滋肾育胎丸联合优思明对PCOS不孕症患者子宫内膜容受性、内分泌指标及妊娠结局的影响

Effects of Zishen Yutai pill combined with yasmin on endometrial receptivity,endocrine indexes,and pregnancy outcome in infertile patients with polycystic ovary syndrome

目的 分析滋肾育胎丸联合优思明对多囊卵巢综合征(PCOS)不孕症患者子宫内膜容受性、内分泌指标及妊娠结局的影响。方法 将80例PCOS不孕症患者均分为对照组和观察组,对照采用优思明治疗,观察组采用滋肾育胎丸联合优思明治疗,两组均治疗3个月;收集患者的临床资料,比较两组患者入院及治疗后的临床疗效、子宫内膜容受性[血流搏动指数(PI)、阻力指数(RI)、子宫内膜血管指数(VI)、血流指数(FI)]、内分泌指标[睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)、雌二醇(E2)、垂体泌乳素(PRL)、空腹胰岛素(FIN)、空腹血糖(FPG)]、血管内皮生长因子(VEGF)、妊娠结局及不良反应发生率。结果 观察组临床有效率高于对照组(P<0.05);治疗后,两组患者子宫内膜厚度、A型子宫内膜率、VI、FI、E2水平均上升,PI、RI、子宫内膜多层率、T、LH、FSH、PRL、FIN、FPG、VEGF均下降(P<0.05),且观察组子宫内膜厚度、A型子宫内膜率、VI、FI、E2高于对照组(P<0.05),观察组PI、RI、子宫内膜多层率、T、LH、FSH、PRL、FIN、FPG、VEGF低于对照组(P<0.05);观察组活产率、妊娠率高于对照组,流产率低于对照组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 滋肾育胎丸联合优思明治疗PCOS不孕症患者效果优于单一优思明治疗,可改善患者子宫内膜容受性、内分泌指标,并提高患者的妊娠率及活产率,安全性较好。

Objective To investigate the effects of Zishen Yutai pill combined with yasmin on endometrial receptivity,endocrine indexes,and pregnancy outcome in infertile patients with polycystic ovarian syndrome(PCOS).Methods A total of 80 infertile patients with PCOS were evenly divided into a control group and an observation group.Control group was given with yousiming,while observation group received Zishen Yutai pill combined with yousiming.Both groups were treated for 3 months.Clinical data of the patients was collected.Besides clinical efficacy,the following items were compared between two groups at admission and after treatment:endometrial receptivity[blood flow pulsatility index(PI),resistance index(RI),endometrial vascular index(VI),and blood flow index(FI)],endocrine indicators[testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2),pituitary prolactin(PRL),fasting insulin(FIN),fasting blood glucose(FPG)],vascular endothelial growth factor(VEGF),pregnancy outcome and incidence of adverse reactions.Results Clinical efficacy rate of observation group was significantly higher than that of control group(P<0.05).After treatment,the endometrial thickness,type A endometrial rate,VI,FI,and E2 level in both groups were increased,while PI,RI,the rate of multilayered endometrial pattern,T,LH,FSH,PRL,FIN,FPG,and VEGF were decreased(P<0.05).The endometrial thickness,type A endometrial rate,VI,FI,and E2 levels in observation group were higher than those in control group(P<0.05),while PI,RI,the rate of multilayered endometrial pattern,T,LH,FSH,PRL,FIN,FPG,and VEGF levels in observation group were lower than those in the control group(P<0.05).The pregnancy rate and live birth rate of observation group were significantly higher than those of control group,while the abortion rate was significantly lower than that of control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion The combination of Zishen Yutai pill and yousiming in treating of infertile patients with PCOS is more effective than yousiming.It can improve the endometrial receptivity and endocrine indexes of the patients,and increase the pregnancy rate and live birth rate with good safety.