补肾化痰活血法对肾阳虚型多囊卵巢综合征排卵障碍性不孕患者子宫内膜容受性及促排卵的干预研究

Invigorating kidney and resolving phlegm method of intervention on kidney yang deficiency PCOS ovulation disorder infertility patients with endometrial receptivity and ovulation

目的:探讨补肾化痰活血法对肾阳虚型多囊卵巢综合征(PCOS)排卵障碍性不孕妇女子宫内膜容受性及促排卵的干预作用。方法:选取我院妇科收治的PCOS所致不孕妇女78例,分两组每组39例。对照组予氯米芬治疗,治疗组在此基础上予补肾化痰活血汤治疗,均治疗6个月经周期。检测血清生殖激素变化,应用彩色超声诊断仪检测子宫内膜发育以及卵泡发育情况,并随访6个月记录妊娠结局情况。结果:与治疗前相比,两组FSH、E_2、P升高,LH降低。子宫动脉RI、PI降低,V_(max)、V_(mean)无变化,子宫内膜厚度增厚。子宫内膜A型比例升高,卵巢体积、卵泡数目降低,主卵泡直径增大。与对照组相比,治疗组FSH、E2、P较高,LH较低,子宫动脉RI、PI较低,子宫内膜厚度较厚,子宫内膜A型比例较高,卵巢体积、卵泡数目较低,主卵泡直径较大,总有效率较高,临床妊娠率、生化妊娠率较高。结论:补肾化痰活血法治疗肾阳虚PCOS排卵障碍性不孕症,有助于卵泡发育及提高子宫内膜容受性。

Objective:Study on invigorating kidney and resolving phlegm method on kidney yang deficiency PCOS ovulation disorder infertility women with endometrial receptivity and the intervention effect of ovulation.Methods:Select 78 cases of infertility caused by PCOS in our hospital were randomly divided into control group and treatment group,each group of 39 cases.The control group was treated with clomiphene treatment,the treatment group based on the given invigorating kidney and resolving phlegm decoction,were treated for 6 menstrual cycles.The changes of serum reproductive hormones were detected,and the development of endometrium and follicular development were detected by color doppler ultrasound.The pregnancy outcomes were followed up for 6 months.Results:Compared with before treatment,the levels of FSH,E 2 and P in the two groups,LH decreased,Uterine artery RI,PI decreased,V max,V mean no change,endometrial thickness.The proportion of A type of endometrium increased,Ovarian volume,follicle number decreased,the diameter of primary follicles increased.Compared with the control group,the treatment group FSH,E 2,P were higher and LH was lower,the endometrial thickness was thicker,the proportion of A was higher,the volume of ovary and the number of follicles were lower,the diameter of main follicle was larger,the total effective rate was higher,the clinical pregnancy rate and the biochemical pregnancy rate were higher.Conclusion:The method of tonifying kidney,removing phlegm and activating blood circulation in the treatment of kidney yang deficiency of PCOS ovulation disorder infertility is helpful to the development of follicle and the enhancement of the capacity of endometrium,which is of great significance to improve the pregnancy rate.