基于三维超声卵泡监测的中医序贯疗法治疗多囊卵巢综合征所致不孕的效果

Effect of traditional Chinese medicine sequential therapy based on three-dimensional ultrasound follicle monitoring in the treatment of infertility induced by polycystic ovary syndrome

目的探讨基于三维超声卵泡监测的中医序贯疗法治疗多囊卵巢综合征(PCOS)所致不孕的效果。方法回顾性选取2020年1月至2021年1月江西中医药大学附属医院妇产科收治的88例PCOS所致不孕患者作为研究对象,按照治疗方法不同分为A组(45例)和B组(43例)。A组采用基于三维超声卵泡监测的中医序贯治疗,B组采用炔雌醇环丙孕酮片治疗,均连续治疗3个月经周期。比较两组的综合疗效、妊娠结局及治疗前后血清性激素[孕酮(P)、雌激素(E2)、睾酮(T)、促黄体生成素(LH)]水平、卵泡总数、优势卵泡平均直径、三维虚拟球径、体积(V)变化。结果A组的总有效率为93.33%,高于B组的76.74%,差异有统计学意义(P<0.05)。两组患者治疗后的P、优势卵泡平均直径、三维虚拟球径、V卵泡均高于本组治疗前,E2、T、LH和卵泡总数均低于本组治疗前,差异有统计学意义(P<0.05)。治疗后,A组患者的P、优势卵泡平均直径、三维虚拟球径、V卵泡均高于B组,E2、T、LH和卵泡总数均低于B组,差异有统计学意义(P<0.05)。随访6个月,A组患者的妊娠率为62.22%,高于B组的30.23%,差异有统计学意义(P<0.05);两组患者的流产率比较,差异无统计学意义(P>0.05)。结论基于三维超声卵泡监测的中医序贯疗法治疗PCOS所致不孕的综合疗效显著,能够显著改善患者血清性激素水平,促进排卵和卵泡发育,提高妊娠率,值得临床推广。

Objective To investigate the clinical effect of traditional Chinese medicine sequential therapy based on three-dimensional ultrasound follicle monitoring in the treatment of infertility induced by polycystic ovary syndrome(PCOS).Methods A total of 88 patients with infertility induced by PCOS who were admitted to the Department of Obstetrics and Gynecology,Affiliated Hospital of Jiangxi University of Chinese Medicine from January 2020 to January 2021 were selected in enrolled for retrospective analysis.According to different treatment methods,the subjects were divided into group A(45 cases)and group B(43 cases).Group A was given traditional Chinese medicine sequential therapy based on three-dimensional ultrasound follicle monitoring,while group B was treated with Ethinylestradiol Cyproterone Tablets.All were treated for 3 menstrual cycles.The comprehensive curative effect,pregnancy outcomes,changes of serum sex hormones(progesterone[P],estrogen[E2],testosterone[T]and luteinizing hormone[LH]),total follicle count,mean diameter of dominant follicles,three-dimensional virtual sphere diameter and volume(V)before and after treatment were compared between the two groups.Results The total effective rate in group A(93.33%)was higher than that in group B(76.74%),and the difference was statistically significant(P<0.05).After treatment,P,mean diameter of dominant follicles,three-dimensional virtual sphere diameter and Vfollicle were higher than those before treatment,while E2,T,LH and total follicle count were lower than those before treatment,the differences were statistically significant(P<0.05).After treatment,P,mean diameter of dominant follicles,three-dimensional virtual sphere diameter and Vfollicle in group A were higher than those in group B,E2,T,LH and total follicle count were lower than those in group B,the differences were statistically significant(P<0.05).During 6 months of follow-up,the pregnancy rate in group A(62.22%)was higher than that in group B(30.23%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in abortion rate between the two groups(P>0.05).Conclusion The comprehensive curative effect of traditional Chinese medicine sequential therapy based on three-dimensional ultrasound follicle monitoring is significant on infertility induced by PCOS,which can significantly improve levels of serum sex hormones,promote ovulation and follicles development,and improve pregnancy rate.