补肾增膜方对薄型子宫不孕症患者子宫内膜血液流变学、容受性、性激素水平及自然妊娠结局影响

Effect of Bushen Zengmo Decoction(补肾增膜方)on Endometrial Hemorheology,Receptivity,Sex Hormone Level and Natural Pregnancy Outcome in Patients with Thin Uterine Infertility

目的探讨补肾增膜方对薄型子宫不孕症患者子宫内膜血液流变学、容受性、性激素水平及自然妊娠结局的影响。方法选择2018年6月—2019年6月于医院就诊的93例薄型子宫内膜伴不孕患者进行前瞻性研究,采用随机数字表法将纳入研究的病例分为中药联合组和对照组。患者于月经周期第5天开始口服戊酸雌二醇片,中药联合组在口服戊酸雌二醇片的同时服用补肾增膜方进行治疗,两组患者均连续治疗3个月经周期。疗程结束后进行为期1年的随访。对比两组患者疗效情况,中医证候积分情况,妊娠率,子宫内膜厚度,子宫内膜类型,全血高、低切黏度,全血还原黏度,红细胞聚集指数,红细胞沉降率,促卵泡成熟激素(FSH),孕酮(P)以及雌二醇(E_(2))含量。结果中药联合组疗效分级情况明显优于对照组(P<0.05);治疗后,两组各项中医证候积分及中医证候积分总分均明显低于治疗前(P<0.05),且中药联合组明显低于对照组(P<0.05);中药观察组随访期间内妊娠率明显高于对照组(P<0.05);中药联合组子宫内膜厚度明显高于对照组(P<0.05),中药联合组A型子宫内膜比例明显高于对照组(P<0.05);中药联合组全血高、低切黏度,全血还原黏度,红细胞聚集指数,红细胞沉降率均明显低于对照组(P<0.05);中药联合组血清FSH含量明显低于对照组(P<0.05),中药联合组血清P、E2含量明显高于对照组(P<0.05)。结论补肾增膜方对薄型子宫不孕症患者疗效较好,可有效增厚患者子宫内膜,改善子宫内膜容受性,促进妊娠,同时提高血清孕激素和雌二醇含量,改善子宫内膜血液流变学。

Objective To explore the effects of Bushen Zengmo Decoction(补肾增膜汤)on endometrial hemorheology,receptivity,sex hormone levels and natural pregnancy outcome in patients with thin uterine infertility.Methods We selected 93 patients with thin endometrium with infertility who were treated in our hospital from June 2018 to June 2019 for prospective study.The cases included in the study were divided into Chinese medicine combination group and control group by random number table method.The patient started to take estradiol valerate tablets on the 5th day of the menstrual cycle.The Chinese medicine combination group took the estradiol valerate tablets while taking Bushen Zengmo Decoction for treatment.Both groups were treated for 3 consecutive menstrual cycles.After the course of treatment,a 1-year follow-up will be conducted.Compare the efficacy of the two groups of patients,the integration of TCM syndromes,pregnancy rate,endometrial thickness,endometrial type,whole blood high and low shear viscosity,whole blood reduced viscosity,red blood cell aggregation index,red blood cell sedimentation rate,and follicular maturation hormone(FSH),progesterone(P)and estradiol(E2)content.Results The curative effect classification of the combination group of Chinese medicine was significantly better(P<0.05);after treatment,the scores of various TCM syndromes and the total scores of TCM syndromes of the two groups were significantly lower(P<0.05),and the combination group of Chinese medicine was lower than the control group;the pregnancy rate in the Chinese medicine observation group during the follow-up period was significantly higher(P<0.05);the endometrial thickness of the Chinese medicine combination group was significantly higher(P<0.05).The proportion of type A endometrium in the combined group was significantly higher(P<0.05);the high and low shear viscosity of whole blood,the reduced viscosity of whole blood,the red blood cell aggregation index,and the red blood cell sedimentation rate in the Chinese medicine combined group were significantly lower(P<0.05);The serum FSH content of the Chinese medicine combination group was significantly lower(P<0.05),and the serum P and E2 content of the Chinese medicine combination group was significantly higher(P<0.05).Conclusion Bushen Zengmo Decoction has a good effect on patients with thin uterine infertility.It can effectively thicken the patients'endometrium,improve endometrial receptivity,promote pregnancy,and at the same time increase serum progesterone and estradiol levels,and improve the endometrium Hemorheology.