马氏补肾助孕疗法联合脱氢表雄酮保护高龄卵巢储备功能减退不孕症患者生育力临床研究

Clinical Study on Ma’s Bushen Zhuyun Therapy Combined with Dehydroepiandrosterone Protecting Fertility of Elderly Patients with Infertility Due to Diminished Ovarian Reserve

目的:观察马氏补肾助孕疗法联合脱氢表雄酮(DHEA)对高龄肾阳虚型卵巢储备功能减退(DOR)不孕症患者生育力的影响。方法:将纳入研究的肾阳虚型DOR不孕症患者随机分为DHEA组和中药组。2组均口服DHEA胶囊治疗,中药组加予马氏补肾助孕疗法治疗。2组疗程均为3个月经周期。观察2组治疗前、治疗3个月经周期后中医证候积分、卵巢激素指标[抗苗勒管激素(AMH)、卵泡生成素(FSH)、促黄体生成素(LH)]及卵巢超声参数[窦卵泡计数(AFC),双侧卵巢间质动脉收缩期峰值速度的平均值(mPSV)、阻力指数的平均值(mRI)]的变化。结果:治疗后,2组中医证候积分均较治疗前降低(P<0.01)。中药组中医证候积分低于DHEA组(P<0.01)。2组AMH水平均较治疗前上升(P<0.01),中药组FSH水平及FSH/LH比值均较治疗前下降(P<0.01)。中药组AMH水平高于DHEA组(P<0.01),FSH水平及FSH/LH比值均低于DHEA组(P<0.01)。2组AFC均较治疗前增加(P<0.01),中药组AFC多于DHEA组,m PSV值高于DHEA组,差异均有统计学意义(P<0.01)。结论:采用马氏补肾助孕疗法联合DHEA治疗高龄肾阳虚型DOR不孕症患者,可有效减缓卵巢内存留原始卵泡的快速耗竭,改善患者的卵巢储备,从而有望提升妊娠潜能,提高妊娠概率。

Objective:To study the effect of Ma’s Bushen Zhuyun therapy combined with dehydroepiandrosterone(DHEA)on fertility of elderly patients with infertility due to diminished ovarian reserve(DOR)of the kidney yang deficiency type.Methods:Patients with infertility due to DOR of the kidney yang deficiency type were randomly divided into two groups.Both groups were treated with oral administration of DHEA capsule,and the Chinese medicine group was additionally treated with Ma’s Bushen Zhuyun therapy.Both groups were treated for three menstrual periods.Before treatment and after the treatment of three menstrual periods,changes in Chinese medicine syndrome scores,indexes of ovarian hormones[anti-mullerian hormone(AMH),follicle-stimulating hormones(FSH),luteinizing hormone(LH)],and ovarian ultrasound parameters[antral follicle count(AFC),mean peak systolic velocity(mPSV)of bilateral ovarian interstitial artery,mean resistive index(mRI)]were observed in the two groups.Results:After treatment,Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.01),and the score in the Chinese medicine group was lower than that in the DHEA group(P<0.01).Levels of AMH in the two groups were increased when compared with those before treatment(P<0.01);levels of FSH and FSH/LH in the Chinese medicine group were decreased when compared with those before treatment(P<0.01).The level of AMH in the Chinese medicine group was higher than that in the DHEA group(P<0.01),and levels of FSH and FSH/LH were lower than those in the DHEA group(P<0.01).AFC in the two groups was increased when compared with that before treatment(P<0.01),and AFC and mPSV value in the Chinese medicine group were larger than those in the DHEA group,differences being significant(P<0.01).Conclusion:In the treatment of elderly patients with infertility due to DOR of the kidney yang deficiency type,the therapy of Ma’s Bushen Zhuyun therapy combined with DHEA can effectively slow down the rapid depletion of retained primordial follicles in ovary,and improve ovarian reserve,thus,it can be expected to enhance the pregnancy probability.