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目的观察断藤益母汤对育龄期女性类风湿关节炎患者卵巢储备功能的影响。方法将60例育龄期女性类风湿关节炎患者随机分为试验组和对照组各30例。试验组给予断藤益母汤,每日1剂;对照组给予甲氨蝶呤片,每次10 mg,每周1次。两组疗程均为3个月经周期。比较两组治疗后月经情况,治疗前后检测血清促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、抗苗勒氏管激素(AMH)水平及子宫内膜厚度、子宫及卵巢体积、窦状卵泡数、子宫及卵巢动脉阻力指数。结果试验组月经紊乱率明显高于对照组(P<0.01);治疗后试验组FSH、LH水平较治疗前显著升高,E2、AMH显著降低(P<0.01),对照组治疗前后FSH、LH、E2、AMH水平无明显变化(P>0.05);试验组治疗后FSH、LH、E2、AMH水平与对照组比较,差异有统计学意义(P<0.05)。试验组窦状卵泡数阻力指数、卵巢动脉阻力指数较对照组升高(P<0.05)。结论断藤益母汤能降低育龄期女性类风湿关节炎患者卵巢储备功能,临床应慎用。
Objective To observe the effect of Zhiteng Yimu Decoction on ovarian reserve function in rheumatoid arthritis patients of women of childbearing age. Methods Sixty rheumatoid arthritis patients of childbearing age were randomly divided into experimental group and control group with 30 cases each. The test group was given Zhiteng Yimu Decoction, one daily; the control group was given methotrexate tablets, 10 mg each time, once a week. Both courses of treatment were 3 menstrual cycles. Menses were compared after treatment. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-Mullerian hormone (AMH), and endometrial thickness were measured before and after treatment. , Uterus and ovarian volume, sinusoidal follicle count, uterine and ovarian artery resistance index. Results The menstrual disturbance rate in the experimental group was significantly higher than that in the control group (P<0.01). After treatment, the levels of FSH and LH in the experimental group were significantly higher than those before treatment, and E2 and AMH were significantly decreased (P<0.01). Before and after treatment, the control group was treated with FSH and LH. The levels of E2 and AMH did not change significantly (P>0.05). The levels of FSH, LH, E2, and AMH in the experimental group were significantly lower than those in the control group (P<0.05). The sinusoidal follicle resistance index and ovarian artery resistance index in the experimental group were higher than those in the control group (P<0.05). Conclusion “Juantan Yimu Decoction” can reduce ovarian reserve in rheumatoid arthritis patients of child-bearing age and should be used with caution.