超声引导下小卵泡穿刺术配合启宫丸治疗多囊卵巢综合征不孕症的临床观察

Clinical observation of infertile patients with polycystic ovary syndrome treating with Qigongwan and immature follicle puncture technique through ultrasound

目的:研究启宫丸配合小卵泡穿刺术治疗多囊卵巢综合征(PCOS)不孕症患者的临床疗效,探讨其对患者内分泌及胰岛素抵抗指标、基础窦卵泡计数的影响。方法:将70例PCOS患者随机分为2组:中药组及对照组,2组都用人绝经期促性腺激素(hMG)促排卵后,在超声引导下经阴道小卵泡穿刺治疗,中药组同时口服启宫丸,连用2个周期,比较治疗前后早卵泡期患者的基础性激素卵泡刺激素(FSH)、促黄体素(LH)、睾酮(T)、胰岛素(FINS)及性激素结合球蛋白(SHBG)等指标及卵巢基础窦卵泡计数的变化。结果:共进行了140个周期的穿刺治疗,治疗后2组患者T、LH、FINS水平及LH/FSH比值均明显降低,SHBG水平明显升高(P<0.05),基础窦卵泡计数有显著性减少(P<0.05),治疗后中药组血FINS、SHBG水平较对照组差异有统计学意义(P<0.05)。结论:对PCOS患者应用启宫丸配合超声引导下小卵泡穿刺技术可改善其内分泌异常及胰岛素抵抗状态,减少基础窦卵泡计数,恢复排卵功能而妊娠。

Objective： To investigate the therapeutic effect of Qigongwan and immature follicle puncture technique through ultrasound on sex hormone and insulin resistance index as well as antral follicle count in the patients with polycystic ovary syndrome （PCOS）. Methods： Seventy patients with PCOS were recruited,and divided them into two grops randomly, experimental group and control group. SHBG, FINS, basic sex hormone （FSH,LH,T） were determined. Then the experimental group pa- tients were treated with Qigongwan orally and HMG intramuscular, whereas the control group patients treated only HMG intramuscular,then all the patients gave transvaginal follicle puncture, compared the variation of SHBG, FINS, basic sex hormone （FSH,LH,T） level as well as antral follicle count before and after treatment. Results： T,LH, FINS level and LH/FSH ratio were significantly lower in patients of both groups after treatment （ P d0.05）, SHBG level were significantly increased, also the antral follicle count were significantly lower （ P d0.05） after treatment. Conclusion： Treatment of Qigongwan and immature follicle puncture technique can improve the endocrinal abnormality and the insulin resistance.