补肾活血方治疗PCOS合并不孕的妊娠结局及对性激素、卵巢功能改善的作用

The pregnancy outcomes,the hormone level and improvement of ovarian function of infertility patients with polycystic ovary syndrome after the treatment of Bushenhuoxue prescription

目的:探讨补肾活血方治疗多囊卵巢综合征(PCOS)不孕效果及对患者性激素水平、卵巢功能改善作用。方法:选取2021年1月-2023年10月本院收治的PCOS不孕患者120例,分为观察组和对照组各60例。对照组口服枸橼酸盐氯米芬片治疗,观察组口服补肾活血方治疗,两组疗程均为3个月经周期,观察两组治疗后子宫内膜容受性、卵泡发育情况、性激素水平、排卵率及妊娠结局。结果:治疗后观察组排卵率(93.3%)、妊娠率(55.0%)高于对照组(80.0%、33.3%),自然流产率(3.3%)低于对照组(16.7%);子宫内膜厚度(9.36±0.77 mm)高于对照组(8.42±0.59 mm),子宫动脉搏动指数(2.02±0.21)、子宫动脉阻力指数(0.59±0.08)低于对照组(2.31±0.26、0.71±0.11),最大卵泡直径(2.23±0.42 cm)、优势卵泡数(2.68±0.51个)均高于对照组(1.92±0.40 cm、2.23±0.42个),卵泡数(19.85±3.98个)少于对照组(24.28±4.06个),血清卵泡刺激素(3.77±0.86 U/L)、黄体生成素(8.11±2.21 U/L)、睾酮(0.51±0.07 ng/ml)水平均低于对照组(4.61±0.79 U/L、9.95±2.61 U/L、0.64±0.14 ng/ml),孕酮(0.89±0.09 nmol/L)水平高于对照组(0.72±0.04 nmol/L)(均P<0.05)。结论:补肾活血方有助于改善PCOS患者子宫内膜容受性,促进卵泡正常发育,纠正性激素紊乱,提高排卵率,改善妊娠结局,有较好的临床疗效。

Objective:To investigate the effect of Bushenhuoxue prescription for treating patients with polycystic ovary syndrome(PCOS),and to study its improvements of hormone and ovarian function of the patients.Methods:120 infertility patients with PCOS admitted to hospital from January 2021 to October 2023 were selected and were divided into experimental group and control group according to the double-blind method,with 60 cases in each group.The patients in the control group were treated with clomiphene citrate tablets for 3 menstrual cycles,and the patients in the experimental group were treated with Bushenhuoxue prescription for 3 menstrual cycles.The endometrial receptivity,the follicle development situation,the hormone level,the ovulation rate,and the pregnancy outcomes of the patients in the two groups after treatment were observed.Results:After treatment,the ovulation rate(93.3%)and the pregnancy rate(55.0%)of the patients in the experimental group were significantly higher than those(80.0%and 33.3%)of the patients in the control group,but the spontaneous abortion rate(3.3%)of the patients in the experimental group was lower than that(16.7%)of the patients in the control group.The endometrial thickness(9.36±0.77 mm)of the patients in the experimental group was significantly higher than that(8.42±0.59 mm)of the patients in the control group.The values of uterine artery pulsatility index(2.02±0.21)and uterine artery resistance index(0.59±0.08)of the patients in the experimental group were significantly lower than those(2.31±0.26 and 0.71±0.11)of the patients in the control group.The largest follicle diameter(2.23±0.42cm)and the number of dominant follicle(2.68±0.51)of the patients in the experimental group were significantly higher than those(1.92±0.40cm and 2.23±0.42)of the patients in the control group.The number of follicles(19.85±3.98)of the patients in the experimental group was significantly less than that(24.28±4.06)of the patients in the control group.The levels of follicle-stimulating hormone(3.77±0.86U/L),luteinizing hormone(8.11±2.21U/L)and testosterone(0.51±0.07ng/ml)of the patients in the experimental group were significantly lower than those(4.61±0.79U/L,9.95±2.61U/L and 0.64±0.14ng/ml)of the patients in the control group,but the progesterone level(0.89±0.09nmol/L)of the patients in the experimental group was significantly higher than that(0.72±0.04nmol/L)of the patients in the control group(all P<0.05).Conclusion:Bushenhuoxue prescription for treating patients with PCOS is helpful to increase their receptivity of endometrium,to promote their normal development of follicle and to correct sex hormone disorder,to increase their ovulation rate and to improve their pregnancy outcomes,and which has good clinical efficacy.