调经促孕丸联合地屈孕酮治疗黄体功能不全性不孕症的疗效观察

Clinical observation of Tiaojing Cuyun Pills combined with dydrogesterone in treatment of infertility due to luteal insufficiency

目的探讨调经促孕丸联合地屈孕酮片治疗黄体功能不全性不孕症临床疗效。方法选取2015年4月—2017年4月在中国航天科工集团七三一医院治疗的黄体功能不全性不孕症患者82例,根据用药差别分为对照组(41例)和治疗组(41例)。对照组口服地屈孕酮片,首剂量40 mg,之后10 mg/次,1次/8 h;治疗组在对照组基础上口服调经促孕丸,5 g/次,2次/d。两组均治疗3个月。观察两组患者临床疗效,同时比较治疗前后两组患者性激素水平、Salle评分、HPS评分和PNI指数及子宫内膜容受性指标。结果治疗后,对照组和治疗组临床有效率分别为80.49%和95.12%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清黄体生成激素(LH)、促卵泡成熟激素(FSH)、孕酮(P)、雌二醇(E_2)水平均显著升高(P<0.05),且治疗组患者FSH、LH、E_2、P水平明显高于对照组(P<0.05)。治疗后,两组Salle评分、HPS评分和PNI指数均明显升高(P<0.05),且治疗组患者Salle评分、HPS评分和PNI指数明显高于对照组(P<0.05)。治疗后,两组子宫内膜厚度显著增加(P<0.05),搏动指数(PI)和阻力指数(RI)显著降低(P<0.05),卵巢基质血流收缩期峰值血流速度(PSV)和舒张末期流速(EDV)显著升高(P<0.05),且治疗组患者这些指标明显好于对照组(P<0.05)。结论调经促孕丸联合地屈孕酮片治疗黄体功能不全性不孕症能够显著改善黄体功能及性激素水平,改善子宫内膜容受性,降低卵巢血流阻力,进而提高妊娠率,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Tiaojing Cuyun Pills combined with dydrogesterone in treatment of infertility due to luteal insufficiency. Methods Patients(82 cases) with infertility due to luteal insufficiency in 731 Hospital of China Aerospace Science and Industry Group from April 2015 to April 2017 were divided into control(41 cases) and treatment(41 cases)groups based on different treatments. Patients in the control group were po administered with Dydrogesterone Tablets, the first dose was40 mg, then 10 mg/time, once every 8 h. Patients in the treatment group were po administered with Tiaojing Cuyun Pills on the basis of the control group, 5 g/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the sex hormone levels, Salle scores, HPS scores, PNI indexes and endometrial receptivity in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.49% and 95.12%respectively, and there were differences between two groups(P < 0.05). After treatment, the FSH, LH, E2, and P levels in two groups were significantly increased(P < 0.05), and these sex hormone levels in the treatment group were significantly higher than those in the control group(P < 0.05). After treatment, the Salle scores, HPS scores, PNI indexes in two groups were significantly increased(P <0.05), and these indicators in the treatment group were significantly higher than those in the control group(P < 0.05). After treatment,the endometrial thickness, PSV, and EDV in two groups was significantly increased(P < 0.05), but PI and RI were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05).Conclusion Tiaojing Cuyun Pills combined with dydrogesterone in treatment of infertility due to luteal insufficiency can significantly improve luteal function and sex hormone levels, improve endometrial receptivity, reduce ovarian blood flow resistance,and improve pregnancy rate, which has a certain clinical application value.