补肾疏肝调周法联合来曲唑治疗多囊卵巢综合征不孕临床研究

Clinical Study on Bushen Shugan Tiaozhou Method Combined with Letrozole forInfertility Due to Polycystic Ovary Syndrome

目的:观察补肾疏肝调周法联合来曲唑(LE)治疗多囊卵巢综合征(PCOS)不孕的临床疗效。方法:采用随机数字表法将100例PCOS不孕患者分为治疗组与对照组各50例。对照组予LE治疗,治疗组在对照组基础上予补肾疏肝调周法治疗。比较2组治疗前后卵泡刺激素(FSH)、总睾酮(T)、黄体生成激素(LH)、抗苗勒管激素(AMH)水平及中医证候积分;比较2组人绒毛膜促性腺激素(HCG)注射日卵泡直径、卵泡个数(卵泡直径>16 mm)及子宫内膜厚度;评估2组临床疗效、不良反应发生及妊娠情况。结果:治疗期间,对照组脱落2例,完成研究48例;观察组脱落2例,完成研究48例。治疗组总有效率、排卵率、妊娠率、活产率均高于对照组(P<0.05)。治疗后,2组中医证候积分、血清LH、LH/FSH及治疗组AMH、T水平均较治疗前降低(P<0.05);治疗组治疗后中医证候积分、血清LH、LH/FSH、T水平低于对照组(P<0.05)。2组血清FSH及对照组AMH、T水平治疗前后比较,差异无统计学意义(P>0.05)。治疗组HCG注射日子宫内膜厚度高于对照组(P<0.05),2组HCG注射日卵泡个数(卵泡直径>16 mm)、卵泡直径及不良反应发生率比较,差异无统计学意义(P>0.05)。结论:补肾疏肝调周法联合LE治疗PCOS不孕疗效确切,能够调节患者激素水平,改善患者子宫内膜厚度,提高排卵率及妊娠率,安全性较高。

Objective:To observe the clinical effect of Bushen Shugan Tiaozhou method combined with Letrozole(LE)for infertility due to polycystic ovary syndrome(PCOS).Methods:A total of 100 cases of PCOS patients with infertility were divided into the treatment group and the control group according to the random number table method,with 50 cases in each group.The control group was treated with LE,and the treatment group was additionally treated with Bushen Shugan Tiaozhou Method based on the treatment of the control group.Before and after treatment,the levels of follicle stimulating hormone(FSH),testosterone(T),luteinizing hormone(LH),and anti-müllerian hormone(AMH),and the traditional Chinese medicine(TCM)syndrome scores were compared between the two groups.The follicle diameter,number of follicles(follicle diameter>16mm),and endometrial thickness were compared between the two groups on the day of human chorionic gonadotropin(HCG)injection.The clinical effects,incidence of adverse reactions and pregnancy status were evaluated in the two groups.Results:During treatment,2 cases were lost and 48 cases were completed in the control group;2 cases were lost and 48 cases were completed in the treatment group. The total effective rates,ovulation rates,pregnancy rates,andlive birth rates in the treatment group were higher than those in the control group (P<0.05). Aftertreatment,the TCM syndrome scores,and the levels of LH and LH/FSH in serum in the two groups,aswell as the levels of AMH and T in the treatment group were decreased when compared with those beforetreatment (P<0.05);the TCM syndrome score, and the levels of LH, LH/FSH and T in serum in thetreatment group were lower than those in the control group (P<0.05). There was no significant differencebeing found in the comparison of FSH levels in serum between the two groups and the levels of AMH and Tin the control group before and after treatment (P>0.05). The endometrial thickness on the day of HCGinjection in the treatment group was higher than that in the control group (P<0.05). There was no significantdifference being found in the comparison of number of follicles (follicle diameter>16 mm), folliclediameter, and incidence of adverse reactions between the two groups on the day of HCG injection (P>0.05). Conclusion: Bushen Shugan Tiaozhou Method combined with LE has a definite curative effect intreating infertility due to PCOS,and can regulate the hormone levels,improve the endometrial thickness,and increase ovulation and pregnancy rates,with relatively high safety.