溴隐亭联合补肾助孕汤对高泌乳素血症性不孕患者血清激素、焦虑及妊娠的影响。

The effects of combined bromocriptine and Bu-shen-zhu-yun decoction on serum hormones, anxiety, and pregnancy in hyperprolactinemic infertility patients.

机构信息

Institute of Rehabilitation, Jiangsu Vocational College of Medicine, Yancheng, China; Department of Gynecology, Nanjing University of Chinese Medicine, Nanjing, China.

Department of Gynecology, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Ann Palliat Med. 2021 Dec;10(12):12230-12243. doi: 10.21037/apm-21-3111.

DOI:10.21037/apm-21-3111

PMID:35016475

Abstract

BACKGROUND

Prolactin (PRL) is a protein hormone secreted by the anterior pituitary gland that regulates pituitary hormones. Hyperprolactinemia (HPRL), a pathological phenomenon of excessive PRL, can cause infertility in severe cases and is currently treated mainly with Western drugs, such as bromocriptine, a dopamine agonist (DA). Unfortunately, DAs produce psychological side effects which limit their long-term use. Traditional Chinese medicine (TCM) has minimal side effects and good results spanning many years of research. The combined treatment of TCM and Western medicine may enhance treatment efficacy and improve the long-term prognosis in HPRL. To analyze the effects of Bu-shen-zhu-yun decoction (BSZY-D) combined with bromocriptine on serum hormones, anxiety, and pregnancy in hyperprolactinemic infertile patients.

METHODS

One hundred patients diagnosed with HPRL infertility from June 2020 to June 2021 in the gynecology clinic of Jiangsu Provincial Hospital of Traditional Chinese Medicine were selected and grouped by envelope method. After excluding patients who withdrew or missed visits, 37 cases assigned to the control group were treated with bromocriptine, and 40 cases assigned to the observation group were treated with bromocriptine combined with BSZY-D. The patients' PRL and kisspeptin (KP) serum indexes, improvements in infertility, Anxiety Self-Assessment Scale (SAS) scores, and improvements in the Insomnia Severity Index Scale (ISI) scores were compared between the two groups.

RESULTS

At 3 and 6 months of treatment, serum PRL, SAS, and ISI scores were significantly lower, and serum KP was significantly higher in the observation group than in the control group (P<0.05). During the study period, the pregnancy rates were 62.50% (25/40) and 37.84% (14/37) in the observation and control groups, respectively. The observation group also had significantly fewer early miscarriages [10.00% (4/40) vs. 32.43% (12/37)] and less adverse reactions [7.50% (3/40) vs. 24.32% (9/37)] than the control group (all P<0.05).

CONCLUSIONS

The combination of bromocriptine with BSZY-D was superior to bromocriptine alone in treating HPRL and HPRL-related infertility, which also demonstrated a positive effect on patients' sleep and low mood.

摘要

背景

催乳素（PRL）是由垂体前叶分泌的一种蛋白质激素，调节垂体激素。高催乳素血症（HPRL）是催乳素过多的一种病理现象，严重情况下可导致不孕，目前主要采用溴隐亭等多巴胺激动剂（DA）西药治疗。然而，DA 会产生心理副作用，限制了其长期使用。中药（TCM）副作用极小，经过多年研究取得了良好的效果。TCM 与西药联合治疗可能会提高治疗效果，改善 HPRL 的长期预后。分析补肾助孕汤（BSZY-D）联合溴隐亭对高催乳素血症不孕患者血清激素、焦虑和妊娠的影响。

方法

选取 2020 年 6 月至 2021 年 6 月江苏省中医院妇科门诊诊断为 HPRL 不孕症的患者 100 例，采用信封法分组。剔除脱落或失访患者后，对照组 37 例采用溴隐亭治疗，观察组 40 例采用溴隐亭联合 BSZY-D 治疗。比较两组患者的催乳素（PRL）和 kisspeptin（KP）血清指标、不孕改善情况、焦虑自评量表（SAS）评分和失眠严重指数量表（ISI）评分。

结果

治疗 3、6 个月时，观察组患者血清 PRL、SAS 和 ISI 评分均明显低于对照组，血清 KP 明显高于对照组（P<0.05）。研究期间，观察组妊娠率为 62.50%（25/40），对照组为 37.84%（14/37）。观察组早期流产[10.00%（4/40）比 32.43%（12/37）]和不良反应[7.50%（3/40）比 24.32%（9/37）]的发生率均明显低于对照组（均 P<0.05）。