中西医结合治疗多囊卵巢综合征所致不孕症38例

Thirty-Eight Cases with Infertility Due to Polycystic Ovary Syndrome Treated by Integrative Chinese and Western Medicine

目的:观察中西医结合治疗多囊卵巢综合征所致不孕症的临床疗效。方法:将76例患者随机分为对照组和观察组,每组各38例。对照组给予来曲唑口服,观察组在对照组的基础加用补肾疏肝汤口服。观察两组患者的临床疗效、排卵率及妊娠率,比较两组患者治疗前后中医证候积分情况及激素水平变化情况。结果:观察组有效率为73.68%,对照组有效率为50.00%,两组患者有效率比较,差异具有统计学意义(P<0.05);观察组排卵率为71.93%、妊娠率为55.26%,对照组排卵率57.02%、妊娠率31.58%,两组患者排卵率及妊娠率比较,差异均有统计学意义(P<0.05)。两组患者治疗后中医证候积分较治疗前明显下下降,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗后观察组黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)较治疗前下降(P<0.05),且观察组低于对照组,差异均有统计学意义(P<0.05);治疗后观察组促卵泡素(follicle-stimulating hormone,FSH)水平较对照组低,但差异无统计学意义(P>0.05);治疗后观察组雌二醇(estradiol,E2)较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.05);治疗观察组基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)及肝细胞生长因子(epatocyte growth factor,HGF)含量明显降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论:中西医结合治疗多囊卵巢综合征所致不孕症可通过调节内分泌激素水平及卵巢内蛋白MMP-9和HGF水平提高排卵率及妊娠率,临床疗效显著。

Objective：To observe the clinical effects of integrative Chinese and western medicine on infertility due to polycystic ovary syndrome （PCOS）. Methods：Totally 76 patients were randomly divided into control group and observation group, with 38 cases in each group. Control group were orally given Letrozole while observation group were added with Kidndy-Tonifying and Liver- Dispersing Decoction for oral administration. The clinical effects, ovulation rate and pregnancy rate in both groups were observed. The scores of TCM symptoms and the changes of the levels of hormones m the two groups were compared. Results ： The effective rate,ovulation rate and pregnancy rate was respectively 73.68% .71.93% and 55.26% in observation group while 50.00%, 57.02% and 31.58% respectively in control group;the differences had statistical significance （P 〈 0.05 ）. After the treatment, the levels of LH and T declined in observation group, and the levels in observation group were lower than that in control group （ P 〈 0.05 ）. The level of FSH in observation group was lower than that in control group, but the difference had no statistical significance （ P 〉 0.05 ）. The level of E2 in observation group increased ,higher than that in control group （ P 〈 0.05 ）. The contents of MMP-9 and HGF decreased apparently after the treatment ,and the contents of them in observation group were lower than those in control group, with statistical significance （P 〈 0.05 ）. Conclusion： In the treatment of infertility due to PCOS, integrative Chinese and western medicine can remarkably improve the ovulation rate and pregnancy rate by regulating the levels of endocrine hormones,MMP-9 and HGF.