益肾祛瘀汤联合中药透敷法对体外受精-胚胎移植失败患者子宫内膜厚度、再移植临床妊娠率的影响

Effect of Yishen Quyu Decoction Combined with Transdermal Application with Chinese Medicine on Endometrial Thickness and Clinical Pregnancy Rate of Retransfer of Patients After In Vitro Fertilization-Embryo Transfer Failure

目的:观察益肾祛瘀汤联合中药透敷法对体外受精-胚胎移植(IVF-ET)失败患者子宫内膜厚度、再移植临床妊娠率的影响。方法:选取120例IVF-ET失败患者,按随机数字表法分为对照组、中药内服组、中药透敷组、联合组各30例。对照组口服维生素E软胶囊,中药透敷组给予中药透敷治疗,中药内服组给予益肾祛瘀汤口服,联合组给予中药内服和透敷治疗,1个月为1个疗程,4组均治疗3个疗程。统计4组治疗后再次行IVF-ET的临床妊娠情况,比较4组治疗前后中医证候评分、局部体征积分、子宫内膜厚度,观察4组用药安全性。结果:联合组临床妊娠率高于中药内服组、中药透敷组和对照组(P<0.05)。治疗后,4组各项中医证候评分、局部体征积分均低于治疗前(P<0.05),且联合组低于中药内服组、中药透敷组、对照组(P<0.05),中药内服组和中药透敷组低于对照组(P<0.05)。治疗后,4组子宫内膜厚度均高于治疗前(P<0.05),且联合组高于中药内服组、中药透敷组和对照组(P<0.05),中药内服组和中药透敷组高于对照组(P<0.05)。结论:益肾祛瘀汤联合中药透敷法可提高IVF-ET失败患者再次IVF-ET的临床妊娠率,改善临床症状和体征,作用机制可能与增加子宫内膜厚度有关。

Objective:To observe the effect of the therapy of Yishen Quyu Decoction combined with transdermal application with Chinese medicine on endometrial thickness and clinical pregnancy rate of retransfer of patients after in vitro fertilization-embryo transfer(IVF-ET)failure.Methods:A total of 120 patients who failed in IVF-ET were selected and divided into the control group,the internal administration of Chinese medicine group,the transdermal application with Chinese medicine group and the combination group according to the random number table method,with 30 cases in each group.The control group was given oral administration of Vitamin E Soft Capsules;the transdermal application with Chinese medicine group was treated with transdermal application with Chinese medicine;the internal administration of Chinese medicine group was treated with oral administration of Yishen Quyu Decoction and the combination group was treated with internal administration of Chinese medicine and transdermal application with Chinese medicine.With one month as one course of treatment,the four groups were treated for three courses.The clinical pregnancy of the second-time IVF-ET after treatment in the four groups was counted;the traditional Chinese medicine(TCM)syndrome scores,scores of local signs and endometrial thickness were compared before and after treatment between the four groups;the safety of medication in the four groups was observed.Results:The clinical pregnancy rate in the combination group was higher than those in the other three groups(P<0.05).After treatment,the TCM syndrome scores and scores of local signs in the four groups were lower than those before treatment(P<0.05),the above scores in the combination group were lower than those in the other three groups(P<0.05),and the above scores in the internal administration of Chinese medicine group and the transdermal application with Chinese medicine group were lower than those in the control group,respectively(P<0.05).After treatment,the endometrial thickness in the four groups were higher than those before treatment(P<0.05),the endometrial thickness in the combination group was higher than those in the other three groups(P<0.05),and the endometrial thickness in the internal administration of Chinese medicine group and in the transdermal application with Chinese medicine group was higher than that in the control group,respectively(P<0.05).Conclusion:The therapy of Yishen Quyu Decoction combined with transdermal application with Chinese medicine can improve the clinical pregnancy rate of re-transfer of patients after IVF-ET failure and improve the clinical symptoms and signs,whose mechanism may be related to the increase of endometrial thickness.