益气健脾方联合复方左炔诺孕酮对多囊卵巢综合征的临床疗效及对vaspin和leptin的影响

目的:研究益气健脾方联合复方左炔诺孕酮对多囊卵巢综合征(polycystic ovary syndrome,PCOS)的临床疗效及对丝氨酸蛋白酶抑制剂(visceral adipose tissue-derived serine protease inhibitor,vaspin)和瘦素(leptin)的影响。方法:选取2019年2月至2020年4月期间我院收治的80例PCOS患者,采用随机数字表法分为对照组和观察组,每组40例。对照组给予复方左炔诺孕酮片,观察组在对照组的基础上加服益气健脾方,治疗3个月经周期后对比两组患者的疗效。分别于治疗前后检测两组患者的激素水平、糖脂代谢指标及血清vaspin和leptin的水平。观察并记录两组患者治疗期间发生的不良反应。结果:治疗后观察组总有效率高于对照组(P<0.05)。治疗后两组患者的睾酮(testosterone, T)、促黄体生成素(luteinizing hormone, LH)和LH/促卵泡素(Follicle stimulating hormone, FSH)均显著降低(P<0.05),且观察组的T、LH和LH/FSH降低较为明显(P<0.05)。治疗后两组患者的空腹血糖(fasting blood glucose, FBG)、空腹胰岛素(fasting insulin, FINS)、Homa IR、总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)均显著降低,高密度脂蛋白(high-density lipoprotein cholesterol, HDL-C)显著升高(P<0.05),与对照组治疗后相比,观察组治疗后的FBG、FINS、Homa IR、TC、TG、LDL-C均较低,HDL-C较高(P<0.05)。治疗后vaspin和leptin均显著降低(P<0.05),且观察组治疗后的vaspin和leptin的表达水平较低(P<0.05)。两组患者不良反应总发生率无统计学差异(P>0.05)。结论:益气健脾方联合复方左炔诺孕酮可有效提高对PCOS的临床疗效,改善患者的激素水平及糖脂代谢指标,降低血清vaspin和leptin的水平,且不增加不良反应发生率。

Effect of Yiqi Jianpi Recipe Combined with Compound Levonorgestrel on the Expressions of Vaspin and Leptin in the Treatment of Polycystic Ovary Syndrome

Objective: To investigate the effect of Yiqi Jianpi Recipe combined with compound levonorgestrel on the expressions of vaspin and leptin in the treatment of polycystic ovary syndrome(PCOS). Methods: 80 patients with PCOS admitted to our hospital from February 2019 to April 2020 were randomly divived into the control group and observation group, with 40 cases each group. The control group was treated with compound levonorgestrel tablets, and the observation group was treated with Yiqi Jianpi Recipe combined with compound levonorgestrel tablets, the clinical efficacy of two groups were compared after 3 menstrual cycles’ treatments. The hormone levels, glucose and lipid metabolism indexes, serum vaspin and leptin of two groups were detected before and after the treatment. The adverse reactions of all patients were recorded during the treatment. Results: The total efficacy rate of observation group was higher than control group(P<0.05). The expression levels of T, LH and LH/FSH of two groups were significantly decreased after the treatment(P<0.05), and the observation group was lower compared with control group(P<0.05). After the treatment, the FBG, FINS, Homa IR, TC,TG and LDL-C of two groups were decreased while HDL-C were increased(P<0.05), as compared with control group, the FBG, FINS,Homa IR, TC, TG and LDL-C of observation group were lower while HDL-C was higher(P<0.05). The serum vaspin and leptin of two groups were decreased after the treatment(P<0.05), and the observation group was lower comparing with control group(P<0.05). The incidence of adverse reactions of two groups had no significant difference(P >0.05). Conclusion: Yiqi Jianpi Recipe combined with compound levonorgestrel could further increase the curative effect in the treatment of PCOS, the hormone levels and indexes of glucose and lipid metabolism were improved, the serum vaspin and leptin were decreased, and the incidence of adverse reactions were not increased.