苏格木勒-7辅助人工周期治疗卵巢储备功能下降效果及对患者子宫动脉血流、月经情况及妊娠结局的影响

Sugemüller-7-Assisted Artificial Cycle in the Treatment of Diminished Ovarian Reserve and Its Influence on Uterine Artery Blood Flow,Menstruation,and Pregnancy Outcome

目的:探讨苏格木勒-7辅助人工周期治疗卵巢储备功能下降的效果及对患者子宫动脉血流、月经及妊娠结局的影响。方法:选取2017年8月~2019年9月我院卵巢储备功能下降患者114例,以随机数字表法分为观察组和对照组。对照组以人工周期干预,观察组给予苏格木勒-7辅助人工周期干预,均治疗6个月经周期。比较两组临床效果,治疗前后子宫动脉血流指标[舒张末期流速(EDV)、收缩期峰值流速(PSV)、阻力指数(RI)],子宫体积,子宫内膜厚度,窦卵泡数,血清指标[黄体生成激素(LH)、促卵泡激素(FSH)、抗缪勒管激素(AMH)、雌二醇(E_(2))],月经情况评分,中医证候积分,不良反应,治疗后1年妊娠结局。结果:与治疗前比较,治疗后两组EDV、PSV、RI、子宫体积、子宫内膜厚度、窦卵泡数、LH、FSH、E_(2)、AMH、月经情况评分、中医证候积分明显改善(P<0.05),治疗6个月经周期后对照组总有效率(78.95%)较观察组(92.98%)明显升高(P<0.05);与对照组比较,观察组治疗3、6个月经周期后,EDV、PSV水平,子宫体积,子宫内膜厚度,窦卵泡数明显升高,RI水平、月经情况评分、中医证候积分明显降低(P<0.05);血清LH、FSH水平均明显降低,AMH、E_(2)水平明显升高(P<0.05);两组治疗期间不良反应发生率差异无统计学意义(P>0.05);观察组治疗后1年受孕率(56.36%)明显高于对照组(36.36%)(P<0.05)。结论:应用苏格木勒-7辅助人工周期治疗卵巢储备功能下降患者可改善子宫动脉血流,提升卵巢储备功能,调节性激素释放,改善月经情况及妊娠结局,疗效显著,且安全性良好。

Objective:To investigate the effect of the Sugemüller-7-assisted artificial cycle on the treatment of diminished ovarian reserve and its influence on uterine artery blood flow,menstruation,and pregnancy outcome.Methods:A total of 114 patients with diminished ovarian reserve in the Affiliated Hospital of Inner Mongolia Minzu University from August 2017 to September 2019 were included and divided into an observation group and a control group by random number table.The control group was given an artificial cycle,while the observation group was given a Sugemüller-7-assisted artificial cycle,both for 6 menstrual cycle treatments.The clinical efficacies,adverse reactions,pre-treatment baseline values,uterine artery flow indices[end-diastolic velocity(EDV),peak systolic velocity(PSV),and resistance index(RI)]3 and 6 months after treatment,uterine volume,endometrial thickness,sinus follicle count,serum indices[luteinizing hormone(LH),follicle-stimulating hormone(FSH),anti-müllerian hormone(AMH),and estradiol(E_2)],menstrual status score,traditional Chinese medicine(TCM)syndrome score,and pregnancy outcome 1 year after treatment between the two groups were compared and observed.Results:Compared with before treatment,the EDV,PSV,RI,uterine volume,endometrial thickness,sinus follicle count,LH,FSH,E_2,AMH,menstrual status score,and TCM syndrome score were improved(P<0.05).The total effective rate of the observation group after 6 menstrual cycles was 92.98%,which was higher than that of the control group(78.95%)(P<0.05).After 3 and 6 menstrual cycles,as compared with the control group,the EDV and PSV levels,uterine volume,endometrial thickness,and the number of follicles were increased in the observation group,while the RI level,menstrual status score,and TCM syndrome score were decreased(P<0.05),and the serum levels of LH and FSH in the observation group were lower than those in the control group,while the levels of AMH and E_2 were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P<0.05).The pregnancy rate in the observation group was 56.36%after 1 year of treatment,which was higher than that in the control group(36.36%)(P<0.05).Conclusion:The treatment of diminished ovarian reserve with Sugemüller-7-assisted artificial cycle can improve uterine artery blood flow,increase ovarian reserve,regulate sex hormone expression,and improve menstruation and pregnancy outcome,with significant effect and good safety.