蔡氏调周法对多囊卵巢综合征不孕患者子宫及卵巢动脉血流动力学的影响

Effects of CAI Xiaosun's Menstruation Periodic Therapy on Hemodynamics of Uterine Artery and Ovarian Artery in Infertility Patients With Polycystic Ovary Syndrome

目的探讨蔡氏调周法对多囊卵巢综合征(PCOS)不孕患者子宫及卵巢动脉血流动力学的影响。方法 25例PCOS不孕患者经后期或基础体温单相时予多囊方加减,经前期基础体温双相不典型时予育肾培元方加减,月经期予四物汤调冲汤加减治疗,3个月为1个疗程。连续用药1～2个疗程后观察临床疗效,于治疗前后监测患者卵泡发育情况以及子宫动脉、卵巢动脉血流收缩期最大流速(Vmax)、舒张末期流速(Vmin),计算阻力指数(RI)。结果 25例患者治疗1个疗程者7例,治疗2个疗程者18例,患者总有效率为84.00%。25例患者治疗前小卵泡19例,优势卵泡5例,成熟卵泡1例;治疗后小卵泡14例,优势卵泡7例,成熟卵泡4例,患者治疗前后卵泡发育情况比较差异有统计学意义(P<0.01)。患者子宫动脉Vmax、双侧卵巢动脉的Vmax及RI治疗后均较治疗前明显改善(P<0.05或P<0.01)。结论蔡氏调周法可通过改善PCOS不孕患者局部微循环、增加子宫和卵巢的供血,起到促进卵泡发育、排卵及蜕膜生长的作用,从而利于受精卵着床,取得较好临床疗效。

Objective To research the effects of Professor CAI Xiaosun＇s menstruation periodic treatment on hemodynamics of uterine artery and ovarian artery in infertility patients with polycystic ovary syndrome （PCOS）. Methods Totally 25 infertility patients with PCOS were given modified Duonang Formula （formula for PCOS ） during the later period of menstruation or single phase of basal body temperature （BBT） and modified Yushen Peiyuan Formula （formula to supplement the kidney and origin） during the earlier period of menstruation or dual phase of BBT. Three months were one treatment course. The therapeutic effect was observed after one or two consecutive treat- ment courses. The follicular development was monitored before and after treatment. The resistance index （RI） was calculated according to the peak systolic flow velocity （Vmax） and diastolic velocity （Vmin） of uterine artery and ovarian artery. Results There were 7 patients received one treatment course and 18 patients received two treatment courses and the total effective rate was 84. 00%. There were 19 patients with small follicles, 5 patients with dominant follicles and 1 patient with mature follicle before treatment. There were 14 patients with small follicles, 7 patients with dominant follicles and 4 patients with mature follicles after treatment. There was a significant difference between before and after treatment in the follicular development （ P 〈 0. 01 ）. The Vmax of uterine artery, Vmax of bilateral ovarian arteries and RI were significantly improved after treatment （P 〈 0.05 or P 〈 0. 01 ）. Conclusion Professor CAI Xiaosun＇s menstruation periodic treatment can improve local microcirculation, increase blood supply to the uterus and ovaries, promote follicular development, ovulation, decidua growth and implantation and achieve better clinical efficacy.