益肾促排方联合氯米芬对多囊卵巢综合征不孕的疗效研究

Study on effect of Yishen Cupai Decoction combined with clomiphene in treating infertility of polycystic ovary syndrome

目的探讨益肾促排方联合氯米芬对多囊卵巢综合征(PCOS)不孕的疗效。方法选取安徽中医药大学第一附属医院2012年5月至2015年11月收治的96例PCOS不孕患者,按照随机数字表法,随机分为常规组(48例)和试验组(48例)。常规组患者从月经第5天开始,口服枸橼酸氯米芬胶囊,每日1次,每次50mg,连服5d。试验组从月经第5天起,在口服枸橼酸氯米芬胶囊的基础上应用益肾促排方,每日一剂,B超监测排卵正常且卵泡直径达到18mm以上则停用,如无该现象则持续服药至下月月经来潮时。治疗3个月经周期后,统计两组患者治疗前后的子宫内膜厚度、卵泡直径、孕酮以及黄体生成素、卵泡刺激素、睾酮和雌二醇指标水平。结果治疗3个月经周期后,试验组患者治疗治愈25例(54.2%),有效19例(39.6%),无效4例(8.3%),总体有效率为93.8%;常规组患者治疗治愈20例(41.6%),有效18例(37.5%),无效10例(20.8%),总体有效率为79.1%。试验组治疗后排卵期卵泡直径、子宫内膜厚度,以及孕酮、黄体生成素、卵泡刺激素、睾酮、雌二醇水平优于常规组,差异均有统计学意义(P<0.05)。结论益肾促排方联合氯米芬治疗PCOS不孕有着较好的治疗效果,可以增加患者妊娠率,效果优于仅使用氯米芬治疗。

Objective To explore the effect of Yishen Cupai Decoction combined with clomiphene in treating infertility of polycystic ovary syndrome（PCOS）.Methods Ninety-six cases of PCOS infertility in our hospital from May 2012 to November 2015 were selected and divided into the conventional group（48 cases）and test group（48 cases）according to the random number table method.The conventional group began to take oral Clomifene Citrate Capsules from 5d of menstruation,once daily,50 mg each time,for consecutive 5d.The test group applied Yishen Cupai Decoction on the basis of oral Clomifene Citrate Capsules,daily one agent,and stopped the medication until ovulation normal and reaching above 18 mm by B-type monitoring,if there was no such phenomenon,then the medication continued until next menstruation.The endometrial thickness,follicle diameter,progesterone and luteinizing hormone（LH）,follicle stimulating hormone（FSH）,testosterone and estradiol levels after three menstrual cycles of treatment were statistically analyzed in the two groups.Results After 3menstrual cycles of treatment,25 cases in the test group were cured（54.2%）,19 cases（39.6%）were effective,4 cases（8.3%）were invalid,and the total effective rate was 93.8%,while 20 cases（41.6%）in the conventional group were cured,18 cases（37.5%）were effective,10 cases（20.8%）were invalid,and the total effective rate was 79.1%;the ovulation follicle diameter,endometrial thickness,progesterone,LH,FSH,testosterone and estradiol levels in the test group were superior to those in the conventional group,the differences were statistically significant（P〈0.05）.Conclusion Yishen Cupai Decoction combined with clomiphene has a better therapeutic effect in treating PCOS fertility,can increase the pregnancy rate,and its effect is better than that of only clomiphene use.