体外受精-胚胎移植中控制性超排卵后的中医证候分布

Chinese Medical Syndrome Disposition of 280 Controlled Ovarian Hyperstim ulation Patients Undergoing in Vitro Fertilization-Embryo Transplatation

目的研究280例行体外受精-胚胎移植(IVF-ET)的患者控制性超排卵(COH)后的中医证候分布规律。方法对280例患者进行信息采集,采用变量聚类分析研究IVF-ET中COH后的证型分布特点,探讨其证候分布规律及规范化证型。同时比较不同中医证型患者注射绒毛膜促性腺激素(HCG)当日血清雌二醇(E2)水平。结果患者COH后主要表现为肾气阴两虚、脾肾阳虚、肝郁气滞兼血瘀3种证型。其中肾气阴两虚证最多,共113例占40.4%,其次为脾肾阳虚证,共77例占27.5%,肝郁气滞兼血瘀证共51例占18.2%,其他证型39例占13.9%。肾气阴两虚组患者注射HCG当日E2水平低于其他组,差异有统计学意义(P<0.05),其余证型间差异无统计学意义(P>0.05)。结论 IVF-ET中COH后临床上所出现中医证型按出现频率由高到低依次为肾气阴两虚证,脾肾阳虚证,肝郁气滞兼血瘀证,其他证型。肾气阴两虚证患者注射HCG当日的低E2水平提示本证型患者的获卵数目及获卵质量可能低于其他证型患者。

Objective To study Chinese medical syndrome disposi ti on of controlled o varian hyperstimulation（COH） during in vitro fertilization-embryo transplantat i on（IVF-ET）.Methods The information acquisition and c luster analysis was used t o research Chinese medical syndrome disposition in 280 cases of COH during IVFET.The level of estradiol（E2） at the date of human chorionic gonadotrophin（ HCG） injection was compared among different syndromes.Result s The major synd romes were dual deficiency of kidney qi and yin syndrome（113 cases,40.4%）,sp lee n-kidney yang deficiency syndrome（77 cases,27.5%） and liver depression and qi sta g nation with blood stasis syndrome（51 cases,18.2%）.The rest 39 cases of other syndromes accounted for 13.9%.E2 level of dual deficiency of kidney qi and yi n syn drome was significantly lower than those of other syndromes（P0.05）.The diffe rences between other syndromes were not statistically significant（P0.05）.Con clusion The syndrome frequency of COH during IVF-ET from high to low i s dual deficiency of kidney qi and yin syndrome,spleen-kidney yang deficiency syndrome,liver d epression and qi stagnation with blood stasis syndrome and other syndromes.E2 l evel of dual deficiency of kidney qi and yin syndrome is low,which maybe indica tes that the amount and quality of producing ova is lower than that of other syndro mes as well.