中西药结合促排卵治疗PCOS不孕患者的临床观察和实验研究

An Clinical Obersevation and Experimental Research on the Ovulation Induction Therapy of Western Medicines combined with Chinese Herbs for the Anovulatory Patients with PCOS

随机对89例PCOS不孕患者采用两种不同的促排卵治疗,西药组45例,促排卵成功26例,6例妊娠;中西药组44例,促排卵成功29例,9例妊娠。两组排卵率比较无统计学差异,妊娠例数因较少,未行统计学比较。用RT-PCR技术检测促排卵后的子宫内膜降钙素的表达,设正常月经周期妇女为对照组,结果显示分别与对照组与中西药组比较,西药组表达明显减弱,对照组与中西药组表达无统计学差异。本研究提示西药的排卵率较高,加用中药后无明显的进一步提高,但使促排卵后的子宫内膜容受性明显改善,提示中西药结合促排卵可提高PCOS不孕患者临床妊娠率。

The 89 anovulatory patients with PCOS underwent different ovulation induction therapies at random： 45 subjects were given western medicines, in wihich 26 had ovulated and 6 were pregnant; 44 subjects were given western medicines combined with Chinese Herbs in wihich 29 had ovulated and 9 were pregnant. The significant difference of ovulation rate was not found between the two groups. Pregnancy rate was not handled because of the few numbers. The expression of endometrial Calcitonin（CT） mRNA in the putative window of implantation was detected by reverse transcription-polymerase chain reaction （RT-PCR） in the three groups, among which infertile women with normal menstrual cycle were selected as control group. The results showed the expression of endometrial CTmRNA during implantation period was significantly weaker in group of western medicines as compared with that in group of western medicines combined with Chinese Herbs and in control group. The expression of endometrial CTmRNA in control group was similar with that in group of western medicines combined with Chinese Herbs. The research showed western medcines had reserved high ovulation rate, combined with Chinese Herbs did not furtherly improve the ovulation rate, but might increase endometrial receptivity after ovulation induction. So it is revealed the ovulation induction therapy of western medicines combined with Chinese Herbs may promote pregnancy rate of patients with PCOS.