滋肾疏肝方治疗肾虚肝郁证围绝经期综合征的效果分析

Analysis of the effect of Zishen Shugan Decoction in treating perimenopausal syndrome with kidney deficiency and liver stagnation syndrome

摘要:

目的 探讨滋肾疏肝方对肾虚肝郁证围绝经期综合征的疗效。方法 选取2022年7月—2024年5月天津市中医药研究院附属医院收治的78例围绝经期综合征患者，随机分为对照组和观察组，各39例。对照组采取雌孕激素序贯治疗，观察组采取滋肾疏肝方治疗。治疗4周后，比较两组的中医症候评分、围绝经期症状综合评分［改良围绝经期Kupperman指数（KI）、绝经评定量表（MRS）］、性激素（雌激素、促卵泡激素、睾酮）、神经递质［5-羟色胺（5-HT）、去甲肾上腺素（NE）、多巴胺（DA）］、疗效及不良反应。结果 观察组治疗前后经期紊乱、潮热汗出、烦躁易怒、腰膝酸软、心悸不安、烦躁失眠、健忘抑郁、性欲减退评分、KI评分、MRS评分、雌激素、促卵泡激素、睾酮、5-HT、NE、DA水平的差值均大于对照组（P <0.05）。观察组治疗总有效率高于对照组（P <0.05）。结论 滋肾疏肝方治疗肾虚肝郁型围绝经期综合征，有助于调节患者的性激素及神经递质，减轻临床症状，疗效及安全性良好。

Abstract:

Objective To explore the effect of Zishen Shugan Decoction in the treatment of perimenopausal syndrome with kidney deficiency and liver stagnation syndrome.Methods A total of 78 patients with perimenopausal syndrome admitted to the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine Sciences from July 2022 to May 2024 were selected and randomly divided into a control group and an observation group, with 39 cases in each group. The control group received sequential estrogen-progestogen therapy (EPT), and the observation group received Zishen Shugan Decoction. After 4 weeks of treatment, the traditional Chinese medicine (TCM) symptom scores, comprehensive perimenopausal symptom scores [modified Kupperman Index (KI) for perimenopause, Menopause Rating Scale (MRS) ], sex hormones (estrogen, follicle-stimulating hormone, testosterone), neurotransmitters [5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA) ], efficacy and adverse reactions were compared between the two groups.Results The differences in scores of menstrual disorder, hot flashes and sweating, irritability, soreness of waist and knees, palpitations, irritability and insomnia, forgetfulness and depression, loss of libido, KI score, MRS score, as well as levels of estrogen (E2), follicle-stimulating hormone (FSH), testosterone (T), 5-HT, NE and DA in the observation group before and after treatment were all greater than those in the control group (P <0.05). The total effective rate of treatment in the observation group was higher than that in the control group (P <0.05).Conclusion Zishen Shugan Decoction is effective in treating perimenopausal syndrome with kidney deficiency and liver stagnation syndrome. It helps regulate sex hormones and neurotransmitters in patients, alleviate clinical symptoms, and has good efficacy and safety.