补肾调经育子汤联合来曲唑对肾虚血瘀型多囊卵巢综合征不孕患者卵泡发育及血清性激素结合球蛋白水平的影响

Effects of Bushen Tiaojing Yuzi Decoction combined with letrozole on follicular development and serum sex hormone binding globulin levels in infertile patients with polycystic ovary syndrome induced by kidney defi-ciency and blood stasis

目的探讨补肾调经育子汤联合来曲唑对肾虚血瘀型多囊卵巢综合征(PCOS)不孕患者卵泡发育及血清性激素结合球蛋白(SHBG)水平的影响,并探讨其临床治疗效果。方法选取2017年2月至2019年2月青海省第四人民医院收治的78例肾虚血瘀型PCOS不孕患者作为研究对象。按就诊顺序随机分为观察组(n=39)和对照组(n=39)。对照组采用来曲唑治疗,观察组采用补肾调经育子汤联合来曲唑治疗。观察两组治疗后卵泡发育情况,比较两组血清SHBG、内脂素(visfatin)、促黄体素(LH)、睾酮(T)、LH/促卵泡激素(LH/FSH)水平,比较两组临床疗效与不良反应情况。结果治疗后,观察组卵泡直径、成熟卵泡个数及优势卵泡数均高于对照组,差异具有统计学意义(P<0.05)。观察组治疗后血清SHBG水平高于对照组,visfatin水平低于对照组,差异具有统计学意义(P<0.05)。观察组治疗后血清LH、T、LH/FSH水平均低于对照组,差异具有统计学意义(P<0.05)。观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗过程中,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论补肾调经育子汤联合来曲唑治疗肾虚血瘀型POCS不孕患者临床效果显著,可明显改善血清SHBG、visfatin水平,促进排卵,改善卵泡发育,且不良反应少。

Objective To investigate the effects of Bushen Tiaojing Yuzi Decoction combined with letrozole on follicular development and serum sex hormone binding globulin levels in infertile patients with polycystic ovary syndrome( PCOS) induced by kidney deficiency and blood stasis,and to explore its clinical therapeutic effect. Methods A total of 78 PCOS infertility patients with kidney deficiency and blood stasis were selected as the re- search subjects. They were randomly divided into observation group ( n = 39) and control group ( n = 39) according to the order of visit. The control group was treated with letrozole,and the observation group was treated with Bushen Tiaojing Yuzi Decoction combined with letrozole. Follicular development of the two groups after treatment was ob- served,serum levels of SHBG,visfatin,LH,T,LH/FSH,and clinical efficacy and adverse reactions were com- pared between the two groups. Results After treatment,the follicle diameter,the number of mature follicles and the number of dominant follicles in the observation group were higher than those in the control group ( P < 0. 05);the serum SHBG level in the observation group was higher than that in the control group,and the visfatin level in the observation group was lower than that in the control group ( P < 0. 05);the serum levels of LH,T and LH/FSH in the observation group were lower than those in the control group ( P < 0. 05) . The total effective rate of the observa- tion group was higher than that of the control group( P < 0. 05) . During the treatment,there was no significant difference in the incidence of ADR between the two groups ( P > 0. 05) . Conclusions Bushen Tiaojing Yuzi De- coction combined with letrozole in the treatment of POCS infertility patients with kidney deficiency and blood stasis has significant clinical effects,which can significantly improve serum SHBG and visfatin levels,promote ovulation and improve follicular development,with fewer adverse reactions.