研究疾病:
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多囊卵巢综合征
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研究疾病代码:
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Target disease:
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Polycystic ovary syndrome
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Target disease code:
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研究类型:
Study type:
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观察性研究
Observational study
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研究设计:
Study design:
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病例对照研究
Case-Control study
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研究所处阶段:
Study phase:
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I期临床试验
Phase I clinical trial
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研究目的:
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1.研究目的
本课题以肥胖型多囊卵巢综合征 (Polycystic Ovarian Syndrome, PCOS) 患者为研究对象,探究朱氏调经方对肥胖型多囊卵巢综合征的临床疗效,同时通过观察肥胖型PCOS患者治疗前后甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)等的变化情况,探讨朱氏调经方对肥胖型PCOS患者血脂的影响。
2.研究意义
多囊卵巢综合征(PCOS)是妇科生殖内分泌领域常见疾病,主要与下丘脑-垂体-卵巢轴(HPO轴)调节功能异常、高雄激素血症、胰岛素抵抗等机制有关,该病除影响生殖内分泌紊乱外,还可能引起脂代谢异常。PCOS患者罹患妊娠期多种疾病、糖尿病、肥胖及心血管疾病等疾病的风险高于其他正常女性,严重威胁生命健康。目前西医治疗存在停药后再次出现月经停闭、高血脂等相关症状的问题,增加了患者的用药恐慌及社会经济负担,因此寻求一种长期安全有效的治疗方法势在必行。
由于PCOS病因不明,现无有效的治愈方案,以对症治疗为主,需长期的健康管理。且在临床观察中发现西医治疗停药后患者症状易反复。前期研究发现国医大师朱南孙教授的经验方——朱氏调经方可以纠正紊乱的HPO轴,改善月经失调。而从其他学者研究中发现,朱氏调经方中的主要药物成分在改善脂代谢方面亦具有较好的作用。因此本课题旨在通过临床观察验证朱氏调经方治疗肥胖型多囊卵巢综合征的疗效,同时探讨朱氏调经方对PCOS患者血脂的影响,以期为多囊卵巢综合征患者提供长期有效的治疗方法。
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Objectives of Study:
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1. Research purpose This subject takes obese polycystic ovary syndrome (PCOS) patients as the research object to explore the clinical efficacy of Zhu's Tiaojing Recipe on obese polycystic ovary syndrome. At the same time, by observing the changes of triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) in obese PCOS patients before and after treatment, To explore the effect of Zhu's Tiaojing Recipe on blood lipid in obese PCOS patients. 2. Research significance Polycystic ovary syndrome (PCOS) is a common disease in the field of gynecological reproductive endocrine. It is mainly related to the abnormal regulation function of hypothalamic pituitary ovarian axis (HPO axis), hyperandrogenemia, insulin resistance and other mechanisms. In addition to affecting reproductive endocrine disorder, PCOS may also cause abnormal lipid metabolism. The risk of multiple diseases, diabetes, obesity and cardiovascular diseases in PCOS patients is higher than that of other normal women, which is a serious threat to life and health. At present, there are some problems in western medicine treatment, such as menstrual arrest, hyperlipidemia and other related symptoms after drug withdrawal, which increases the drug panic and socio-economic burden of patients. Therefore, it is imperative to find a long-term safe and effective treatment method. Because the etiology of PCOS is unknown, there is no effective cure plan. Symptomatic treatment is the main method, and long-term health management is needed. In the clinical observation, it is found that the symptoms of patients are easy to repeat after the withdrawal of Western medicine treatment. Previous studies found that Zhu's menstrual regulating prescription, an empirical prescription of Professor Zhu Nansun, a master of Chinese medicine, can correct the disordered HPO axis and improve menstrual disorders. From the research of other scholars, it is found that the main drug components of Zhu's Tiaojing recipe also play a good role in improving lipid metabolism. Therefore, this topic aims to verify the efficacy of Zhu's Tiaojing recipe in the treatment of obese polycystic ovary syndrome through clinical observation, and to explore the effect of Zhu's Tiaojing Recipe on blood lipid in PCOS patients, in order to provide long-term effective treatment for polycystic ovary syndrome patients.
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药物成份或治疗方案详述:
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2.3.1中药治疗组:
予中药朱氏调经方治疗。朱氏调经方组成:党参20g,丹参20g,当归20g,黄芪20g,巴戟天15g,菟丝子15g,覆盆子15g,仙灵脾15g,熟地黄15g。方法:自月经周期或孕激素撤退出血的第1天开始口服中药(采用传统中药煎煮法,每天1剂,水煎 2次,每次煎至药汁 250ml,两次药汁混匀后分早晚2次温服。以上中药饮片均由上海中医药大学附属岳阳中西医结合医院中药房配制),服用3个月经周期后观察临床疗效。
2.3.2西药对照组:
予二甲双胍治疗。方法:自月经周期或孕激素撤退出血的第1天开始服药:二甲双胍(上海信谊药厂有限公司,国药准字H31022081,0.5g/片),每天3次,每次1片,服用3 个月经周期后观察临床疗效。
两组患者治疗期间均进行生活方式干预(每天运动 30 分钟,每周不少于 5 次),治 疗期间嘱咐患者注意经期卫生、保暖,饮食清淡且定时定量、保持心情舒畅愉悦。两组均随访观察至停药后 3 个月。
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Description for medicine or protocol of treatment in detail:
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2.3.1 TCM treatment group:
Zhu's meridian prescription was given for treatment. The formula consists of dangshen 20g, Salvia miltiorrhiza 20g, Angelica 20g, Astragalus 20g, Euphorbia officinalis 15g, Cutazi 15g, Raspberry 15g, Xianling Spleen 15g, rehmannia glutinosa 15g. Methods: Oral Chinese medicine was taken from the first day of menstrual cycle or progesterone withdrawal bleeding (traditional Chinese medicine decocting method was adopted, 1 dose per day, decocted twice in water, decocted to 250ml each time, mixed twice in the morning and evening, two warm doses. The above TCM decoction pieces were prepared by the Chinese Medicine pharmacy of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine), and the clinical efficacy was observed after 3 menstrual cycles.
2.3.2 Western medicine control group:
Metformin was treated. Methods: Metformin (Shanghai Xinyi Pharmaceutical Co., LTD., State drug approval H31022081, 0.5g/ tablet) was taken from the first day of menstrual cycle or progesterone withdrawal bleeding, 3 times a day, 1 tablet each time, and clinical efficacy was observed after 3 menstrual cycles.
During treatment, both groups received lifestyle intervention (exercise 30 minutes a day, no less than 5 times a week). During treatment, patients were told to pay attention to menstrual hygiene, keep warm, eat light diet with regular and quantitative diet, and keep happy and cheerful. Both groups were followed up to 3 months after drug withdrawal.
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纳入标准:
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1.3纳入标准
(1)年龄在18-40岁之间的女性;
(2)符合西医多囊卵巢综合征的诊断标准;
(3)BMI≥25Kg/m2;
(4)进入本研究前3个月内未进行激素类及降脂类药物治疗;
(5)患者签署知情同意书,志愿受试。
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Inclusion criteria
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1.3 Inclusion Criteria
(1) Women aged between 18 and 40;
(2) Meet the diagnostic criteria of Western medicine for polycystic ovary syndrome;
(3) BMI 25 kg/m2 or;
(4) No hormone or lipid-lowering drugs were taken within 3 months before entering the study;
(5) Patients signed informed consent and volunteered to take the test.
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排除标准:
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1.4排除标准
(1)年龄小于18岁或大于40岁者;
(2)研究前3个月内曾用过影响内分泌及脂代谢的药物和避孕药者;
(3)对二甲双胍药物过敏;
(4)妇科检查或B超检查有子宫及附件器质性病变者;
(5)其它原因所致的与PCOS临床和内分泌征象相仿的疾病,如卵泡膜细胞增殖症、卵巢或肾上腺肿瘤、肾上腺皮质增生症等;
(6)合并有心、肝、肾等严重原发性疾病,精神病患者;
(7)不符合纳入标准,未按规定用药,无法判断疗效或资料不全等影响疗效或安全性判断者。
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Exclusion criteria:
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1.4 Exclusion Criteria
(1) persons younger than 18 or older than 40;
(2) those who had used drugs and contraceptives affecting endocrine and lipid metabolism within 3 months before the study;
(3) allergic to metformin;
(4) Gynecological examination or B ultrasound examination of organic lesions of the uterus and accessories;
(5) Diseases similar to the clinical and endocrine signs of PCOS due to other reasons, such as follicular membrane cell hyperplasia, ovarian or adrenal tumor, adrenal cortical hyperplasia, etc.;
(6) patients with serious primary diseases such as heart disease, liver disease and kidney disease or mental illness;
(7) Those who do not meet the inclusion criteria, do not use drugs as prescribed, cannot judge the efficacy or incomplete data affect the judgment of efficacy or safety.
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研究实施时间:
Study execute time:
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从From
2021-07-23
至To
2022-04-30
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征募观察对象时间:
Recruiting time:
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从From
2021-11-24
至To
2022-07-30
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