补肾健脾方在体外受精-胚胎移植助孕的脾肾两虚型卵巢储备功能减退患者中的应用效果

Application Effect of Bushen Jianpi Formula in Patients with DiminishedOvarian Reserve of Spleen and Kidney Deficiency Type Assistedby in Vitro Fertilization-Embryo Transfer

目的探讨补肾健脾方在体外受精-胚胎移植(IVF-ET)助孕的脾肾两虚型卵巢储备功能减退(DOR)患者中的应用效果。方法选取2021年6月至2023年1月在焦作市妇幼保健院接受IVF-ET助孕的100例脾肾两虚型DOR患者,按随机数字表法分为观察组(50例)与对照组(50例)。IVF-ET前给予对照组口服维生素E 3个月经周期后进入促排卵周期,观察组患者在对照组基础上给予3个月经周期的补肾健脾方进行调节并服用至扳机日。比较两组治疗前后中医症候评分,并对比两组患者用药及治疗情况[促性腺激素(Gn)用药时间、Gn用药总量、扳机日雌激素水平、周期取消率]、取卵及胚胎情况(获卵数、2PN受精数、可利用胚胎数、优质胚胎数)及妊娠结局(首次胚胎解冻移植周期着床率、临床妊娠率、早期流产率)。结果治疗后,两组脾肾两虚症候评分对比,观察组低于对照组(P<0.05);两组Gn用药时间、扳机日雌激素水平、周期取消率差异无统计学意义(P>0.05);两组Gn用药总量对比,观察组低于对照组(P<0.05);两组获卵数、2PN受精数、可利用胚胎数、优质胚胎数对比,观察组均多于对照组(P<0.05);观察组首次胚胎解冻移植周期着床率、妊娠率均高于对照组(P<0.05);两组流产率差异无统计学意义(P>0.05)。结论应用补肾健脾方可增加接受IVF-ET助孕的脾肾两虚型DOR患者获卵数、2PN受精数、可利用胚胎数及优质胚胎数,并能够减少Gn用药总量,改善胚胎着床率及临床妊娠率。

Objective To investigate the application effect of Bushen Jianpi formula in patients with diminished ovarian reserve(DOR)of spleen and kidney deficiency type assisted by in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 100 patients with spleen and kidney deficiency type DOR who received IVF-ET assisted pregnancy at Jiaozuo Maternal and Child Health Hospital from June 2021 to January 2023 were randomly divided into an observation group(50 cases)and a control group(50 cases)using a random number table method.Before IVF-ET,the control group was given oral vitamin E for three menstrual cycle and then entered the ovulation induction cycle.On the basis of the control group,the patients in the observation group were given three menstrual cycle of Bushen Jianpi formula for regulation and taking until the trigger day.The scores of TCM symptoms before and after treatment were compared between the two groups,and the medication and treatment of the two groups[times of gonadotropin(Gn)administration,total amount of Gn administration,estrogen level on trigger day,cycle cancellation rate],oocyte retrieval and embryo status(number of oocytes retrieved,number of 2PN fertilization,number of available embryos,number of high-quality embryos)and pregnancy outcomes(implantation rate of the first embryo thawing transfer cycle,clinical pregnancy rate,early abortion rate)were compared.Results After treatment,the comparison of spleen and kidney deficiency syndrome scores between the two groups showed that the observation group was lower than the control group(P<0.05).There was no significant difference in the number of days of Gn administration,estrogen levels on the trigger day,and cycle cancellation rate between the two groups(P>0.05).The comparison of the total amount of Gn medication between the two groups showed that the observation group was lower than the control group(P<0.05).The comparison of the number of eggs obtained,2PN fertilization,available embryos,and high-quality embryos between the two groups showed that the observation group was higher than the control group(P<0.05).The implantation rate and pregnancy rate of the first embryo thawing transfer cycle in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the abortion rate between the two groups(P>0.05).Conclusion The application of Bushen Jianpi formula can increase the number of eggs obtained,2PN fertilization,available embryos,and high-quality embryos in DOR patients with spleen and kidney deficiency who receive IVF-ET assisted pregnancy.It can also reduce the total amount of Gn medication,improve embryo implantation rate,and clinical pregnancy rate.