滋肾育胎丸同步促进未破裂卵泡黄素化综合征患者卵泡与子宫内膜发育的三维超声评价

Evaluation on the influence of Zishen Yutai Pill on follicle and endometrium growth of patients with LUFS by three-dimensional ultrasound

目的:运用三维能量多普勒超声结合4D-view软件评价滋肾育胎丸对LUFS患者卵泡及子宫内膜发育的影响,找出治疗靶点及作用机制。方法:42例脾肾两虚证LUFS患者随机分为3组:A组给予克罗米芬片+人绒毛促性腺激素;B组给予滋肾育胎丸;C组给予克罗米芬片+人绒毛促性腺激素+滋肾育胎丸,疗程均为3个月。观察各组治疗前后月经周期各节点卵泡体积、子宫内膜体积、卵巢及子宫内膜下血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI)等各参数变化。结果:3个月后,3组卵泡体积及子宫内膜体积均较治疗前增加。卵泡体积增长率C组>A组>B组;子宫内膜体积增长率C组>B组>A组。A组在围排卵期卵巢VI、FI、VFI较治疗前增高(P<0.05);B组及C组自卵泡中期至黄体晚期卵巢及子宫内膜下VI、FI、VFI增高(P<0.05),且呈周期性改变。结论:滋肾育胎丸在卵泡中期后能同时改善LUFS患者卵巢及子宫内膜下血流灌注,促进卵泡及子宫内膜发育。

Objective： To evaluate the influence of Zishen Yutai Pill on follicle and endometrium growth of patients with luteinized unruptured follicle syndrome（LUFS） by three-dimensional power Doppler ultrasound（3D-US） and 4D-view software. Methods： 42 LUFS patients with syndrome of deficiency of spleen and kidney were randomly divided into three groups： group A was treated by clomifene citrate capsules and human chorionic gonadotropin（HCG）, group B was treated by Zishen Yutai Pill, group C was treated by clomifene citrate capsules and HCG combined with Zishen Yutai Pill, treatment for 3 months. Before and after treatment, the volume of follicle and endometrium, the vascularization index（VI）, flow index（FI）, vascularization flow index（VFI） of ovary and endometrium in each menstrual cycle were observed. Results： After treatment, the volume of follicle and endometrium were increased in group A, B, and C（P〈0.05）; the order of follicle volume growth rate from high to low was group C, group A, and B; the order of endometrium volume growth rate from high to low was group C, group B, and A. After treatment, the blood flow parameters（VI, FI, VFI） of ovary during the periovulation phase were increased in group A（P〈0.05）; the blood flow parameters（VI, FI, VFI） of ovary and endometrium from mid-follicular to late luteal phase were increased periodically in the group B and group C（P〈0.05）. Conclusion： Zishen Yutai Pill could improve the blood flow perfusion of ovarian and endometrial after the mid-follicular phase and promote the development of the follicle and endometrium in LUFS patients.