目的 探討坤靈丸聯(lián)合地屈孕酮片治療多囊卵巢綜合征所致月經(jīng)不調(diào)的臨床療效。方法 選擇2018年9月—2019年9月在洛陽市中醫(yī)院治療的104例多囊卵巢綜合征所致月經(jīng)不調(diào)患者，根據(jù)用藥的區(qū)別分為對照組和治療組，每組各52例。對照組患者口服地屈孕酮片，從月經(jīng)周期的第11天開始直到第25天，10 mg/次，2次/d；治療組在對照組基礎(chǔ)上口服坤靈丸，15丸/次，2次/d。所有患者均連續(xù)治療3個月經(jīng)周期。觀察兩組患者臨床療效，比較治療前后兩組患者痤瘡綜合分級系統(tǒng)（GAGS）評分、月經(jīng)失血圖（PBAC）評分、改良F-G多毛評分法（F-G）和基礎(chǔ)體溫（HPS）評分及臨床癥狀改善時間和性激素水平。結(jié)果 治療后，總有效率方面治療組顯著優(yōu)于對照組（98.08% vs 82.69%，P<0.05）。治療后，治療組GAGS、PBAC、F-G和HPS評分均要優(yōu)于對照組（P<0.05）。治療后，治療組在經(jīng)期恢復(fù)正常時間、經(jīng)量恢復(fù)正常時間、經(jīng)色恢復(fù)正常時間、神疲乏力消失時間、肥胖改善時間上均優(yōu)于對照組（P<0.05）。經(jīng)治療，兩組血清促黃體生成激素（LH）、促卵泡生成激素（FSH）、睪酮（T）水平均顯著降低（P<0.05），且治療組降低更明顯（P<0.05）。結(jié)論 坤靈丸聯(lián)合地屈孕酮片治療多囊卵巢綜合征所致月經(jīng)不調(diào)不僅可提升臨床有效率并改善臨床癥狀，還可促進(jìn)性激素水平改善，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Kunling Pills combined with dydrogesterone in treatment of irregular menstruation caused by polycystic ovary syndrome. Methods Patients (104 cases) with irregular menstruation caused by polycystic ovary syndrome in Luoyang Hospital of TCM from September 2018 to September 2019 were divided into control and treatment groups based on different treatments, and each group had 52 cases. Patients in the control group were po administered with Dydrogesterone Tablets from the 11th day of the menstrual cycle to the 25th day, 10 mg/time, twice daily. Patients in the treatment group were po administered with Kunling Pills on the basis of the control group, 15 pills/time, twice daily. Patients in two groups were treated for 3 menstrual cycle. After treatment, the clinical efficacy was evaluated, and the scores of GAGS, PBAC, F-G and HPS, the improvement time of clinical symptoms, and the sex hormone levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly better than that of the control group (98.08% vs 82.69% P<0.05). After treatment, the scores of GAGS, PBAC, F-G and HPS in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the treatment group was significantly superior to the control group in menstrual recovery time, menstrual volume recovery time, menstrual color recovery time, fatigue disappearance time and obesity improvement time (P<0.05). After treatment, the serum LH, FSH and T levels in both groups were significantly decreased (P<0.05), and the decrease was more significant in the treatment group (P<0.05). Conclusion Kunling Pills combined with Dydrogesterone Tablets in the treatment of irregular menstruation caused by polycystic ovary syndrome can not only improve the clinical effective rate and improve clinical symptoms, but also improve the level of sex hormones, which has a certain clinical application value.

R984

河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題（2019ZY3017）