自拟益经通络汤辅助治疗卵巢储备功能减退性闭经患者的临床效果及其对妊娠成功率的影响

Clinical effect of self-prepared Yijing Tongluo Decoction for the adjuvant treatment of patients with diminished ovarian reserve amenorrhea and its influence on the successful rate of pregnancy

目的 探讨自拟益经通络汤辅助治疗卵巢储备功能减退(DOR)性闭经患者的临床效果及其对妊娠成功率的影响。方法 将84例有生育需求的DOR性闭经患者随机分为对照组和观察组,每组42例。对照组患者采用人工周期替代疗法,观察组患者在对照组治疗基础上采用自拟益经通络汤辅助治疗。比较两组治疗前后的卵巢功能[卵巢直径、窦卵泡计数(AFC)、卵巢动脉血流收缩期峰值流速(PSV)、卵巢基质血流阻力指数(RI)]、中医证候积分、血清性激素[雌二醇、促卵泡生成激素(FSH)、促黄体生成素(LH)、睾酮、抗苗勒管激素(AMH)]水平、治疗总有效率、妊娠成功率,以及治疗期间并发症的发生情况。结果 治疗后,两组患者的卵巢直径、AFC、卵巢动脉血流PSV及血清雌二醇水平较治疗前增加或升高,卵巢基质血流RI及血清FSH、LH、睾酮水平较治疗前降低,中医证候总积分亦较治疗前降低,且观察组上述指标优于对照组(P<0.05)。观察组治疗后的AMH水平高于治疗前及对照组(P<0.05),对照组治疗前后的AMH水平差异无统计学意义(P>0.05)。观察组治疗总有效率、妊娠成功率高于对照组(P<0.05)。两组患者治疗期间不良反应发生率差异无统计学意义(P>0.05)。结论 自拟益经通络汤辅助治疗DOR性闭经患者的疗效确切,可显著改善患者的卵巢储备功能并提高妊娠成功率,且不良反应较少。

Objective To investigate the clinical effect of self-prepared Yijing Tongluo Decoction for the adjuvant treatment of patients with diminished ovarian reserve(DOR)amenorrhea and its influence on the successful rate of pregnancy.Methods A total of 84 patients with DOR amenorrhea who had demand for reproduction were randomly divided into control group or observation group,with 42 cases in each group.The control group employed artificial cycle replacement therapy,based on which the observation group received self-prepared Yijing Tongluo Decoction for adjuvant treatment.The pre-and post-treatment ovarian function with respect to ovarian diameter,antral follicle count(AFC),blood flow peak systolic velocity(PSV)of ovarian artery,blood flow resistance index(RI)of ovarian stroma,and Traditional Chinese Medicine syndromes score,serum sex hormones levels(estradiol,follicle-stimulating hormone[FSH],luteinizing hormone[LH],testosterone,and anti-Müllerian hormone[AMH]),total effective rate of treatment,successful rate of pregnancy,as well as the occurrence of complications during treatment were compared between the two groups.Results After treatment,ovarian diameter,AFC,blood flow PSV of ovarian artery,and level of serum estradiol of the two groups were increased or elevated,whereas blood flow RI of ovarian stroma,and levels of serum FSH,LH,testosterone,and total Traditional Chinese Medicine syndromes score were decreased as compared with before treatment,as well as the observation group exhibited superior indices as above to compared with the control group(P<0.05).The observation group exhibited a higher post-treatment AMH level as compared with before treatment and the control group(P<0.05),whereas AMH level of the control group depicted no statistically significant difference between before and after treatment(P>0.05).The observation group yielded higher total effective rate of treatment,successful rate of pregnancy as compared with the control group(P<0.05).There was no statistically significant difference in adverse reactions during treatment between patients of the two groups(P>0.05).Conclusion Self-prepared Yijing Tongluo Decoction for the adjuvant treatment of patients with DOR amenorrhea exerts definite therapeutic effect,which can significantly ameliorate ovarian reserve function and increase the successful rate of pregnancy in patients,with relatively less adverse reactions.