补肾祛瘀化痰汤对多囊卵巢致不孕患者卵巢功能及妊娠结局的影响

Effect of Bushen Quyu Huatan Decoction on Ovarian Function and Pregnancy Outcome in Patients with Infertility Caused by Polycystic Ovary Syndrome

目的:探讨补肾祛瘀化痰汤对多囊卵巢致不孕患者卵巢功能及妊娠结局的影响。方法:将148例多囊卵巢致不孕患者随机分为对照组74例和研究组74例。对照组予以枸橼酸氯米芬胶囊50 mg,1次/d,月经周期或撤药性出血第5天开始口服,连续服用5 d;研究组在对照组基础上予以补肾祛瘀化痰汤150 mL,2次/d,月经周期或撤药性出血第5天开始口服,连续服用20 d。两组患者均治疗3个周期。比较两组间临床疗效、妊娠率、卵巢血流动力学指标、血清性激素水平及不良反应发生率。结果:对照组总有效率(54.06%)低于研究组总有效率(77.02%),具有统计学意义(P<0.05)。对照组妊娠率(43.24%)低于研究组妊娠率(70.27%),具有统计学意义(P<0.05)。治疗后,与对照组比较,研究组卵巢动脉收缩期峰值流速(PSV)、搏动指数(PI)水平较高,阻力指数(RI)水平较低,血清黄体生成激素(LH)、黄体生成激素/卵泡刺激素(LH/FSH)、睾酮(T)水平较低,具有统计学意义(P<0.05)。治疗过程中,两组不良反应为恶心、腹胀、胃痛和视力模糊。研究组和对照组不良反应发生率分别为12.15%和9.45%,两组间差异无统计学意义(P>0.05)。结论:补肾祛瘀化痰汤能明显调节多囊卵巢致不孕患者卵巢血流动力学指标及性激素水平,提高卵巢功能,改善妊娠结局,临床疗效及安全性高,有临床推广应用价值。

Objective:To investigate the effect of Bushen Quyu Huatan Decoction on ovarian function and pregnancy outcome in patients with infertility caused by polycystic ovary syndrome. Methods:A total of 148 patients with infertility caused by polycystic ovary syndrome were randomly divided into control group with 74 cases and experiment group with 74 cases. The control group was treated with clomifene citrate capsules 50 mg, once a day,taking orally from the fifth day of menstrual cycle or withdrawal bleeding, continuously for 5 d. On the basis of the control group, the experiment group received Bushen Quyu Huatan Decoction 150 mL,twice a day,taking orally from the fifth day of menstrual cycle or withdrawal bleeding, continuously for 20 d. Two groups were both treated for 3 cycles. The clinical efficacy, pregnancy rate, indexes of ovarian hemodynamics, serum sex hormone levels and incidence of adverse drug reactions were compared between two groups. Results:The total effective rate in the control group(54.06%)was lower than that in the experiment group(77.02%)with significant difference(P<0.05). The pregnancy rate in the control group(43.24%)was lower than that in the experiment group(70.27%) with significant difference(P<0.05). After treatment, compared with the control group, the peak systolic velocity(PSV) and pulsatility index(PI) of ovarian artery were higher. The resistance index(RI) level was lower in the experiment group. Serum levels of luteinizing hormone(LH), luteinizing hormone/follicle stimulating hormone(LH/FSH) and testosterone(T) levels were lower with significant difference(P<0.05). In the course of treatment, the adverse drug reactions in the two groups were nausea, bloating, stomachache and blurred vision. The incidence of adverse reactions in the experiment group and the control group was 12.15% and 9.45%, respectively. There was no significant difference between the two groups(P>0.05). Conclusion:Bushen Quyu Huatan Decoction can significantly regulate the indexes of ovarian hemodynamics and sex hormone levels in patients with infertility caused by polycystic ovary syndrome. It can improve ovarian function and pregnancy outcome. The clinical efficacy and safety were high and it has the value of clinical popularization and application.