低剂量阿司匹林联合调经促孕丸对多囊卵巢综合征患者卵泡周围血流信号及妊娠结局的影响

Effect of low-dose Aspirin combined with Tiaojing Cuyun Pills on follicular blood flow and pregnancy outcome of patients with polycystic ovarian syndrome

目的 研究低剂量阿司匹林联合调经促孕丸对多囊卵巢综合征(PCOS)合并不孕患者卵泡周围血流信号及妊娠结局的影响及其临床应用价值。方法 选取2018年9~12月在首都医科大学附属北京妇产医院妇科内分泌门诊诊治的PCOS不孕患者78例(107个周期)。采用入院患者编号奇偶性方法进行随机分组:试验组38例,采用来曲唑(LTZ)+阿司匹林+调经促孕丸治疗;对照组40例,单用LTZ治疗。两组于肌肉注射人体绒膜促性腺激素(HCG)日B超监测子宫内膜,卵泡成熟度,周围动脉血流数值[阻力指数(RI)、卵泡周围血流搏动指数(PI)、收缩期最大流速(PSV)、舒张末期血流速度(EDV)],周期排卵,周期临床妊娠等;评价临床干预价值。对照组未妊娠者重新采用试验组治疗方案者29例,观察促排卵治疗效果。结果 试验组周期妊娠率高于对照组(P <0.05)。与对照组比较,试验组HCG日PI、RI值显著下降,EDV明显升高(P <0.05)。对照组促排卵失败患者下一周期采用试验组方案干预治疗,与更换用药方案前比较,同一患者HCG日PI、RI明显降低,EDV明显升高(P <0.05),周期妊娠率明显升高(P <0.05)。结论 低剂量阿司匹林联合调经促孕丸治疗PCOS不孕对比单纯西医治疗有明显优势,能显著促进卵泡生长发育、进一步提高妊娠率,是一种有效的助孕方式。

Objective To study the clinical effect of low dose Aspirin combined with Tiaojing Cuyun Pills on the follicular blood flow and pregnancy outcome of patients with polycystic ovary syndrome(PCOS)and its clinical application value.Methods From September to December 2018,78 infertility women(107 cycles)with PCOS were selected and they were randomly grouped according to the odd-even of admission number:38 cases of experimental group were treated with Letrozole(LTZ),Aspirin and Tiaojing Cuyun Pills,while 40 cases of control group were treated with LTZ only.The endometrial thickness,follicles maturation,values of follicle peripheral artery[pulsatility index(PI),resistance index(RI),peak systolic velocity(PSV),end diastolic velocity(EDV)],periodic ovulation rate and periodic pregnancy rate on the day of human chorionic gonadotropin(HCG)administration were measured by B ultrasound,and the clinical intervention value was observed.The patients who failed pregnancy in the control group were reintegrated into the experiment group in the next cycle(n=29),and the ovulation treatment effect was observed.Results The rate of pregnancy cycle in the experiment group was higher than that in the control group(P<0.05).Patients who failed pregnancy were given the same intervention as experimental group in the next cycle,compared with before changing medication regimen,PI and RI were significantly lowered,while EDV was significantly increased(P<0.05),the rate of pregnancy cycle was significantly higher of the same patients.Conclusion Compared with simple Western medicine treatment,low-dose Aspirin combined with Tiaojing Cuyun Pills can effectively improve follicle perifollicular artery blood flow,enhance the oocyte development and clinical pregnancy rate.It is an effective way to help pregnancy.