标题：疏肝健脾方加减治疗PCOS所致不孕症患者的疗效及对PRL、FSH、P水平的影响

      作者：李骊 1，赵瑶 1，杨喜平 2，雷姝 1，张绒 3    1.宝鸡市妇幼保健院药剂科，陕西 宝鸡 721000；2.宝鸡市天健医院中医科，陕西 宝鸡 721000；3.宝鸡市天健医院妇科，陕西 宝鸡 721000

      卷次： 2023年34卷22期

      【摘要】 目的 观察疏肝健脾方加减治疗多囊卵巢综合征(PCOS)所致不孕症患者的疗效，并探讨其对患者催乳素(PRL)、促卵泡生长激素(FSH)、孕酮(P)水平的影响。方法 选择2018年10月至2022年10月宝鸡市妇幼保健院收治的80例因PCOS所致不孕症患者为研究对象，根据随机数表法将患者分为观察组和对照组，每组40例。对照组患者采用克罗米芬治疗，观察组患者采用克罗米芬联合疏肝健脾方加减治疗，一个月经周期为1个疗程，均连续治疗3个疗程。比较两组患者的疗效，以及治疗前后的PRL、FSH、P水平及排卵情况，并统计两组患者的不良反应发生情况。结果 观察组患者的治疗总有效率为 97.50%，明显高于对照组的 82.50%，差异有统计学意义(P<0.05)；治疗前，两组患者的PRL、FSH、P水平比较差异均无统计学意义(P>0.05)，治疗后，两组患者的P水平均显著升高，且观察组为(15.31±2.11) ng/mL，明显高于对照组的(12.10±2.09) ng/mL，而PRL、FSH水平均显著降低，且观察组分别为(12.31±2.16) IU/L、(3.46±0.82) IU/L，明显低于对照组的(16.31±1.98) IU/L、(5.14±1.01) IU/L，差异均有统计学意义(P<0.05)；治疗前，两组患者的成熟卵泡数、排卵数比较差异均无统计学意义(P>0.05)，治疗后，两组患者的成熟卵泡数、排卵数均显著升高，且观察组分别为(3.89±0.12)个、(4.13±0.89)个，明显高于对照组的(2.31±0.42)个、(2.98±0.78)个，差异均有统计学意义(P<0.05)；观察组患者的不良反应总发生率为7.50%，略低于对照组的12.50%，但差异无统计学意义(P>0.05)。结论 疏肝健脾方加减治疗PCOS所致不孕症可以有效调节患者的性激素水平，促进排卵，临床应用效果显著，且安全性较高，具有临床应用价值。
      【关键词】 多囊卵巢综合征；不孕症；疏肝健脾方；催乳素；促卵泡生长激素；孕酮；不良反应
      【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2023）22—3262—04

Clinical efficacy of modified Shugan Jianpi Formula on infertility caused by polycystic ovary syndrome and itseffect on prolactin, follicle growth hormone, and progesterone levels.
LI Li 1, ZHAO Yao 1, YANG Xi-ping 2, LEI Shu 1,ZHANG Rong 3. 1. Department of Pharmacy, Baoji Maternal and Child Health Care Hospital, Baoji 721000, Shaanxi,CHINA; 2. Department of Traditional Chinese Medicine, Baoji Tianjian Hospital, Baoji 721000, Shaanxi, CHINA; 3.Department of Gynecology, Baoji Tianjian Hospital, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical efficacy of modified Shugan Jianpi Formula on infertility causedby polycystic ovary syndrome (PCOS) and its effect on the levels of prolactin (PRL), follicle growth hormone (FSH),and progesterone (P). Methods A study was conducted on 80 patents of infertility caused by PCOS admitted to BaojiMaternal and Child Health Hospital from October 2018 to October 2022, which were divided into two groups using arandom number table method, with 40 patents in each group. The patents in the control group were treated with clomi-phene, and those in the observation group were treated with clomiphene+Shugan Jianpi formula. After 3 courses of treat-ment (one menstrual cycle as one course of treatment), the efficacy of the two groups were compared, the levels of PRL,FSH, P, and ovulation status before and after treatment were recorded, and the occurrence of adverse reactions in the twogroups were counted. Results The total effective rate in the observation group was 97.50%, which was significantlyhigher than 82.50% in the control group (P<0.05). Before treatment, there was no statistically significant difference in thelevels of PRL, FSH, and P between the two groups of patients (P>0.05). After treatment, the P levels in both groups in-creased, and the level in the observation group was significantly higher than that in the control group: (15.31±2.11) ng/mLvs (12.10±2.09) ng/mL; PRL and FSH decreased in both groups, and the levels in the observation group were (12.31±2.16) IU/L and (3.46±0.82) IU/L, significantly lower than (16.31±1.98) IU/L and (5.14±1.01) IU/L in the control group;the differences were statistically significant difference (P<0.05). Before treatment, there was no statistically significantdifference in the number of mature follicles and ovulation between the two groups of patients (P>0.05). After treatment, thenumber of mature follicles and ovulation in both groups increased, and the numbers in the observation group were signifi-cantly higher than those in the control group: (3.89±0.12) vs (2.31±0.42), (4.13±0.89) vs (2.98±0.78), both P<0.05. Therewas no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Themodified Shugan Jianpi Formula in the treatment of infertility caused by PCOS can effectively regulate the level of sexhormone and promote ovulation, which was high safety and can be popularized.
      【Key words】 Polycystic ovary syndrome; Infertility; Shugan Jianpi Formula; Prolactin; Follicle-stimulating hor-mone; Progesterone; Adverse reactions