补肾健脾加减方对卵巢储备功能减退患者卵巢储备功能及IVF-ET结局的影响

Effect of Bushen Jianpi Decoction on Ovarian Reserve Function for Patients with DOR and IVF-ET Outcome

目的:观察补肾健脾加减方对卵巢储备功能减退(DOR)患者的卵巢储备功能及IVF-ET的影响。方法:选取江苏省中医院妇科及生殖科门诊DOR患者60例,随机将其分成2组,分别为对照组及治疗组,每组30例,对照组予芬吗通口服28天停药,待月经来潮,于行经第2天继续服用芬吗通,连续3个周期。治疗组在对照组基础上予补肾健脾加减方治疗,3个周期结束后接受IVF-ET周期。分析比较治疗组患者治疗前后基础卵泡数、基础内分泌水平、IVF周期治疗参数的变化。结果:治疗组经治疗后中医症候积分明显低于对照组(P<0.05),中医症候改善总有效率明显高于对照组(P<0.05),性激素指标FSH值、E2值、LH值较前下降,且与对照组存在显著性差异(P<0.05),两组基础卵泡数较前增加(P<0.05),治疗组与对照组比较基础窦卵泡计数明显增加(P<0.05),治疗组患者胚胎种植率、临床妊娠率较对照组均明显提高(P<0.05),周期取消率呈降低趋势(P<0.05)。结论:补肾健脾加减方可有效改善DOR患者其卵巢储备功能,提高卵巢反应性,增加促排卵效果,进而提高IVF-ET的临床妊娠率。

Objective： To observe the effect of Modified Bushen Jianpi Decoction on ovarian reserve function and IVF-ET in patients with ovarian reserve dysfunction （DOR）. Methods： 60cases of DOR patients in Jiangsu Prorncial Hospital of Trational Chinese Medicine gynecology Cnd fertinty clinic were randomly divided into 2groups, controlled group and treatment group, 30cases in each group, the controlled group was treated with femonston treatment, taking 28days in a row, after stopping until menstruation, in the second day repeated use, taking a total of 3cycles, the treatment group on the basis of the controlled group treated by Modified Bushen Jianpi Decoction, 3cycle after receiving IVF-ET cycle. The changes of basal follicle count, basal en- docrine level and treatment parameters of IVF cycle were analyzed before and after treatment in the reatment group. Results ： The treatment group after treatment of TCM syndrome score was significantly lower than the controlled group （ P〈0. 05 ）, TCM syn- drome improvement rate was signifieantly higher than the controlled group （P〈0. 05）, FSH, E2, LH there was a significant difference with the controlled group （ P〈0. 05 ）, basal follicular number was increased than before （ P〈0. 05 ）, the treatment group increased significantly compared with the controlled group of follicle count （P〈0. 05）, embryo implantation rate and clini- cal pregnancy rate were increased （P〈0. 05）, the cycle cancellation rate decreased （P〈0. 05 ）. Conclusion： Modified Bushen Jianpi Decoction can effectively improve the ovarian reserve function of DOR patients, increase the ovarian reactivity, increase the effect of ovulation induction, and thus improve the clinical pregnancy rate of IVF-ET.