加味黄芪桂枝五物汤对肾虚型不孕症患者激素水平及血流动力学的影响

The impact of hormone and hemodynamic of Huangqi Guizhi five drugs decoction for patients with kidney deficiency infertility

目的探讨加味黄芪桂枝五物汤对肾虚型不孕症患者激素水平及血流动力学的影响。方法采用前瞻性研究,将112例肾虚型不孕症患者依据随机数字表法分为观察组和对照组各56例。对照组采用常规雌孕激素周期治疗,观察组在对照组的基础上联合服用黄芪桂枝五物汤。比较两组患者临床疗效、中医证候积分、激素水平和血流动力学指标等。结果观察组有效率为83.93%明显高于对照组的66.07%,差异有统计学意义(P<0.05);观察组治疗后,月经情况、头晕耳鸣、腰膝酸软、舌质等证候积分均明显低于对照组,差异均有统计学意义(P<0.01);雌二醇(E2)、孕酮(P)水平明显高于对照组(P<0.05),促卵泡激素(FSH)、黄体生成素(LH)水平明显低于对照组,差异均有统计学意义(P<0.01);子宫动脉血流阻力指数(RI)、子宫动脉血流搏动指数(PI)、子宫动脉收缩压和舒张压比值(S/D)均明显低于对照组,差异均有统计学意义(P<0.05)。结论加味黄芪桂枝五物汤有助于改善肾虚型不孕症患者临床症状,提高治疗效果,可能与调节血清激素水平,改善子宫动脉血流动力学指标有关。

Objective To study effect of hormone and hemodynamic of Huangqi Guizhi five drugs decoction for patients with kidney deficiency infertility.Methods 112 patients with kidney deficiency infertility from June 2014 to May 2015 were divided into observation group and control group.The control group was given female progestational hormone cycles therapy,the observation group combined wtih Huangqi Guizhi five drugs decoction therapy.After this,hormone levels,hemodynamic,clinical curative effect were compared between two groups.Results The effective rate of observation group was 83.93%,which was significantly higher than the control group 66.07%(χ^2=4.762,P<0.05).Menstruation situation,dizziness tinnitus,lumbar debility,tongue ect symptom score were significantly lower than the control group[(1.36±0.24 vs.2.01±0.34),(1.12±0.26 vs.2.01±0.35),(1.22±0.24 vs.2.02±0.30)](t=11.688,13.949,12.445,13.583,P<0.001).Serum E2,P were significantly higher than control group.FSH,LH were significantly lower than control group[(108.24±12.24 vs.98.24±11.94)pmol/L,(9.14±1.02 vs.6.23±0.78)μg/L,(2.58±0.45 vs.4.24±0.67)U/L,(6.84±0.84 vs.8.24±1.02)U/L](t=4.376,16.959,15.391,7.929,P<0.05,P<0.001).Uterine artery RI,PI,S/D were significantly lower than control group[(0.70±0.08 vs.0.86±0.0),(2.51±0.24 vs.2.77±0.21),(10.03±0.97 vs.11.21±0.84)](t=3.159,3.910,6.882,P<0.05).Conclusion Huangqi Guizhi five drugs decoction can help improve clinical symptoms of patients with kidney deficiency infertility,improve therapy effect,may be related to regulating serum hormone levels,improve the uterine artery blood flow mechanics index.