补肾助孕组方人工周期联合枸橼酸氯米芬治疗多囊卵巢综合征不孕随机平行对照研究

Bu Shen Zhu Yun Prescription Artificial cycle Therapy Combined with Clomiphene Citrate Tablets Infertility Caused by Polycystic Ovary Syndrome Randomized Controlled Study

[目的]观察补肾助孕组方人工周期联合枸橼酸氯米芬治疗多囊卵巢综合征不孕疗效。[方法]使用随机平行对照方法,将50例门诊患者按抽签法简单随机分为两组。对照组24例枸橼酸氯米芬片,50mg/次,1次/d;经期后第5d口服,连服5d。治疗组26例补肾助孕组方,西药治疗同对照组;经后期（卵泡期）-促卵泡汤（山茱萸、茯苓各15g,当归6g,白术炒、白芍炒、熟地、女贞子各12g,旱莲草15g,菟丝子30g,续断15g,仙茅、仙灵脾各20g,桑寄生、巴戟天、杜仲、覆盆子、补骨脂各15g,肉苁蓉、鹿角片先煎各10g,川牛膝、怀牛膝各12g,厚朴10g,甘草6g）;月经第6d开始,1剂/d,连用5d,月经后第11~12d B超监测卵泡;经间期（排卵期）-促卵汤（促卵泡汤加路路通、赤芍各15g）;卵泡发育至优势开始,1剂/d,连用2d,指导同房,第3d监测卵泡已排出,改用促黄体汤;卵泡未排且开始萎缩视为失败;经前期（黄体期）-促黄体汤（促卵泡汤去赤芍,鹿角片,加山药炒20g）,B超监测卵泡已排出后用,卵泡萎缩继续服用,1剂/d,连用14d;行经期（月经期）-活血化瘀汤（桃仁12g,红花10g,当归6g,白术炒12g,赤芍15g,生地12g,月季花、泽兰各15g,益母草30g,三棱12g,莪术15g,皂角刺10g,路路通、王不留行各15g,桂枝、香附、广郁金、川芎、川牛膝、怀牛膝各12g,厚朴、苍术各10g,甘草6g）;月经第ld用药,l剂/d,连用5d。连续治疗3个月经周期为1疗程。观测临床症状、优势卵泡直径、排卵日子宫内膜厚度、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈12例,无效14例,总有效率46.15%。对照组痊愈9例,无效15例,总有效率37.50%。治疗组疗效优于对照组,相关指标治疗组改善优于对照组（P〈0.01）。[结论]补肾助孕组方人工周期联合枸橼酸氯米芬治疗多囊卵巢综合征不孕疗效满意,无严重不良反应,值得推广。

[Objective]To observe the artificial cycle Bu Shen Zhu Yun prescription clomiphene citrate tablets combined with polycystic ovary syndrome caused by infertility treatment.[Methods]Randomized parallel controlled method,50 outpatients by lottery method is simple and randomly divided into two groups.The control group 24 cases of clomiphene citrate tablets,50mg/second,1/d;after the first period 5d oral,and even served 5d.Treatment group of 26 patients Bu Shen Zhu Yun prescription,western medicine with the control group.By the late（follicular phase）-follicle soup（Shanzhuyu,Fuling 15 g,Danggui 6g,Baizhu,Baishao,Shudi,Nv zhenzi each 12 g,Hanliancao 15 g,Tusizi 30 g,Xuduan 15 g,Xianmao,Xianlingpi each 20 g,Sangjisheng,Bajitian,Duzhong,Fupenzi,Buguzhi 15 g,Roucongrong,Lujiaopian 10 g,Chuanniuxi,Huainiuxi 12 g,Houpu 10 g,Gancao 6g）;since the beginning of menstruation 6d medication,a/d,in conjunction 5d.After menstruation 11~12d Bmonitoring follicle.Between periods（ovulation）-Promoting egg soup（follicle Tonga Passepartout,red peony root 15g）.Follicles to start taking advantage of,a/d,in conjunction 2d,guide the same room,the first 3d monitor follicle discharge,instead of luteinizing soup;follicle Not row and began to shrink as a failure.Premenstrual（luteal phase）-luteinizing soup（follicle soup to TPG,Lujiaopian,Shanyao 20g）,B-monitoring follicle after discharge,taking the same follicle atrophy,a/d,in conjunction 14 d.Menstruation（menstrual period）-HXHY（Taoren 12 g,Honghua 10 g,Danggui 6g,Baizhu 12 g,Chishao15g,Shengdi 12 g,Yuejihua,Zelan 15 g,Yimucao 30 g,Sanleng 12 g,E’zhu 15 g,Zaojiaoci 10 g,Lulutong,Wangbuliuxing 15 g,Guizhi,Xiangfu,Guangyujin,Chuanxiong,Chuanniuxi,Huainiuxi 12 g,Houpu,Cangzhu 10 g,Gancao 6g）;ld menstruation medication,l agents/d,in conjunction 5d.Continuous treatment of three menstrual cycles for a course.Observation of clinical symptoms,dominant follicle diameter,ovulation date endometrial thickness,adverse reactions.One course of treatment,to determine efficacy.[Results]The cure in 12 cases,14 cases,the total efficiency of 46.15%.The control group cured in 9 cases,15 cases,the total efficiency of 37.50%.Treatment group than the control group,the treatment group improved related indicators than the control group（P〈0.01）.[Conclusion]Bu Shen Zhu Yun prescription artificial cycle therapy combined with clomiphene citrate tablets infertility caused by polycystic ovary syndrome results were satisfactory,no side effects,worthy of promotion.