中药促排汤联合炔雌醇环丙孕酮和二甲双胍治疗多囊卵巢综合征不孕的临床探讨

Clinical discussion of PCOS combined with infertility treated by TCM promoting ovulation decoction combined with ethinylestradiol cyproterone and metformin

目的：比较多囊卵巢综合征（PCOS）不孕症患者经炔雌醇环丙孕酮和二甲双胍预治疗后应用中药促排汤与氯米芬（CC）促排卵的效果。方法：选择2010年5月～2012年5月在成都市计划生育指导所不孕门诊诊断为PCOS不孕症患者120例,经预治疗后随机分为观察组（中药组）60例,对照组（CC组）60例。PCOS诊断标准参考鹿特丹标准。结果：观察组60例184个周期,排卵107个周期,排卵率58.15%,临床妊娠率28.97%（31/107）,早期流产率12.90%（4/31）;对照组60例176个周期,排卵109个周期,排卵率61.93%,临床妊娠率15.60%（17/109）,早期流产率23.53%（4/17）,两组比较排卵率和早期流产率差异无统计学意义（P〉0.05）,临床妊娠率差异有统计学意义（P〈0.05）。结论：PCOS不孕症患者经预治疗纠正内分泌代谢紊乱后应用中药促排汤临床疗效可靠,可以获得较高的妊娠率。

Objective： To compare the promoting ovulation effects of traditional Chinese medicine （TCM） promoting ovulation de- coction and CC on PCOS patients with infertility which pretreated by ethinylestradiol cyproterone and metformin. Methods： A total of 120 P- COS patients with infertility from outpatient department of infertility in the institute were selected and divided into two groups randomly after pretreated by etbinylestradiol cyproterone and metformin： observation group （60 patients treated with TCM ） and control group （60 patients treated with CC ） ; the diagnostic criteria of PCOS referred to Rotterdam reference. Results： In observation group, 184 cycles were obtained, and 107 cycles were found with ovulation, the ovulation rate, the clinical pregnancy rate, the early abortion rate were 58.15% , 28.97% （31/107） and 12. 90% （4/31） , respectively; in control group, 176 cycles were obtained, and 109 cycles were found with ovulation, the o- vulation rate, the clinical pregnancy rate, the early abortion rate were 61.93% , 15.60% （17/109） and 23.53% （4/17）, respectively, there was no statistically significant difference in ovulation rate and early abortion rate between the two groups （ P 〉 0. 05 ）, but there was sta- tistically significant difference in clinical pregnancy rate between the two groups （ P 〈 0. 05 ） . Conclusion ： The clinical effect of TCM pro- moting ovulation decoction for PCOS patients with infertility after correcting endocrine disturbance is reliable, and high pregnancy rate can be obtained.