加减苁蓉菟丝子丸联合氯米芬治疗肾虚型排卵障碍性不孕临床研究

Clinical Study on Modified Congrong Tusizi Pills Combined with Clomiphene for Infertility Caused by Ovulation Disorder of Kidney Deficiency Type

目的:观察加减苁蓉菟丝子丸联合氯米芬治疗肾虚型排卵障碍性不孕的临床疗效。方法:将60例患者分为2组,加减苁蓉菟丝子丸联合氯米芬(中西医结合组) 30例,单用氯米芬(西医组) 30例,疗程均为3月,比较治疗前后内分泌激素、基础体温、B超监测排卵、子宫内膜的变化及妊娠情况。结果:中西医结合组排卵率为68.62%,西药组排卵率为61.64%。2组排卵率比较,差异无统计学意义(P> 0.05)。中西医结合组妊娠率46.67%,西医组20.00%,2组比较,差异有统计学意义(P <0.05)。中西医结合组自然流产率14.29%,西医组66.67%,2组比较,差异有统计学意义(P <0.05)。2组治疗前后性激素比较,差异均有统计学意义(P <0.01)。2组治疗后睾酮(T)、雌二醇(E_2)比较,差异有统计学意义(P <0.01,P <0.05)。2组治疗后优势卵泡直径、排卵日子宫内膜厚度均较前改善(P <0.01)。2组治疗后排卵日子宫内膜厚度比较,差异有统计学意义(P <0.01)。全部病例在服药期间未出现不良反应。结论:加减苁蓉菟丝子丸联合氯米芬能够促进排卵,并改善子宫内膜容受性,促排卵后能有效提高妊娠率,降低流产率,且安全性较好。

Objective:To obverse the clinical effect of the modified Congrong Tusizi pills combined with clomiphene for infertility caused by ovulation disorder of kidney deficiency type. Methods:A total of 60 cases of patients were divided into two groups,30 cases in each group. The integrated Chinese and western medicine therapy group was given modified Congrong Tusizi pills combined with clomiphene,and the western medicine group was given clomiphene for treatment. The course of treatment in both groups was three months. The changes of endocrine hormones,basal body temperature,ovulation monitored by B-ultrasound,endometrium and pregnancy before and after treatment were observed. Results:The ovulation rate was 68.62% in the integrated Chinese and western medicine therapy group,and 61.64% in the western medicine group,there being no significance in the difference(P > 0.05). The pregnancy rate was 46.67% in the integrated Chinese and western medicine therapy group,and 20.00% in the western medicine group,the difference being significant(P < 0.05). The spontaneous abortion rate was 14.29% in the integrated Chinese and western medicine therapy group,and66.67% in the western medicine group,the difference being significant(P < 0.05). Compared the sex hormones between the two groups before and after treatment,differences being significant(P < 0.01). Compared the levels of testosterone(T) and estradiol(E2) after treatment between the two groups,the difference being significant(P < 0.01,P < 0.05). After treatment,the diameters of dominant follicles and the thickness of endometrium on the day of ovulation in the two groups were improved(P < 0.01). Compared the thickness of endometrium on the day of ovulation between the two groups,the difference being significant(P < 0.01). No adverse reaction was found during the treatment. Conclusion:The therapy of modified Congrong Tusizi pills combined with clomiphene can promote the ovulation,improve the endometrial receptivity. After the promotion of ovulation,the pregnancy rate can be increased and the abortion rate can be decreased with good safety.