复方玄驹胶囊联合补佳乐治疗薄型子宫内膜的临床疗效研究

Efficacy of Xuanju capsule with progynova in treatment of thin endometrium

目的探讨冻融胚胎移植(FET)过程中,复方玄驹胶囊联合补佳乐治疗薄型子宫内膜的临床疗效。方法选取2016年1~8月在中国人民解放军第202医院助孕治疗,既往因子宫内膜薄取消周期或移植后未成功妊娠而再次行FET的薄型子宫内膜患者130例为研究对象,随机分为4组。A组:不给予药物干预;B组:给予补佳乐3mg口服,bid,至移植日;C组:给予复方玄驹胶囊3粒口服,tid,至移植日;D组:联合应用补佳乐和复方玄驹胶囊,用法同上。每周随访子宫内膜厚度及激素水平,移植后1个月随访妊娠情况,并进行对比分析。并对治疗前后子宫内膜厚度的变化情况按患者年龄(≥35岁、<35岁)及不孕年限(>2年、≤2年)进行分层分析。结果按年龄分层分析显示,无论<35岁还是≥35岁,患者子宫内膜厚度均呈增加趋势,D组增长最为显著,组间比较有显著性差异(P<0.05)。4组中不孕年限≤2年患者的子宫内膜增长厚度均显著大于不孕年限>2年者(P<0.05)。D组的临床妊娠率显著高于A组(P=0.010);经二元Logistic回归分析发现,<35岁患者的年龄及移植胚胎数对薄型子宫内膜患者的妊娠率有较好的预测作用;D组移植前E2水平和移植胚胎数对妊娠率有较好的预测作用。结论 FET内膜准备过程中复方玄驹胶囊与补佳乐联用可有效促进子宫内膜增厚,改善内膜容受性,提高妊娠率。

Objective：To explore the efficacy of Xuanju capsule combined with progynova in patients with thin endometrium in frozen embryo transfer（FET）cycle.Methods：A total of 130 patients who were cancelled the transplantation due to thin endometrium or failed to be pregnant after transfer and undergoing to another FET were recruited from Chinese PLA 202 hospital Between Jan.and Aug.2016.They were randomly divided into four groups by random number table.The patients were not given any drug in group A;the patients were given progynova orally（3mg bid）until the day of embryo transfer in group B;the patients were given Xuanju capsule orally（3pills tid）until the same day in group C;and the patients were given both progynova and Xuanju capsule（ditto）in group D.Endometrial thickness and hormone levels of patients were detected every week after treatment and gestation status were evaluated at 1 month after embryo transfer.The changes in endometrial thickness before and after treatment were stratified by age（≥35years,〈35years）and infertility years（〉2years,≤2years）.Results：According to age stratification analysis,regardless of 35years or≥35years,the endometrial thickness of all the patients showed an increasing trend.The most significant change of endometrial thickness was found in group D,and the difference was significant between the groups（P〈0.05）.The endometrial thickness increased in the patients with infertile duration≤2years was significantly higher than that in the patients with infertile duration〉2 years（P〈0.05）in the four groups.The clinical pregnancy rate of group D was significantly higher than that of group A（P=0.010）.Binary logistic regression analysis found that age of〈35 years and the number of transplanted embryos had a better predictive effect on the pregnancy rate in patients with thin endometrium.The E2 level and the number of transplanted embryos had a better predictive effect on pregnancy rate in group D.Conclusions：In the endometrial preparation process of FET cycle,Xuanju capsule combined with progynova can improve the endometrial thickness and endometrial receptivity,and increase the pregnancy rate.