补肾化瘀方对卵巢储备功能低下不孕患者子宫内膜容受性的影响

Effect of Bushen Huayu Recipe(补肾化瘀方)on Endometrial Receptivity of Infertile Patients wwith Diminished Ovarian Reserve

目的观察补肾化瘀方对卵巢储备功能低下(diminished ovarian reserve,DOR)不孕患者子宫内膜容受性的影响。方法纳入70例DOR不孕患者,同时辨证为肾虚血瘀证,用随机数字法分为对照组35例和观察组35例。对照组给予来曲唑、戊酸雌二醇、地屈孕酮治疗,观察组给予来曲唑、补肾化瘀方、地屈孕酮治疗。以3个月经周期为1个疗程,停药后随访3个月经周期。比较两组患者的性激素水平,HCG注射日两组患者的子宫内膜厚度、类型、血流,以及两组妊娠率。结果(1)治疗前后两组患者性激素、AMH比较后,FSH/LH比值、基础血清FSH值较治疗前降低,T和AMH值较治疗前升高;治疗后组间比较,观察组优于对照组,差异均有统计学意义(P<0.05)。(2)HCG注射日,观察组患者的子宫内膜明显增厚、子宫动脉PI、RI降低、A型内膜例数均优于对照组。(3)观察组患者的妊娠率高于对照组。结论补肾化瘀方能改善DOR不孕患者的子宫内膜容受性,提高临床妊娠率。

Objective To observe the effect of Bushen Huayu Recipe(补肾化瘀方)on endometrial receptivity in infertile pa⁃tients with diminished ovarian reserve(DOR).Methods Seventy cases of DOR infertility with kidney deficiency and blood stasis syndrome were randomly divided into control group and observation group,35 cases in each group.The control group was treated with letrozole,estradiol valerate and dydrogestrone,while the observation group was treated with letrozole,Bushen Huayu Decoc⁃tion and dydrogestrone.Three menstrual cycles were taken as one course,followed up for 3 menstrual cycles after stopping the medication.The sex hormone levels,endometrial thickness,type,blood flow and pregnancy rate of the two groups were compared.Results After comparing the sex hormone and anti-Müllerian hormone(AMH)before and after treatment,follicle stimulating hor⁃mone(FSH)/luteinizing hormone(LH)ratio and basal serum FSH value of the two groups were lower than those before treatment,while values of testosterone(T)and AMH were higher than those before treatment.After treatment,the those of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05).On the day of HCG injection,the endometrial thickening,the decrease of pulsatility index(PI)and resistance index(RI)of uterine artery and the num⁃ber of cases of type A endometrium in the observation group were better than those in the control group.The pregnancy rate of the observation group was higher than that of the control group.Conclusion Bushen Huayu Decoction can improve the endometrial receptivity and the clinical pregnancy rate of patients with diminished ovarian reserve infertility.