益肾健脾方改善多囊卵巢综合征不孕症患者子宫内膜容受性的临床观察

Clinical Observation on Yishen Jianpi Decoction in Improving Endometrial Receptivity of Patients with Polycystic Ovary Syndrome Infertility

目的观察益肾健脾方改善多囊卵巢综合征不孕症患者子宫内膜容受性的临床疗效,并探讨其机理。方法将60例多囊卵巢综合征不孕症患者随机分为对照组(单独应用克罗米芬)和实验组(益肾健脾方+克罗米芬),每组30例,连续观察3个月经周期,统计每组排卵例数及妊娠例数,观察治疗前、后每组子宫内膜厚度类型及血流状态。结果 (1)实验组和对照组患者治疗后排卵率相近,比较无显著差异(P>0.05),但妊娠率显著高于对照组(P<0.05);(2)实验组治疗后子宫内膜厚度较治疗前及对照组均增加,比较有显著差异(P<0.05),实验组治疗后A+B型内膜例数较治疗前增加,但比较无显著差异(P>0.05),且子宫内膜类型分布无显著差异(P>0.05);(3)实验组治疗后子宫内膜血流参数PI、RI明显低于治疗前及对照组,比较有显著明显差异(P<0.05)。结论益肾健脾方可增加多囊卵巢综合征不孕症患者子宫内膜厚度,降低子宫内膜血流参数PI、RI,有效改善子宫内膜容受性,提高妊娠率。但对排卵率和子宫内膜类型的分布影响不明显。

Objective To observe the curative effect of Yishen Jianpi decoction in improving endometrial receptivity of patients with polycystic ovary syndrome infertility, and to discuss the mechanism of action. Methods Sixty cases of polycystic ovary syndrome infertility patients were randomly divided into control group who were treated with CC and experimental group who were treated with Yishen Jianpi decoction and CC, and each group had 30 patients, with continuous observation of three menstrual cycles.The ovulation rate and pregnancy rate of each group were calculated, endometrial thickness and blood flow status in each group before and after treatment were observed. Results The experimental group and the control group of patients had similar ovulation rate, and there was no significant difference（P〈0.05）, but the pregnancy rate in the experimental group was significantly higher than that in the control group（P〉0.05）. The endometrial thickness of the experimental group after treatment was increased comparing with that before treatment and the control group, and there were significant differences（P〈0.05）. In the experimental group, the number of patients treated with A＋B was increased, but no significant difference（P〉0.05）, and there was no obvious difference in the distribution of endometrial type（P0.05）. The blood flow parameters PI and RI in the experimental group after treatment were significantly lower than those in the treatment group before treatment and the control group, and there were significant differences（ P〈0.05）. Conclusion Yishen Jianpi decoction can increase endometrial thickness and reduce endometrial blood flow parameters PI and RI, effectively improve the endometrial receptivity and the pregnancy rate. But the effect on the ovulation rate and the distribution of the endometrial type was not obvious.