育肾方对肾虚型薄型子宫内膜不孕症患者子宫内膜容受性的影响

Effect of Yushen Formula on endometrial receptivity of patients with thin endometrium infertility of kidney-deficiency

目的 观察育肾方对肾虚型薄型子宫内膜不孕症患者子宫内膜容受性(ER)的影响。方法 将73例肾虚型薄型子宫内膜不孕症患者按照随机数字表法分为2组,治疗组37例予育肾方治疗,对照组36例予阿司匹林肠溶片治疗,2组疗程均为3个月经周期。比较2组治疗前后子宫内膜厚度及容积、子宫内膜分型、子宫动脉血流动力学指标、子宫内膜血流分型、中医证候评分、治疗后6个月内妊娠情况。结果 2组治疗后子宫内膜厚度及容积均较本组治疗前增加(P<0.05);治疗后治疗组子宫内膜厚度及容积均高于对照组(P<0.05)。2组治疗后A型子宫内膜比例较本组治疗前升高(P<0.05),C型子宫内膜比例较本组治疗前降低(P<0.05);2组治疗后子宫内膜分型比较差异无统计学意义(P>0.05)。2组治疗后子宫动脉血流平均搏动指数(mPI)、平均阻力指数(mRI)、双侧子宫动脉血流收缩期峰值流速/舒张末期流速平均值(mS/D)均较本组治疗前降低(P<0.05);治疗组治疗后mPI低于对照组(P<0.05)。2组治疗后Ⅰ型子宫内膜血流分型比例较本组治疗前升高(P<0.05);2组治疗后子宫内膜血流分型比较差异无统计学意义(P>0.05)。治疗组治疗后行经时短、经血量少、经色黯淡、腰骶痠痛、性欲减退评分及总评分均较本组治疗前降低(P<0.05);对照组治疗后行经时短、经血量少评分及总评分均较本组治疗前降低(P<0.05);治疗后治疗组总评分低于对照组(P<0.05)。2组治疗后6个月内妊娠率比较差异无统计学意义(P>0.05)。结论 育肾方治疗肾虚型薄型子宫内膜不孕症,能增加患者子宫内膜厚度及容积,改善子宫内膜类型,促进宫腔血流灌注,缓解肾虚症状,从而提高ER。

Objective To observe the effect of Yushen Formula on endometrial receptivity(ER)of patients with thin endometrium infertility(kidney-deficiency).Methods Totally 73 patients with thin endometrium infertility(kidney-deficiency)were randomly divided into the treatment group(n=37,received Yushen Formula)and the control group(n=36,received aspirin enteric-coated tablets).After 3 menstrual cycles of treatment,the endometrial thickness(ET),endometrial volume(EV),type of endometrium,uterine arteries haemodynamic index,endometrial blood flow typing,traditional Chinese medicine(TCM)syndrome score were included as comparators;the pregnancy on month 6 was observed.Results After treatment,ET and EV in groups were increased(P<0.05),which in the the treatment group were superior to the control group(P<0.05);increased proportion of A-type endometrium and decreased proportion of type C endometrium were detected(all P<0.05),the difference was not statistically significant in the type of endometrium between group(P>0.05);mean pulsatility index(mPI)and mean resistance index(mRI)of the uterine arteries,mean systolic/diastolic ratio(mS/D)of the bilateral uterine artery in groups were decreased(P<0.05),mPI in the treatment group was lower than that in the control group(P<0.05);endometrial blood flow typing(typeⅠ)in groups was increased(P<0.05),none of the endometrial blood flow typing differed significantly between groups(P>0.05);TCM syndrome scores in groups were decreased(P<0.05),the treatment group was more prevalent(P<0.05);there was no significant difference being found in the comparison of the pregnancy rate on month 6 between groups(P>0.05).Conclusion For patients with thin endometrium infertility(kidney-deficiency),Yushen Formula can increase ET and EV,improve the type of endometrial,promote blood perfusion of the uterine cavity,relieve the symptoms of kidney deficiency,and therefore improve ER.