补肾化痰活血法联合枸橼酸氯米芬治疗肾虚血瘀型多囊卵巢综合征排卵障碍性不孕的临床疗效研究

Clinical Efficacy of Tonifying Kidney,Resolving Phlegm and Promoting Blood Circulation Combined with Clomifene Citrate in the Treatment of Ovulatory Dysfunction Infertility of Polycystic Ovary Syndrome with Kidney Deficiency and Blood Stasis

目的:探讨补肾化痰活血法联合枸橼酸氯米芬治疗肾虚血瘀型多囊卵巢综合征(PCOS)排卵障碍性不孕的临床疗效。方法:将2019年6月至2020年6月该院收治的84例肾虚血瘀型PCOS排卵障碍性不孕患者按照随机数字表法分为A组(42例)和B组(42例),A组患者采用枸橼酸氯米芬治疗,B组患者采用补肾化痰活血法联合枸橼酸氯米芬治疗。观察两组患者治疗前后甲状腺激素水平、子宫内膜容受性及卵巢排卵情况的变化,同时评价两组患者的用药疗效及安全性。结果:治疗后,B组患者血清三碘甲状腺原氨酸、甲状腺素水平明显高于A组,血清促甲状腺激素水平明显低于A组,差异均有统计学意义(P<0.05);治疗后,B组患者平均卵巢体积明显小于A组,子宫动脉阻力指数明显低于A组,子宫内膜厚度、子宫动脉搏动指数明显高于A组,差异均有统计学意义(P<0.05);治疗后,B组患者卵泡数目明显少于A组,主卵泡直径明显长于A组,差异均有统计学意义(P<0.05);B组患者的总有效率(90.48%,38/42)明显高于A组(73.81%,31/42),差异有统计学意义(P<0.05)。用药期间,A组患者不良反应总发生率为9.52%(4/42),B组患者为11.90%(5/42),组间比较,差异无统计学意义(P>0.05)。结论:补肾化痰活血法联合枸橼酸氯米芬治疗PCOS排卵障碍性不孕的效果良好,能促进排卵,有效调节患者甲状腺激素水平,改善子宫内膜容受性,提高着床率。

OBJECTIVE:To probe into the clinical efficacy of tonifying kidney,resolving phlegm and promoting blood circulation combined with clomifene citrate in the treatment of ovulatory dysfunction infertility of polycystic ovary syndrome(PCOS)with kidney deficiency and blood stasis.METHODS:From Jun.2019 to Jun.2020,84 patients with ovulatory dysfunction infertility of PCOS with kidney deficiency and blood stasis admitted into the hospital were divided into the group A(n=42)and the group B(n=42)according to the random number table method.The group A was treated with clomifene citrate,while the group B received tonifying kidney,resolving phlegm and promoting blood circulation combined with clomifene citrate.Changes of thyroid hormone level,endometrial receptivity and ovarian ovulation before and after treatment in two groups were observed,and the efficacy and safety of medication in two groups were evaluated.RESULTS:After treatment,the serum levels of triiodothyronine and thyroxine in group B were significantly higher than those in group A,and the serum level of thyroid-stimulating hormone was significantly lower than that in group A,the differences were statistically significant(P<0.05).After treatment,the average ovarian volume in group B was significantly smaller than that in group A,the uterine artery resistance index in group B was significantly lower than that in group A,and the endometrial thickness and uterine artery pulse index were significantly higher than those in group A,with statistically significant difference(P<0.05).After treatment,the number of follicles in group B were significantly lower than those in group A,and the diameter of main follicles was significantly longer than that in group A,with statistically significant difference(P<0.05).The total effective rate of group B(90.48%,38/42)was significantly higher than that of group A(73.81%,31/42),the difference was statistically significant(P<0.05).During the medication period,the total incidence of adverse reactions in group A was 9.52%(4/42)and that in group B was 11.90%(5/42),there was no significant difference between two groups(P>0.05).CONCLUSIONS:The efficacy of tonifying kidney,resolving phlegm and promoting blood circulation combined with clomifene citrate in the treatment of ovulatory dysfunction infertility of PCOS with kidney deficiency and blood stasis is significant,which can promote ovulation,effectively regulate thyroid hormone level,improve endometrial receptivity and increase implantation rate.