PCOS患者早期自然流产与子宫内膜雌孕激素受体的关系及中西医结合治疗

Study on mechanism and integrative medicine treatment of early spontaneous abortion in patients with polycystic ovary syndrome

目的：探讨多囊卵巢综合征（PCOS）患者早期自然流产与子宫内膜雌激素受体（ER）、孕激素受体（PR）的关系以及中西医结合治疗的可行性。方法：选择PCOS不孕患者62例为观察组，同期输卵管性不孕患者30例为对照组。两组患者均于月经干净3～7d时在宫腔镜下取子宫内膜标本，行免疫组织化学检查，观察ER和PR在子宫内膜腺体和间质细胞的表达强度，比较两组的差异。再于术后对观察组对象给予达英一35联合中药天癸方连续治疗3个月经周期，停药后第1次月经干净3～7d在官腔镜引导下取子宫内膜标本，观察治疗前后ER、PR表达强度的变化。结果：En、PR在子宫内膜腺体和间质中的表达观察组较对照组明显减弱（P〈0．05）；经中西医结合治疗3个周期后，观察组患者子宫内膜腺体和间质中的ER、PR表达强度均明显提高（P〈0．05）。结论：PCOS患者子宫内膜ER、PR减少可能是其自然流产的重要原因，中西医结合治疗能有效提高PCOS患者子宫内膜ER、PR水平。

Objective： To explore the relationship between early spontaneous abortion and levels of estrogen receptor （ER） and progesterone receptor （PR） in the endometria of patients with polycystic ovary syndrome （PCOS） and the effect of integrative medicine treatment. Methods ： Sixty - two women who suffered from infertility caused by PCOS were enrolled in the study group, and thirty infertile women served as the control： The expressions of ER and PR in the endometria collected by hysteroscopy on day 3 to day 7 after a period were evaluated by immunohistochemical staining analysis. The patients in the study group were treated with diane - 35 and Chinese herbal formula Tiangni Fang for 3 mouths after the operation. And the expressions of ER and PR in the endometrial were evaluated again after the treatment. Results ： The expressions of ER and PR in the endometria were significantly lower in the study group than that in the control group （ P 〈 0.05 ）. In the study group, the expressions of ER and PR were significantly higher after the treatment （P 〈 0.05）. Conclusion： The decreased levels of ER and PR in the endometria of the PCOS patients may induce a spontaneous abortion. Integrative medicine treatment could