目的 补肾活血健脾汤治疗多囊卵巢综合征（PCOS）伴骨量减少患者血清生殖激素、排卵情况及骨代谢的影响。方法 选取2021年5月―2023年4月于广州中医药大学第一临床医学院接受治疗且符合纳排标准的106例PCOS伴骨量减少患者,根据随机列表法分为治疗组与对照组,各53例。对照组给予达英-35联合橄榄油治疗,治疗组在以上基础给予补肾活血健脾汤治疗,观察两组生殖激素[促卵泡生成素（FSH）、黄体生成素（LH）、雌二醇（E₂）]、排卵情况、月经及骨代谢[骨钙素（BGP）、I型前胶原N端前肽（PINP）]的改善效果,并评估其临床疗效。结果 与治疗前相比,两组卵巢体积、子宫内膜厚度、卵泡个数、月经持续时长、月经量及血清BGP、PINP均显著增加,月经周期及血清FSH、LH、E₂均降低,且治疗后与对照组相比,治疗组卵巢体积、子宫内膜厚度、卵泡个数、月经持续时长、月经量及血清BGP、PINP均较高,月经周期及血清FSH、LH、E₂均较低;治疗组总有效率显著高。结论 PCOS伴骨量减少患者在临床常规治疗基础上给予补肾活血健脾汤治疗,不仅能改善患者生殖激素指标水平,有效纠正排卵及月经情况,还能正向调节其骨代谢,疗效显著,值得临床进一步推广并应用。

Objective To observe the effect of treatment with Bushen Huoxue Jianpi Decoction on serum reproductive hormones,ovulation and bone metabolism in patients with PCOS and osteopenia. Methods A total of 106 patients with PCOS and osteopenia who were treated in the First Clinical Medical College,Guangzhou University of Traditional Chinese Medicine from May 2021 to April 2023,and met the inclusion and exclusion criteria were enrolled in this study. They were randomly assigned to the treatment group and the control group,with 53 patients in each group. Patients in the control group were treated with Diane-35 combined with olive oil. On this basis,patients in the treatment group were treated with Bushen Huoxue Jianpi Decoction. Reproductive hormones（FSH,LH and E₂）,ovulation,menstruation and bone metabolism（BGP and PINP）in the two groups were observed. Clinical efficacy was evaluated. Results After treatment,ovarian volume,endometrial thickness,follicle count,duration and volume of menstruation,serum BGP and PINP in the two groups were significantly increased. Menstrual cycle and serum FSH,LH and E₂ were significantly reduced. Meanwhile,ovarian volume,endometrial thickness,follicle count,duration and volume of menstruation,serum BGP and PINP in the treatment group were larger/longer/higher than those in the control group（P<0.05）. Menstrual cycle and serum FSH,LH and E₂ in the treatment group were shorter/lower than those in the control group（P<0.05）. The total effective rate in the treatment group was significantly higher. Conclusion Treatment with Bushen Huoxue Jianpi Decoction can not only improve reproductive hormone levels and effectively correct ovulation and menstruation in patients with PCOS and osteopenia but also positively regulate bone metabolism,with significant effect.