30 patients are phlegm-based, Blood stasis type accounted for 16 cases (53%) of 30 patientS。Before treatment,17 cases of The group has monitored ovarian volume: 5 patients (17%) of 17 cases have Ovarian volume (≥8),28 patients monitored follicular,4 patients had dominant follicle, Ovaries have follicles (2-9mm) of both ovaries in 23 cases (77%) of 30 patients come to dozens,27 patients of 30 patients Checked reproductive hormones, Testosterone of 7 cases 27 patients increased,15 cases 27 patients have Ratio of LH/FSH (≥2)。14 cases of 30 patients Checked insulin levels, Among them,13 cases are insulin resistance。2, effect1) The time of the last doctor in patients,10 patients (33.3%)have menstrual normal (≤35 days).3 cases of 30 patients treated 1 month, 9 cases treated 2 month 18 cases patients treated 3 months,6 cases patients (33.3%) have menstrual cycle less than 35 days after treated 7 patients (38.9%) have menstrual cycle of 36-60days, more than 61 days in 5 patients (27.8%) patients,4 (22%) patients have regular Menstruation, showed up after 3 cycles of stopping them。 2) 9 patients of 18 patients Asked fertility,3 patients (33%) pregnancied successfully after treatment3) Compared Ovarian volume of 16 patients before and after treatment, the volume of left ovary of 8 patients reduced, the right ovarian volume of 7 patients decreased, ovarian volume were reduced in 5 patients before and after treatment, Statistics of ovarian volume before and after treatment show that Ovarian volume was significantly reduced after treatment (P>0.05),24 patients monitor ed follicular before and after treatment:Before treatment,4 patients had dominant follicle, After treatment,15 patients had dominant follicle.4) 9 patients checked reproductive hormonesof treatment before and after, Before treatment, four cases patients have LH/FSH≥2, Testosterone of 2 cases patients get ahead of the normal。after treatment, Ratio of LH/FSH of 2 patients returned to normal, Testosterone of 2 cases patients returned to normal。5) compared insulin levels of 3 patients Before and after treatment, INS, 1hINS,2hINS,3hINS decreased significantly.Conclusionobservation and comparison through of the before and after treatment, the Treatment of Polycystic Ovary Syndrome from the "reality" can improve Menstruation and promotion follicular development and promotion pregnancy。更多还原