<b>クロミフェン無効な多嚢胞性卵巣症候群に対し,柴苓湯の併用療法が奏効した6症例の検討</b>  [in Japanese] <b>Study on Six Cases of Infertile Women with Clomiphene-Resistant </b><b>Polycystic Ovary Syndrome Successfully Treated </b><b>with Concomitant Saireito Therapy </b>  [in Japanese]

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Abstract

多嚢胞性卵巣症候群(polycystic ovary syndrome : PCOS)は生殖年齢女性の5-8%に発症し,月経異常や不妊症などの主要な原因の一つである。PCOS の治療は受診年齢や背景,特に挙児希望の有無により異なる。挙児希望のある女性のPCOS に対する治療の第一選択はクロミフェン療法である。ただし抗エストロゲン作用に伴う,子宮内膜の菲薄化や頸管粘液の減少も伴うことや,クロミフェン療法が無効な患者もいる。そこでクロミフェン療法が無効なPCOS 患者に柴苓湯を併用し,排卵周期が回復した6症例を経験した。柴苓湯が有効であった症例の多くは,東洋医学的に瘀血や水滞スコア値が高く,また投与後の血中LH 値,LH/FSH 比が無効群よりも低下した。さらに柴苓湯有効群はテストストロン値もより低下していた。ゴナドトロピン療法や腹腔鏡手術などの第2選択が行われる前に,証に応じて試みる価値があると推察した。

Polycystic ovary syndrome (PCOS) occurs in 5 to 8% of females of reproductive age and is one of the leading causes of menstrual abnormalities and infertility. The treatment of PCOS varies, depending on the patient's age and background, particularly on the presence/absence of a desire to have children. In those desiring to have children, clomiphene therapy is the first-line treatment for PCOS. However, the anti-estrogen action of clomiphene may lead to a thinning of the endometrium and decreased cervical mucus production, while some patients show a poor response to the agent. In this study, saireito was administered to clomiphene-resistant PCOS patients, and the ovulation cycle improved in 6. Effective cases of saireito tended to have higher <i>oketsu </i>(blood stagnation) and <i>suitai </i>(water stagnation) statescores before treatment, also serum LH levels and LH/FSH ratios were lower due to the concurrent saireito medication. Furthermore, these effective cases had lower levels of serum testosterone than the non-effective and clomiphene-effective cases. This clinical report suggests the appropriateness of performing this therapy in accordance with <i>sho </i>(oriental patterns or symptoms), before second-line treatments such as gonadotropin therapy or laparoscopic surgery.

Journal

  • Kampo Medicine

    Kampo Medicine 66(2), 83-88, 2015

    The Japan Society for Oriental Medicine

Codes

  • NII Article ID (NAID)
    130005092925
  • NII NACSIS-CAT ID (NCID)
    AN00015774
  • Text Lang
    JPN
  • ISSN
    0287-4857
  • NDL Article ID
    026437927
  • NDL Call No.
    Z19-246
  • Data Source
    NDL  J-STAGE 
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