2022 年第 12 期 第 17 卷

自拟祛痰化瘀汤治疗多囊卵巢综合征合并冠状动脉微循环障碍的效果观察

Effect of self-made Qutan Huayu decoction on the treatment of polycystic ovary syndrome complicated with coronary microvascular dysfunction

作者：邵昱玮1蒋姗姗2王亚静2庞俏燕2

英文作者：Shao Yuwei1 Jiang Shanshan2 Wang Yajing2 Pang Qiaoyan2

单位：1广西中医药大学基础医学院，南宁530000；2广西中医药大学附属瑞康医院妇科，南宁530011

英文单位：1Basic Medicine College Guangxi University of Chinese Medicine Nanning 530000 China; 2Department of Gynecology Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine Nanning 530011 China

关键词：多囊卵巢综合征；冠状动脉微循环障碍；祛痰化瘀汤

英文关键词：Polycysticovarysyndrome;Coronarymicrovasculardysfunction;QutanHuayudecoction

• 摘要：

• 目的  观察自拟祛痰化瘀汤治疗多囊卵巢综合征（PCOS）合并冠状动脉微循环障碍（CMVD）的效果。方法  选取广西中医药大学附属瑞康医院2018年6月至2021年6月收治的PCOS合并CMVD患者84例，根据随机数字表法分为对照组和观察组，各42例。对照组给予常规心血管药物及调经治疗；观察组在对照组基础上给予自拟祛痰化瘀汤治疗。比较2组治疗前后中医证候评分、血脂、性激素、血管内皮功能指标水平、微循环阻力指数(IMR)及冠状动脉血流储备分数（FFR）。结果  治疗后，2组中医证候评分均低于治疗前，且观察组均低于对照组（均P＜0.05）。2组三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平均低于治疗前，且观察组均低于对照组，高密度脂蛋白胆固醇水平均高于治疗前，且观察组高于对照组（均P＜0.05）。2组血清卵泡刺激素、黄体生成素、睾酮水平均低于治疗前，且观察组均低于对照组［（5.1±0.9）U/L比（6.2±1.0）U/L、（5.2±1.3）U/L比（7.9±2.9）U/L、（0.26±0.04）μg/L比（0.41±0.16）μg/L］，雌二醇、抗米勒管激素水平均高于治疗前，且观察组均高于对照组［（113±30）ng/L比（99±24）ng/L、（5.5±1.3）μg/L比（3.9±1.0）μg/L］（均P＜0.05）。2组血清血管紧张素Ⅱ、内皮素1水平均低于治疗前，且观察组均低于对照组，一氧化氮水平均高于治疗前，且观察组高于对照组（均P＜0.05）。2组IMR均低于治疗前，且观察组低于对照组，2组FFR均高于治疗前，且观察组高于对照组（均P＜0.05）。观察组总有效率高于对照组（P=0.024）。结论  自拟祛痰化瘀汤可降低PCOS合并CMVD患者血脂水平，改善性激素水平、血管内皮功能及微血管功能，临床疗效显著。

• Objective  To observe the effect of self-made Qutan Huayu decoction on the treatment of polycystic ovary syndrome (PCOS) complicated with coronary microvascular dysfunction (CMVD). Methods  A total of 84 patients with PCOS and CMVD admitted to Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from June 2018 to June 2021 were enrolled. Patients were randomly divided into control group and observation group, with 42 cases in each group. The control group received conventional cardiovascular drugs and menstrual regulation treatment. The observation group was treated with self-made Qutan Huayu decoction on the basis of the control group. The scores of traditional Chinese medicine syndromes, serum lipid, sex hormone, vascular endothelial function indexes, microcirculation resistance index (IMR) and coronary fractional flow reserve (FFR) were compared between the two groups before and after treatment. Results  After treatment, scores of traditional Chinese medicine syndromes in both groups were lower than those before treatment, and the scores in the observation group were lower than those in the control group(all P<0.05). Levels of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group; levels of high-density lipoprotein cholesterol in both groups were higher than those before treatment, and the level in the observation group was higher than that in the control group(all P<0.05). Levels of follicle stimulating hormone, luteinizing hormone and testosterone in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group［（5.1±0.9）U/L vs （6.2±1.0）U/L,（5.2±1.3）U/L vs （7.9±2.9）U/L,（0.26±0.04）μg/L vs （0.41±0.16）μg/L］; levels of estradiol and anti-Müllerian hormone in both groups were higher than those before treatment and the levels in the observation group were higher than those in the control group［（113±30）ng/L vs （99±24）ng/L,（5.5±1.3）μg/L vs （3.9±1.0）μg/L］(all P<0.05). Serum levels of angiotensin Ⅱ and endothelin-1 in both groups were lower than those before treatment and the levels in the observation group were lower than those in the control group; levels of nitric oxide in both groups were higher than those before treatment and that in the observation group was higher than that in the control group(all P<0.05). IMR in both groups were lower than those before treatment and IMR in the observation group was lower than that in the control group; FFR in both groups were higher than those before treatment and FFR in the observation group was higher than that in the control group(all P<0.05). The total effective rate in the observation group was higher than that in the control group(P=0.024). Conclusions  The self-made Qutan Huayu decoction can reduce the blood lipid level, improve the sex hormone level, vascular endothelial function and microvascular function in patients with PCOS complicated with CMVD. The clinical effect is significant.