疏肝补肾方对卵巢储备功能不良患者体外受精-胚胎移植妊娠结局的影响

The Influence of Formula for Dispersing Liver and Nourishing Kidney on Periodic Outcome of in Vitro Fertilization-Embryo Transfer in Patients with Ovarian Reserve Dysfunction

目的:观察疏肝补肾方对卵巢储备功能不良(ovarian reserve dysfunction,DOR)患者体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)妊娠结局的影响。方法:将140例DOR患者随机分为观察组和对照组,每组各70例。对照组患者给予常规西药治疗,观察组在对照组的基础上加用自拟疏肝补肾方治疗。观察两组患者的临床疗效,比较两组患者治疗前后中医证候积分、窦卵泡个数,检测两组患者治疗前后血清雌激素[黄体生成素(luteinizing hormone,LH)、促卵泡生成素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E2)]及卵泡液[褪黑素(melatonin,MET)、晚期氧化蛋白产物(advanced oxidation protein products,AOPPs)]水平变化情况,比较两组取卵情况、胚胎情况以及IVF-ET妊娠结局。结果:对照组有效率为72. 86%,观察组有效率为87. 14%,两组患者临床疗效比较,差异具有统计学意义(P <0. 05)。两组患者治疗后中医证候积分低于同组治疗前,窦卵泡数多于同组治疗前,差异有统计学意义(P <0. 05);观察组患者治疗后中医证候积分低于对照组,窦卵泡数多于对照组,差异有统计学意义(P <0. 05)。两组患者治疗后血清E2、LH、FSH水平低于同组治疗前,且观察组低于对照组,差异有统计学意义(P <0. 05)。观察组患者成熟卵泡数、正常受精数、胚胎数、优质胚胎数均高于对照组,差异有统计学意义(P <0. 05)。观察组患者卵泡液MT水平高于对照组,AOPPs水平低于对照组,差异有统计学意义(P <0. 05)。观察组临床妊娠率高于对照组,差异有统计学意义(P <0. 05);两组患者流产率比较,差异无统计学意义(P> 0. 05)。结论:自拟疏肝补肾方能够有效改善DOR患者卵巢储备功能,提高IVF-ET效果。

Objective: To observe the influence of Formula for Dispersing Liver and Nourishing Kidney on periodic outcome of in vitro fertilization-embryo transfer in patients with ovarian reserve dysfunction( DOR). Methods: One hundred and forty patients with DOR were randomly divided into the observation group and the control group,with 70 cases in each group. The patients in the control group were treated with routine western medicine,while the ones in the observation group were treated with self-made Formula for Dispersing Liver and Nourishing Kidney on the basis of the control group. The clinical efficacies of the two groups were observed. The scores of TCM syndromes and the number of sinus follicles were compared before and after the treatment. Serum estrogen [luteinizing hormone( LH),follicle stimulating hormone( FSH),estradiol( E2) ] and follicles level changes [melatonin( MET) and advanced oxidation protein products( AOPPs) ]were measured before and after the treatment. The egg retrieval,embryo condition and IVF-ET cycle outcome of the two groups were compared. Results: The effective rate was 72. 86% in the control group and 87. 14% in the observation group. There was a significant difference between the two groups( P < 0. 05). After the treatment,the scores of TCM syndromes in the two groups were lower than those before the treatment,and the number of sinus follicles in the two groups was more than that before the treatment. There were significant differences between the two groups( P <0. 05). After the treatment,the score of TCM syndrome in the observation group was lower than that in the control group,and the number of sinus follicles in the observation group was higher than that in the control group. There were significant differences between the two groups( P < 0. 05). The levels of serum E2,LH and FSH in the two groups after the treatment were lower than those before the treatment in the same group,and those in the observation group were lower than those in the control group. There were significant differences between the two groups( P < 0. 05). The number of mature follicles,normal fertilization,embryos and high quality embryos in the observation group were higher than those in the control group. There were significant differences between the two groups( P < 0. 05). The MT level in follicular fluid of the observation group was higher than that of the control group,and the AOPPs level was lower than that of the control group. There were significant differences between the two groups( P < 0. 05).The clinical pregnancy rate in the observation group was higher than that in the control group. There was a significant difference between the two groups( P < 0. 05),and there was no significant difference in the abortion rate between the two groups( P >0. 05). Conclusion: Self-made Formula for Dispersing Liver and Nourishing Kidney can effectively improve the ovarian reserve function of DOR patients and improve the effect of IVF-ET.