不孕症各中医证型患者超声卵泡监测特征性分析

Ultrasound follicular monitoring characteristics of infertile patients with different TCM syndromes

目的分析不孕症各中医证型患者的卵泡监测特点。方法统计155例不孕症各中医证型患者的窦卵泡数(AFC)及排卵类型,分析各证型患者的卵泡监测特征。结果不孕症中医证型以肾虚为主;以AFC预测卵巢储备功能,其中瘀滞胞宫证患者卵巢储备功能下降最明显(81%),痰湿阻滞证卵巢储备功能下降比例最少(47%);肾阳亏虚患者小卵泡排卵的发病率最高(33%),肝气郁滞患者无排卵(22%)及卵泡黄素化不排卵(13%)的比例较高。结论肾虚证是不孕症的主要证型,其与卵泡发育及排卵障碍相关;肝郁气滞证与排卵障碍相关,主要表现为小卵泡排卵及卵泡黄素化不排卵;瘀滞胞宫证与卵巢储备功能下降相关,痰湿阻滞证与多囊卵巢综合征所致不孕相关。

Objective To analyze ultrasound characteristics in infertility patients with different TCM syndromes. Methods The sinus follicle number and ovulation type of 155 infertile patients with different TCM syndromes were analyzed, the follicle monitoring characteristics of the patients with different TCM syndromes were studied. Results TCM syndrome of infertility was given priority to kidney defficiency. When the ovarian reserve function was predicted by sinus follicle number, the patients with syndrome of static blood blocking in uterus had the most obvious reduction in ovarian reserve function （81%）, but those with phlegmy wet block syndrome had the least reduction （47%）. The incidence of small follicle ovulation was the highest in the patients with kidney Yang deficiency （33%）, the patients with liver Qi stagnation had high incidences of anovulation （22%） and luteinized follicle anovulation （13%）. Conclusions Kidney deficiency is the main syndrome type of infertility, and has high correlation with follicular development and ovulation obstacle. Syndrome of liver Qi stagnation is associated with ovulation disorder and manifested as small follicle ovulation and luteinized follicle anovulation. Syndrome of static blood blocking in uterus has a close correlation with reduction of ovarian reserve function. The phlegmy wet block syndrome is correlated with infertility caused by polycystic ovary syndrome.