芳香化酶抑制剂合补肾活血法促排卵的临床观察

Clinical Observation of Aromatase Inhibitor Combined with Bushen Huoxue Method on the induction of Ovulation

目的:比较芳香化酶抑制剂-来曲唑(LE)合补肾活血方与克罗米芬(CC)合补肾活血方促排卵的临床疗效。方法:将67例卵泡成熟障碍患者随机分为治疗组34例,对照组33例。治疗组于月经周期第5天口服LE2.5mg,1天1次,连服5天,继之服用补佳乐1mg,1天1次,连服5天;对照组于月经周期第5天口服CC2.5mg,1天1次,连服5天,继之服用补佳乐1mg,1天1次,连服5天;两组均于月经周期第5天开始服用补肾活血方,1天1剂,连服14剂。结果:两组成熟卵泡率、卵泡成熟所需天数比较,差异无显著性意义;治疗组成熟卵泡每周期均数与对照组比较,差异有显著性意义(P<0.05);治疗组hCG日子宫内膜平均厚度、子宫内膜厚度<7mm周期数与对照组比较,差异有显著性意义(P<0.05);治疗组宫颈黏液评分与对照组比较,差异有极显著性意义(P<0.01);其中11例经CC+补肾活血方治疗无卵泡发育者,采用LE+补肾活血方治疗后,均有优势卵泡生成,并全部排出,hCG日子宫内膜厚度均>9mm,宫颈黏液评分均>10。结论:LE合补肾活血方为有效促排卵方法,LE有望取代CC作为一线促排卵药物使用。

Objective：To compare the clinical efficacies of the aromatase inhibitor-letrozole （LE） combined with Bushen Huoxue method with those of clomiphene citrate（CC） combined with Bushen Huoxue method on the induction of ovulation. Methods：67 women with follicle dysmaturity were randomly divided into the trial group（ 34 cases） and the control group （33 cases）. Patients in the trial group and the control group were respectively given LE 2.5mg or CC 2.5mg daily for 5 days from the fifth day of menstrual cycle, then both given Progynova 1 mg daily in the following Sdays and Bushen Huoxue method daily for 14 days from the fifth day of menstrual cycle. Results：Comparing the vesicula graafianae rates and the required days of vesicula graafianae of the two groups after treatment, there was no significant difference （ P 〉 0.05 ）. The mean cycle of vesicula graafianae, the thickness of endometrium in hCG day , the periodicity of endometrial thickness 〈 7mm and cervix mucus score of LE group were significant different to those of CC group（ P 〈 0.05 ,P 〈 0.01 ）. 11 cases who had no follicular development after the treatment of CC combined with Bushen Huoxue method developed dominant follicles and ovulated and whose thickness of endometrium 〉 9mm and cervix mucus scores 〉 10mm after altering to adopt LE combined with Bushen HuoXue method. Condusion：LE combined with Bushen HuoXue method is effective for the induction of ovulation. Being a new standard, LE will substitutes CC to be the first-line treatment of ovulation stimulants.