清热祛湿化瘀法辅助治疗IVF-ET中宫腔积液的临床观察

Clinical Observation of Endometrial Cavity Fluid in Patients During In-Vitro Fertilization-Embryo Transfer Treated with Adjunctive Therapy of Clearing Heat,Dispelling Dampness,and Resolving Blood Stasis

【目的】观察清热祛湿化瘀法辅助治疗体外受精—胚胎移植(IVF-ET)中宫腔积液的临床疗效。【方法】将60例行IVF助孕且移植周期发现宫腔积液的患者随机分为中药联合抽吸治疗组(简称治疗组)和单纯抽吸对照组(简称对照组),每组各30例。治疗组在月经周期第10～12天或激素替代治疗的第10～12天,阴道B超发现宫腔积液,随即在阴道B超监视下行宫腔抽吸术,术后内服清热祛湿化瘀中药方至移植日停药。对照组在月经周期第10～12天或激素替代治疗的第10～12天,阴道B超发现宫腔积液,随即在阴道B失,宫腔积液消失者进行胚胎移植,并观察2组的移植取消率和临床妊娠率情况。【结果】(1)治疗后,治疗组患者的宫腔积液发生率显著低于对照组,差异有统计学意义(P<0.05)。(2)治疗后,治疗组患者的移植取消率显著低于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的临床妊娠率比较,差异无统计学意义(P>0.05)。【结论】清热祛湿化瘀疗法可明显减少宫腔积液发生率,并在不影响临床妊娠率的基础上,可减少移植取消率。

Objective To investigate the clinical efficacy of adjunctive effect of therapy of clearing heat,dispelling dampness,and resolving blood stasis on endometrial cavity fluid(ECF)in the patients during in-vitro fertilization-embryo transfer(IVF-ET).Methods Sixty cases of ECF patients during IVF-ET were randomized into Chinese medicine combined suction group and suction group,30 cases in each group.The two groups received intrauterine suction once ECF was found on the day 10-12 of menstrual cycle or on the day 10-12 of hormone replacement therapy(HRT)visualized through transvaginal B ultrasound scan.And additionally,Chinese medicine combine dsuction group was given oral use of Chinese medicine for clearing heat,dispelling dampness,and resolving blood stasis after suction,and the oral use of Chinese medicine continued till the day for embryo transfer.On the day of embryo transfer,transvaginal B ultrasound scan was performed to confirm the existence of ECF.And embryo transfer was carried out for the patients without ECF.The embryo transfer cancellation rate and clinical pregnancy rate were compared in the two groups.Results(1)After treatment,the incidence of ECF in Chinese medicine combined suction group was much lower than that in the suction group,the difference being significant(P<0.05).(2)After treatment,the embryo transfer cancellation rate in Chinese medicine combined suction group was much lower than that in the suction group,the difference being significant(P<0.05).(3)After treatment,the difference of clinical pregnancy rate between the two groups was insignificant(P>0.05).Conclusion Therapy of clearing heat,dispelling dampness,and resolving blood stasis can obviously reduce the incidence of ECF,and can reduce the embryo transfer cancellation rate without decreasing the clinical pregnancy rate.