通管方对胚胎反复种植失败患者子宫内膜容受性的影响

The Effect of Tongguan Decoction on Endometrial Receptivity in Patients with Repeated Embryo Implantation Failure

目的:观察通管方对胚胎反复种植失败血瘀证患者子宫内膜容受性的影响。方法:选择胚胎反复种植失败血瘀证不孕症患者62例,随机分为试验组31例和对照组31例。两组于第4周期行IVF-ET术,通过记录患者中医证候积分、子宫内膜厚度及类型、子宫内膜血流、血清VEGF及临床妊娠率,评估其疗效及安全性。结果:最终共有60例患者完成随访,试验组的总有效率为83.3%,对照组为43.3%,两组相比差异有统计学意义(P<0.05)。治疗后试验组的中医证候积分明显低于对照组(P<0.05);试验组A型子宫内膜例数高于对照组(P<0.05);试验组3型子宫内膜血流例数高于对照组(P<0.05);试验组血清VEGF水平高于对照组(P<0.05);两组患者治疗后子宫内膜厚度无明显差异(P>0.05);两组患者临床妊娠率比较差异有统计学意义(P<0.05)。结论:通管方可有效改善胚胎反复种植失败血瘀证患者的中医临床证候,提高A型子宫内膜、3型子宫内膜血流的比例及血清VEGF水平,进而改善子宫内膜容受性,有助于提高胚胎反复种植失败患者的临床妊娠率。

Objective:To observe the effect of Tongguan Decoction on endometrial receptivity in patients with repeated embryo implantation failure and blood stasis syndrome.Methods:62 infertility patients of childbearing age with blood stasis syndrome due to repeated embryo implantation failure were randomly divided into an experimental group of 31 cases treated with combination of traditional Chinese and Western medicine IVF-ET and a control group of 31 cases treated with combination of traditional Chinese and Western medicine IVF-ET.Two groups underwent IVF-ET surgery in the fourth cycle.Evaluate the overall efficacy and safety of patients by recording their TCM syndrome scores,endometrial thickness and type,endometrial blood flow,changes in serum VEGF levels,and clinical pregnancy rates.Results:60 patients completed the follow-up,and the total effective rate of the experimental group was 83.3%(25/30)and that of the control group was 43.3%(13/30),the difference between the two groups was statistically significant(P<0.05).After treatment,TCM syndrome scores in experimental group were significantly lower than those in control group(P<0.05);The number of type A endometrium cases in experimental group was significantly higher than that in control group(P<0.05);The number of type 3 endometrial blood flow cases in experimental group was significantly higher than that in control group(P<0.05);Serum VEGF level of experimental group was higher than that of control group(P<0.05);There was no significant difference in endometrial thickness between the two groups after treatment(P>0.05);There was significant difference in clinical pregnancy rate between the two groups(P<0.05).Conclusion:Tongguan Decoction can effectively improve the clinical symptoms of traditional Chinese medicine in patients with blood stasis syndrome of repeated embryo implantation failure.It can increase the proportion of blood flow to type A and type 3 endometrium,as well as serum VEGF levels in patients with blood stasis syndrome of repeated embryo implantation failure,thereby improving endometrial receptivity and helping to increase the clinical pregnancy rate of patients with blood stasis syndrome of repeated embryo implantation failure.