温肾活血汤改善子宫内膜容受性的临床研究

Clinical Research of Wenshen Huoxue Decoction in the Improvement of Endometrial Receptivity

目的探讨温肾活血汤联合克罗米芬(clomiphene citrate,CC)治疗排卵障碍性不孕症的临床疗效及其改善子宫内膜容受性的作用机制。方法将129例排卵障碍性不孕症患者随机分为A组(CC)、B组(温肾活血汤+CC)、C组(阿司匹林+CC),每组43例,治疗1～3个月经周期,观察排卵率、LUFS发生率、周期妊娠率,以及HCG注射日子宫内膜类型及内膜厚度。结果 B组A+B型内膜率显著高于A组及C组(P<0.05);B组内膜平均厚度显著高于A组(P<0.05)。周期排卵率:B组>C组>A组,但各组间差异无统计学意义;LUFS发生率:B组<C组<A组,B组与A组比较差异有统计学意义(P<0.05)。周期妊娠率:B组>C组>A组,B组显著高于A组(P<0.05)。结论温肾活血汤能显著提高CC促排卵治疗后的临床妊娠率,降低LUFS的发生率,改善子宫内膜容受性,其效果好于CC组和阿司匹林联合CC组。反证了CC促排卵后符合"宫寒不孕"的理论。

Objective To explore the clinical efficacy on anovulatory infertility treated with wenshen huoxue decoction combined with clomiphene citrate（CC） and discover the mechanism on the improvement of endometrial receptivity. Methods One hundred and twenty - nine patients of anovulatory infertility were randomized into A group（ CC ） , B group （wenshen huoxue decoction ＋ C C ）and C group （aspirin ＋ CC ） ,43 ca- ses in each group. After treatment for 1- 3 menstrual cycles, the ovulation rate, LUFS incidence rate, periodic pregnancy rate, endometrial type and intima thickness on the day of HCG injection were observed. Results The proportion of A ＋ B endometrial type in B group was higher significantly than that in A group and C group respectively（ P 〈0.05 ）and the mean thickness of intima in B group was higher significantly than that in A group（ P 〈 O. 05 ）. For the periodic ovulation rate：B group 〉 C group 〉 A group, but the differences were not significant statistically in comparison among the groups. For LUFS incidence rate： B group 〉 C group 〉 A group, the difference was significant between B group and A group （ P 〈 0.05 ）. For the periodic pregnancy rate ： B group 〉 C group 〉 A group, the result in B group was higher significantly than that in A group （ P 〈 O. 05 ）. Conclusion Wenshen huoxue decoction increases significantly the clinical pregnancy rate after ovu- lation induction by CC, reduces LUFS incidence rate and improves endometrial receptivity. The results of it are better than those in CC group and aspirin ＋ CC group. This research provides the counterevidence on in-fertility due to uterine coldness after CC ovulation induction.