补肾调冲汤治疗肾阳虚血瘀型黄体功能不全性不孕症临床研究

Clinical Study of Infertility due to Luteal Insufficiency of Kidney Yang Deficiency and Blood Stasis Treated with Bushen Tiaochong Decoction

目的：观察补肾调冲汤对肾阳虚血瘀型黄体功能不全性不孕症的临床疗效,并探讨其作用机制。方法 ：将62例符合纳入标准的患者随机分为治疗组和对照组各31例,治疗组治以补肾调冲汤联合黄体酮胶丸,对照组单纯用黄体酮胶丸治疗,进行临床疗效观察及对比研究。结果：两组在妊娠率、中医证候疗效、临床疗效、调节孕激素等方面差异均有统计学意义（P〈0.05）。且两组治疗后高温相评分相比差异有统计学意义（P〈0.05）。黄体中期雌二醇、孕酮值比较,治疗组治疗后孕酮值与对照组相比差异有统计学意义（P〈0.05）。子宫内膜血流参数比较,治疗组治疗后搏动指数（PI）、阻力指数（RI）与对照组相比差异有统计学意义（P〈0.05）。结论：补肾调冲汤能明显提高肾阳虚血瘀型黄体功能不全性不孕症妇女的临床妊娠率,其机制可能与提高孕激素水平,改善中医证候,改善子宫内膜下血流灌注,促进了黄体功能健全,改善内膜容受性有关。

Objective：To observe the clinical efficacy of Bushen Tiaochong Decoction on infertility due to luteal insufficiency of kidney yang deficiency and blood stasis,and to explore the underlying mechanism.Methods：Sixty two patients were randomly divided into treatment group and control group,31 cases in each group. The treatment group was treated with Bushen Tiaochong Decoction and progesterone soft capsules,while the control group was only given progesterone soft capsules. The clinical efficacy was observed and compared. Results：There were differences on pregnancy rate,TCM syndrome improvement,clinical efficacy and progestational hormone levels between two groups with statistical significiance（P〈0.05）. And the difference between the two groups after treatment of high phase score（HPS） was statistically significant（P〈0.05）.After treatment,the progesterone level in the control group was different from that in the treatment group,with statistical significiance（P〈0.05）. On endometrial blood flow parameters,after treatment,pulsatility index（PI） and resistance index（RI） in the control group were different from that in the treatment group,with statistical significiance（P〈0.05）. Conclusion：Bushen Tiaochong Decoction can significantly improve the pregnancy rate in the patients with infertility due to luteal insufficiency of kidney yang deficiency and blood stasis,and the mechanism may be related to the increase of progesterone level,improvement of TCM syndrome,endometrial perfusion and endometrial receptivity,and promoting the luteal function.