五子衍宗丸合毓麟珠加减治疗子宫内膜薄型不孕症的临床研究

Clinical Study on Wuzi Yanzong Pill and Yulin Zhu in the Treatment of Infertility of Thin Endometrium Type

目的:观察五子衍宗丸合毓麟珠加减配合小剂量雌激素对肾虚血瘀型子宫内膜薄型不孕症患者妊娠结局的影响。方法:将符合诊断标准的92例肾虚血瘀型子宫内膜薄型不孕症患者按照随机数字表法分为观察组和对照组,每组各46例,对照组给予戊酸雌二醇片(补佳乐)治疗,2 mg/d;观察组在对照组基础上加服五子衍宗丸合毓麟珠加减,1剂/d,均治疗3个月经周期。比较治疗前后两组患者的子宫内膜厚度、子宫内膜动脉参数、血清性激素水平的变化,评估临床疗效、妊娠结局及不良反应发生情况。结果:观察组总有效率为91.3%,高于对照组总有效率73.9%(P<0.05);治疗后两组子宫内膜厚度、血清孕酮(P)、雌二醇(E 2)水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);治疗后两组血流阻力指数(PI)和搏动指数(RI)指标、血清促卵泡成熟激素(FSH)水平较治疗前明显降低(P<0.05),且观察组明显低于对照组(P<0.05);治疗后,观察组妊娠率为76.1%,高于对照组(56.5%,P<0.05);两组治疗期间均未出现严重不良反应。结论:五子衍宗丸合毓麟珠加减配合小剂量补佳乐能调节肾虚血瘀型子宫内膜薄型不孕症患者血清性激素水平,改善子宫内膜血供,促进子宫内膜增厚,有助于提高妊娠率。

Objective:To observe the effect of modified Wuzi Yanzong pill and Yulin Zhu combined with low dose estrogen on the pregnancy outcome of infertility patient of thin endometrium type with Shenxu Xueyu syndrome.Methods:92 patients of thin endometrium infertility with Shenxu Xueyu syndrome were divided into observation group and control group according to random number table method,with 46 cases in each group.The control group was given estradiol valerate tablet(Progynova),2 mg/d;On the basis of the control group,the observation group was given additional modified Wuzi Yanzong pill and Yulin Zhu,1 dose/d.After treated for 3 menstrual cycles,the changes of endometrial thickness,endometrial artery parameters,and serum sex hormone level before and after treatment were compared between the two groups.The clinical efficacy,pregnancy outcome and adverse reaction were analysed.Results:The total effective rate of the observation group was 91.3%,which was significantly higher than that of the control group(73.9%,P<0.05);After treatment,the endometrial thickness,the levels of serum P and E 2 of the two groups were significantly higher than those before treatment(P<0.05),with more increase found in the control group(P<0.05);The levels of PI and RI,serum FSH were significantly lower than before treatment in both groups(P<0.05),with more reduction found in the observation group(P<0.05);After treatment,the pregnancy rate of the observation group was 76.1%,which was significantly higher than that of the control group(56.5%,P<0.05).No severe adverse reaction was found in both groups during treatment.Conclusion:The application of modified Wuzi Yanzong pill and Yulin Zhu combined with low dose Progynova in the treatment of thin endometrium infertility patients with Shenxu Xueyu syndrome can regulatethe level of serum sex hormone,promote the blood supply of endometrium,promote the thickening of endometrium,and improve the pregnancy rate.