疏肝滋肾方对冻融胚胎移植周期临床结局影响

Effect of Shugan Zishen Decoction on Clinical Outcomes of Frozen-thawed Embryo Transfer Cycles

目的:观察疏肝滋肾方对冻融胚胎移植周期临床结局及子宫内膜环境的影响。方法:将86例肝郁肾虚型患者冻融胚胎移植周期随机分为两组,治疗组(n=42)于前1个月经周期黄体期起采用疏肝滋肾方治疗,至移植日停止。内膜准备采用常规激素替代方法 ;对照组(n=44)内膜准备采用常规激素替代方法,月经第2天起口服雌二醇至移植日,移植日起两组均行黄体支持,14 d后检测血HCG,HCG阳性者于移植28 d后行B超观察胚胎发育情况。比较两组患者治疗前后肝郁肾虚症状,内膜转化日子宫内膜的厚度、形态以及血流,临床妊娠结局。结果:治疗组患者治疗后肝郁肾虚症状得到明显改善,差异有统计学意义(P<0.01);治疗组内膜转化日子宫内膜下血流参数、厚度较对照组改善,差异有统计学意义(P<0.05);治疗组子宫内膜类型、生化妊娠率及临床妊娠率较对照组有提高,但未显示有明显统计学差异。结论:在IVF-ET冻融胚胎移植周期,疏肝滋肾方能改善患者肝郁肾虚症状,增加子宫内膜厚度及血流情况,有助于提高临床妊娠率。

Objective ：To observe the effect of Shugan Zishen Decoction on endometrial receptivity and clinical outcomes of frozen-thawed embryo transfer cycles（FET）. Methods ：86 infertile patients in the reproductive medical center patients diagnosed as the kidney deficiency and liver depression syndrome in the research protocol were randomly divided into two groups. The patients in treatment group（n=42）with Shugan Zishen Decoction initiated in the mid-luteal phase of the preceding cycle. The two groups prepared for FET with hormone replacement treatment. Observing and recording the general data of two groups ：kidney deficiency and liver depression syndrome score before and after treatment;the endometrial thickness,endometrial morphology,endometrial blood flow velocity. The results of serum β-h CG on the 14 th day and ultrasound monitoring on the 28 th day after FET were reported for pregnancy outcomes. Results ：The patients of two groups had similar profiles of age,type of infertility. The difference of the two groups patients with kidney deficiency and liver depression syndrome score before and after treatment has statistical significance（P〈0.01）. The endometrial thickness and endometrial blood flow parameters in treatment group were higher than that of control group on the day of endometrial conversion,the difference showed statistical significance（P〈0.05）;The type of endometrium and pregnant rate of treatment group were better than the control group,however the difference was insignificant. Conclusion ：Shugan Zishen Decoction can improve the syndromes of kidney deficiency and liver depression,and increase the endometrial thickness and blood perfusion to help for raising the clinical pregnant rate.