定坤丹联合归肾丸加味治疗肾虚血瘀型不孕症临床研究

Clinical Value of Dingkun Pill Combined with Jiajian Guishen Pill in the Treatment of Kidney Deficiency and Blood Stasis Type Infertility on Patients

目的探究分析定坤丹联合归肾丸加味治疗肾虚血瘀型不孕症的临床疗效。方法选取2016年1月—2018年12月期间来院就诊的肾虚血瘀型不孕症76例作为临床研究对象,采用随机数字表法对研究对象进行随机双盲分组,对照组和观察组各38例,对照组患者在月经第5天给予定坤丹口服,1丸/次,2次/d;观察组患者在月经第5天给予定坤丹联合归肾丸加味口服,归肾丸每日1剂,水煎,分2次服用。观察两组患者治疗前后中医证候积分变化情况,同时比较两组患者治疗前后卵巢储备功能、卵巢动脉血流指标以及排卵、妊娠情况。结果治疗前,两组患者各项中医证候积分情况组间比较差异无统计学意义(P>0.05),治疗后,两组患者各项中医证候积分均明显降低(P<0.05),且观察者患者腰酸膝软、倦怠乏力、肢肿、畏寒肢冷等中医证候积分均明显低于对照组患者(P<0.05)。治疗前两组患者卵泡直径及子宫内膜厚度比较差异无统计学意义(P>0.05),治疗后,两组患者卵泡直径及子宫内膜厚度改善明显(P<0.05),观察组患者卵泡直径及子宫内膜厚度均明显优于对照组患者(P<0.05)。观察组及对照组患者治疗前各项卵巢动脉血流指标组间比较差异无统计学意义(P>0.05),治疗后,两组患者阻力指数(RI)及波动指数(PI)较治疗前无明显改变(P>0.05),舒张末期流速(EDV)及收缩期峰值流速(PSV)则明显升高(P<0.05),且治疗后观察组患者EDV及PSV明显高于对照组患者(P<0.05)。观察组患者妊娠率明显高于对照组患者(P<0.05),且观察组患者的周期排卵率也明显高于对照组患者(P<0.05),组间差异显著,具有统计学意义。结论定坤丸联合归肾丸能有效治疗肾虚血瘀型不孕症,降低中医证候积分,明显改善卵泡及子宫内膜发育情况,提高患者排卵率及妊娠率,改善卵巢功能,值得临床推广。

Objective To study the clinical value of Dingkun Pill combined with Jiajian Guishen Pill in the treatment of patients with kidney deficiency and blood stasis type infertility.Methods 76 cases of research objects were derived from January 2016—December 2018 in our hospital and received treatment of kidney deficiency and blood stasis type infertility in female patients,according to the blind selection principles were divided into control group and observation group.On the fifth day of menstruation,the control group was given oral treatment of dingkun pills,a daily dose of 2 pill,2 times a day,while the observation group of patients in addition to daily use of Jiajian Guishen Pill(dosage:1 doses/day).After the treatment,the patients in the two groups were compared with TCM syndrome points,ovarian reserve function,ovarian artery blood flow index,ovulation and pregnancy.Results The TCM syndrome points of lumbar acid knee soft,fatigue fatigue,limb swelling,chills limb cold in the observation group were significantly lower than the control group(P<0.05)after treatment.The follicle diameter and endometrial thickness in the observation group were significantly higher than the control group(P<0.05).The endometrial spiral artery blood flow pulsation index(PI)and endometrial spiral artery blood flow resistance index(RI)in two group has no statistical significance(P>0.05),but the end-diastoloc velocity(EDV)and peak systolic velocity(PSV)in the observation group were significantly higher than the control group(P<0.05).The ovulation rate and pregnancy rate of the observation group was significantly higher than the ovulation rate of the control group(P<0.05),the comparison of the above data showed that the observation group had a comparative study value.Conclusion Dingkun Pill combined with Jiajian Guishen Pill can effectively treat infertility due to kidney deficiency and blood stasis,can reduce TCM syndrome points,improve the development of follicle and endometrium,at the same time also increased ovulation rate and pregnancy rate,which is worthy of clinical promotion.