Study on Treatment of Polycystic Ovarian Syndrome with Infertility by Combined Therapy of Chinese Herbal Medicine and Compound Cyproterone Acetate

Objective: To evaluate the effect of combined therapy of Chinese herbal medicine and compound cyproterone acetate (CPA) in treating non-obesity polycystic ovarian syndrome (PCOS) and to explore its mechanism in improving withdrawal ovulation. Methods: Eighty-six patients of non-obesity P-COS, typed as Shen-deficiency with blood stasis Syndrome or Shen-deficiency with Phlegm-Dampness Syndrome by Syndrome Differentiation in traditional Chines medicine, were randomly divided into three groups: (1) The TCM group (n = 26) was treated with Chinese drugs for 6 menstrual cycles; (2) The western medicine (WM) group (n=30) was treated with 1 tablet of CPA for 21 days, with the treatment beginning from the 5th day of menstruation. The treatment was given for 3 menstrual cycles by repetitious medication, which stopped and restarted on the 5th day of withdrawal bleeding. Then the ovulation promoting therapy was applied by using clomifene citrate and human chorionic gonadotropin (CC/hCG) for 3 menstrual cycles; (3) The TCM-WM group (n=30) was treated with the medications used for the above two groups. The menstrual cycle, the volume and duration of the menstruation, as well as the improvement of acne and pilosis [Ferriman-Gallway (F-G) scoring] were observed after 3 cycles ended. Moreover, condition of ovulation was monitored by B-ultrasonography at the 4th- 6th cycle and status of pregnancy was observed. Results: Compared with before treatment, the blood level of luteinizing hormone (LH) and testosterone (T) in all 3 groups after treatment significantly decreased (P<0. 05), with its ratio to follicle-stimulating hormone (LH/FSH) recovered to normal, but without markedly change in levels of FSH, estradiol (E2) and prolactin (PRL). The menstrual cycle in most patients got regular and acne significantly alleviated (P<0. 05), and the improvement of infrequent menstruation and acne was better in the WM group and the TCM-WM group than that in the TCM group, but pilosis showed no significant improvement in all three groups. The periodical ovulation rate in the TCM-WM group (73. 1%) and the WM group (68. 3%) was significantly higher than that in the TCM group (40%). The pregnancy rate in the TCM-WM group (53. 8%) was significantly higher than that in the other two groups (26.1% and 25% respectively, all P<0.05). Conclusion: Using combined therapy of TCM and composite CPA followed by o-vulation promoting agents of TCM and WM to treat patients of non-obesity PCOS could relieve the clinical symptoms, improve the abnormal blood level of sex hormones and significantly elevate the pregnancy rate.

Meta analysis of infertility due to polycystic ovarian syndrome treated by kidney-tonifying and blood-activating therapy

Objective:To explore the Meta-analysis of polycystic ovary syndrome-induced infertility by tonifying kidney and activating blood circulation.Methods:Chinese keywords or subject words such as"kidney-tonifying and Blood-Activating Therapy","polycystic ovary syndrome","infertility"were searched in CNKI,Wanfang and Weipu databases,and English keywords such as"Kidney-tonifying and Blood-Activating Therapy","Stein-Leventhal syndrome","Infertility"were searched in Pubmed database for a period of 2.From 2000 to 2019,Meta-analysis was carried out with Review Manager 5.0.Results:Thirteen randomized controlled literatures were screened out,and the control group was treated with routine western medicine and the treatment group was treated with Kidney-tonifying and Blood-activating therapy.All of them included literatures mentioned grouping method,but no blind method was mentioned,and the literature quality was generally low.Meta-analysis of the effective rate showed that Z=3.69(P=0.0002<0.001),95%CI(1.77,6.42),indicating that the effective rate in the treatment group was higher than that in the control group.Meta-analysis of the cycle ovulation rate showed that Z=2.19(P=0.03<0.05),95%CI(1.08,4.35),indicating that the cycle ovulation rate in the treatment group was higher than that in the control group.Meta-analysis of pregnancy rate showed that:Z=7.07(P<0.00001),95%CI(2.27,4.24),indicating that the pregnancy rate in the treatment group was higher than that in the control group;bias analysis found that the literature was distributed on both sides of the dotted line,most of which were biased.Meta-analysis of the incidence of LUFS showed that Z=3.25(P=0.001<0.05),95%CI(0.02,0.38),indicating that the incidence of LUFS in the treatment group was lower than that in the control group.Meta-analysis of serum E2 level after treatment showed that Z=4.41(P<0.0001),95%CI(11.01,28.64),indicating that the serum E2 level in treatment group was higher than that in control group after treatment.Conclusion:Meta-analysis shows that the method of tonifying kidney and activating blood circulation has a significant effect on infertility caused by polycystic ovary syndrome.It can improve the level of sex hormones,improve the efficiency,cycle ovulation rate and pregnancy rate,and reduce the incidence of LUFS.However,the quality of the included literature is not high,which needs to be further included in high-quality literature to confirm.

The research progress of Chinese medicinal food therapy on infertility

Infertility is one of the common gynecological diseases,and the incidence has been on the rise in recent years,and according to WHO,infertility will become the third most serious disease after tumor and cardiovascular disease in the 21st century.Food therapy and medicine in China has a long history,Sun Simiao Valuable Prescriptions for emergencies:"If you can use food to calm the disease,release the emotions and dispel the disease,can be said to be good workers",which is also an important embodiment of the Chinese medicine"cure the disease"idea.With the improvement of the living standard of Chinese residents in recent years,food therapy and medicinal food have become popular as a new treatment method because of its efficacy and ease of acceptance.The author summarizes and summarizes the research results of Chinese medicine and medicinal food in the treatment of infertility in recent years in order to provide reference for clinical treatment of infertility.

Effect of cognitive behavioral therapy on anxiety and depression of infertile women: A meta-analysis

Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.

Histology and Immunohistochemistry Study on Mianbu Fang Healing Immunological Infertility of Male Mice

To observe the histological and immunohistochemical changes caused by of Traditional Chinese Medicine——Mianbu Fang (Immunological Infertility Healing Mixture) in testis and epididymus of male mice with immunological infertility induced by antisperm antibody (AsAb). Materials & Methods Models of mice with immunological infertility were used by injection of mice sperm. These mice were treated with Mianbu Ⅰ, Mianbu Ⅱ or Prednisone Acetates. The characteristics on histology and immunohistochemistry of mice were analyzed. Results High level of AsAb was detected in serum and seminal vesicle plasma of model mice after treatment. Immune compounds mostly deposited in limiting membrane of seminiferous tubules, spermatogonium and epithelia of epididymis ducts. The number of spermatogenic cells per convoluted seminiferous tubule decreased. However, the Chinese medicine could significantly reduce the level of AsAb, or even eliminate the antibodies and clear out the immune compounds and increase the number of spermatogenic cells of seminiferous tubules. Conclusion Chinese Medicine Mianbu Ⅰand Ⅱ can regulate, absorb and clear out circulation and partial AsAb, as well as immunological compound. Hence, they can increase the number of spermatogenic cells of seminiferous tubules and increase the pregnancy of mice.

116 CASES OF TUBAL OBSTRUCTIVE INFERTILITY TREATED BY ACUPUNCTURE AND POINT-APPLICATION OF DRUGS

Tubal obstructive in fertility is often due to insufficiency of kidney-Qi, dysfunction andvascular obstruction of the uterine collaterals, in view of these pahogenetic characteristics, we havetreated 116 cases of tubal obstructive in fertility based on .differentiation of symptoms and signs byacupuncture at Guanyuan(CV4 ), Shuidao (ST 26), Guilai (ST 29 ), Diji (SP 8 ), Sanyinjiao (SP 6 ),Taixi(KI 3), Taichong(LR 3) which have functions of removing obstruction in collaterals by warmingkidney, regulating functions of the Chongmai and removing obstruction of the Renmai, increasihg levelsof female sex hormones, activating ovarian function, and external application to Guanyuan(CV 4) pointwith fresh Radix Aconiti Praeparata, Herb of Garden Balsam, Radix Salviae Miltiorrhizae, Fructus Evodiae, Fructus Foeniculi, Mirabilitum, Ramulus Cinnamomi, Fructus Liguidambaris, etc., which have thefunction of softening and resolving hard masses, subduing swelling and disintegrating masses, improvingblood circulation of the pelvic cavity, promoting absorption of the obstructed focus. AInong them 83cases were cured (pregnancy) accounting for 71. 6 %. The effective rate reached 90. 5 %. Clinically, itis proved that the combination of acupuncture with drugs has satis factory effects.

Conventional treatment options and herbal remedies for male infertility:An overview

Male infertility is responsible for an estimated 50%of all cases of infertility.Treatments for male infertility include surgery,in-vitro fertilization,hormone therapy,and herbal remedies.Assisted reproductive technologies and methods have made it possible to identify and treat previously untreatable causes of male infertility.Currently available treatments for male infertility are prohibitively expensive,difficult to obtain,necessitate a lengthy course of treatment,and have a host of side effects.Herbal therapy offers male infertility treatment that is less expensive and has fewer side effects than other treatments.The current review focuses on the various treatment options for male infertility.

加用中药周期疗法改善IUI患者妊娠结局的临床研究

[目的]观察加用中药周期疗法改善宫腔内人工授精(IUI)患者妊娠结局的临床效果。[方法]将40例行诱导排卵联合IUI的脾肾两虚型排卵障碍性不孕患者,分为中药周期疗法联合诱导排卵组(治疗组)20例,单纯诱导排卵组(对照组)20例,比较两组临床疗效、扳机日子宫内膜厚度和形态、排卵率及妊娠率。[结果]治疗组总有效率为95%,对照组为60%,两组差异有统计学意义(P<0.05)。治疗组扳机日子宫内膜厚度、A型内膜比例较对照组显著增加(P<0.05)。治疗组和对照组患者的排卵率相当(P>0.05)。治疗组妊娠率为45%,对照组为15%,两组差异有统计学意义(P<0.05)。[结论]在宫腔内人工授精周期中,使用中药周期疗法能使子宫内膜增厚,改善子宫内膜容受性,从而提高妊娠率。

中医药治疗子宫内膜异位症相关不孕症机制概述

子宫内膜异位症是一种常见的妇科疾病,与女性不孕症密切相关。现代医学认为子宫内膜异位症相关不孕症的发病与免疫因素、遗传因素、激素活性、炎症状态有关,但是还未探索出明确的发病机制。西医治疗包括期待疗法、假孕疗法、假绝经疗法、促排卵疗法、免疫疗法、手术、辅助生殖疗法等手段。中医治疗此病有丰富的经验,且效果明确。文章收集近年中医药治疗子宫内膜异位症相关文献,从调节机体激素水平,促进卵泡发育及排出,调节子宫内膜局部免疫状态,增加受精卵结合及着床几率,降低自然受孕或体外受精(IVF)术后流产几率等不同方面,探讨中医药治疗的作用机制,为临床提供不同诊疗思路。

从肺肾同调理论辨治多囊卵巢综合征

总结殷岫绮教授运用肺肾同调法辨治多囊卵巢综合征(PCOS)经验。殷教授立足阴阳五行及气血津液理论,认为肺肾协理气机、调节水液、输布精微之作用与女性生殖活动息息相关,肺肾二脏通调气液的功能异常是PCOS发病的重要病机;治疗PCOS可从宣通肺肾入手,上透肺郁不伤正气,下通经血不耗肾阴,以期气液宣通,精充血旺,化源得资。并附验案1则。

活血通管五味汤口服、灌肠联合导丝介入治疗输卵管阻塞性不孕临床观察

目的探讨活血通管五味汤口服、灌肠联合导丝介入治疗输卵管阻塞性不孕的近、远期临床效果。方法选取2019年6月—2021年12月河北省沧州中西医结合医院收治的输卵管阻塞性不孕患者84例,采用随机数字表法分为治疗组与对照组,各42例。治疗组给予活血通管五味汤口服、灌肠联合X线下输卵管导丝介入治疗,对照组给予单纯X线下输卵管导丝介入治疗,对比分析两组临床效果、再次堵塞率、异位妊娠率及3个月内、6个月内妊娠率等。结果治疗组总有效率为97.62%(41/42),高于对照组的80.95%(34/42)(P<0.05)。治疗后,治疗组再次堵塞率明显低于对照组,3个月内、6个月内妊娠率均高于治疗组(P<0.05);两组异位妊娠发生率比较,差异无统计学意义(P>0.05)。结论活血通管五味汤口服、灌肠联合导丝介入治疗输卵管阻塞性不孕,效果满意,可以提高患者受孕率,值得临床借鉴。

隔药脐灸疗法对肾阳虚宫寒不孕症患者子宫内膜容受性的影响

目的探讨隔药脐灸疗法对肾阳虚宫寒不孕患者冻融胚胎移植周期子宫内膜容受性的影响。方法采用前瞻性随机对照临床研究,选取2019年6月至2021年6月于烟台市烟台山医院生殖医学中心行降调节激素替代周期冻胚移植,经中医辨证为肾阳虚宫寒不孕症患者200例,年龄21~35岁。使用计算机软件进行随机抽样,分为治疗组和对照组,每组100例。治疗组在冻胚移植周期给予降调节激素替代+隔药脐灸(从降调日隔日给予隔药脐灸直到移植日)治疗,对照组行降调节激素替代,不给予隔药脐灸。观察治疗前后肾阳虚宫寒不孕患者的症候评分变化,子宫内膜厚度和分型、子宫内膜血流、子宫动脉血流变化[搏动指数(PI)、阻力指数(RI)]及临床妊娠率。采用独立样本t检验、χ^(2)检验进行统计分析。结果治疗前,治疗组与对照组肾阳虚宫寒症证候积分比较,差异无统计学意义(P=0.805);治疗后,治疗组与对照组肾阳虚宫寒症证候积分[(4.36±1.54)分比(11.69±2.36)分]比较,差异有统计学意义(P<0.001)。治疗组与对照组子宫内膜转化日子宫内膜厚度[(9.82±1.01)mm比(9.84±0.96)mm]比较,差异无统计学意义(P=0.909);治疗组A型内膜[73.03%(65/89)]与对照组[51.09%(47/92)]比较,差异有统计学意义(P<0.001);子宫内膜下血流分型Ⅲ型比例治疗组[58.43%(52/89)]高于对照组[21.74%(20/92)],差异有统计学意义(P<0.001);治疗组子宫内膜转化日的PI为(1.54±0.22)、RI为(0.53±0.19),均低于对照组[PI为(1.90±0.31)和RI为(0.71±0.25)],差异均有统计学意义(均P<0.001);治疗组临床妊娠率为51.69%(46/89),高于对照组30.43%(28/92),差异有统计学意义(χ^(2)=8.452,P=0.004)。结论隔药艾灸可通过增加子宫A型内膜和Ⅲ型子宫内膜血流比例,改善子宫内膜容受性,从而提高冻胚移植的临床妊娠率。

脐周八穴埋线对肥胖型多囊卵巢综合征不孕症患者IVF-ET治疗结局的影响

目的:探讨脐周八穴埋线治疗对肥胖型多囊卵巢综合征(PCOS)不孕症患者体外受精-胚胎移植(IVF-ET)结局的影响。方法:将90例肥胖型PCOS不孕症患者按随机数字表法分为观察组和对照组各45例。对照组患者接受IVF-ET治疗,观察组患者以脐周八穴埋线联合IVF-ET治疗,检测治疗前、后患者抑制素B(INHB)、黄体生成素(LH)、睾酮(T)、卵泡刺激素(FSH)、视黄醇结合蛋白4(RBP-4)、白脂素(Asprosin)、瘦素(LEP)、脂联素(APN)、白细胞介素-17(IL-17)、胆固醇(TC)、甘油三酯(TG)水平,以及卵巢基质血流动力学指标舒张末期流速(EDV)、收缩期最大流速(PSV)、阻力指数(RI),记录患者促性腺激素(Gn)使用剂量、获取卵泡个数、MⅡ卵率、受精率、优质胚胎率、临床妊娠率、流产率。结果:治疗后,两组患者INHB、T、LH、TC、TG、Asprosin、RBP-4、LEP、IL-17水平较治疗前降低,FSH、APN水平较治疗前升高(P<0.05),且观察组INHB、T、LH、TC、TG、Asprosin、RBP-4、LEP、IL-17水平较对照组低,FSH、APN水平较对照组高(P<0.05);治疗后,两组EDV、RI水平均降低,PSV水平升高(P<0.05),且观察组EDV、RI水平较对照组低,PSV水平较对照组高(P<0.05);观察组Gn使用剂量少于对照组(P<0.05),获取卵泡个数多于对照组(P<0.05),受精率、MⅡ卵率、临床妊娠率高于对照组(P<0.05)。结论:脐周八穴埋线治疗肥胖型PCOS不孕症行IVF-ET患者,可改善患者性激素指标,调节卵巢储备功能与基质血流动力学,改善糖脂代谢与胰岛素敏感性,抑制机体炎症,有利于获取卵泡,改善妊娠结局。

改善子宫内膜容受性的临床治疗述评

不孕不育症已成为影响人类健康的重大问题,促进人口长期、均衡增长关乎中华民族未来的发展。虽然现代辅助生殖技术已经相对成熟,但受孕率仍然很低。胚胎顺利着床和妊娠率提高的关键是提高子宫内膜容受性(ER)。怎样改善ER,提高胚胎的着床率,使内膜与胚胎发育水平趋于一致,进而提高临床妊娠率,是目前人类医学生殖探讨的重难点问题。文章综述了近年来中、西医在改善ER方面取得的成就,以期能够为临床提高妊娠成功比例提供帮助。

针药并用治疗多囊卵巢综合征不孕症的疗效观察

目的 观察针药并用治疗多囊卵巢综合征(polycystic ovary syndrome, PCOS)不孕症的临床疗效。方法 将60例PCOS不孕症患者随机分为观察组和对照组,每组30例。两组均予基础治疗,对照组采用口服中药治疗,观察组在对照组的基础上采用电针治疗。观察两组治疗前后排卵情况、体表测量学指标[身体质量指数(body mass index, BMI)、腰臀比(waist-to-hip ratio, WHR)]、血清生殖激素[促卵泡生成素(follicle-stimulating hormone, FSH)、促黄体生成素(luteinizing hormone, LH)、催乳素(prolactin, PRL)、雌二醇(estradial, E2)、睾酮(testosterone, T)和雄烯二酮(androstenedione, AND)]及糖脂代谢指标[空腹血糖(fasting plasma glucose, FPG)、空腹胰岛素(fasting insulin, FINS)、甘油三酯(triglyceride, TG)、总胆固醇(total cholesterol, TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL)、低密度脂蛋白胆固醇(low-densitylipoproteincholesterol,LDL)及稳态模型胰岛素抵抗指数(homeostasismodel assessment-insulin resistance, HOMA-IR)]的变化,并比较两组临床疗效。结果 两组治疗后BMI较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗后WHR较治疗前降低,差异有统计学意义(P<0.05)。观察组治疗后血清LH水平及LH/FSH较治疗前降低(P<0.05);两组治疗后血清T和AND水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗后血清FPG水平和HOMA-IR较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);观察组治疗后血清FINS水平较治疗前降低(P<0.05)。观察组治疗后血清TC水平较治疗前降低(P<0.05),且低于对照组(P<0.05);观察组治疗后TG较治疗前降低(P<0.05)。观察组总有效率为93.3%,对照组为73.3%,两组总有效率比较差异有统计学意义(P<0.05)。结论 在基础治疗的基础上,针药并用能更有效地改善PCOS不孕症患者的排卵情况,有效降低血清生殖激素和糖脂代谢指标水平。

微导丝贯穿法联合臭氧介入治疗输卵管阻塞性不孕症

目的观察微导丝贯穿法联合臭氧介入治疗输卵管阻塞性不孕症效果。方法回顾性分析149例输卵管阻塞性不孕症患者资料,其中A组(n=44)接受常规输卵管再通术(FTR),B组(n=51)接受微导丝贯穿法FTR,C组(n=54)接受微导丝贯穿法联合臭氧FTR治疗;比较治疗后1个月各组输卵管复通率及1年内自然妊娠率。结果治疗后1个月,A、B、C组输卵管复通率分别为63.38%(45/71)、80.22%(73/91)及92.78%(90/97),各组依次升高(P均<0.05);1年内A、B、C组自然妊娠率分别为20.45%(9/44)、27.45%(14/51)及48.15%(26/54),C组高于A、B组(P均<0.05),且A、B组差异无统计学意义(P=0.427)。结论 微导丝贯穿法联合臭氧介入治疗输卵管阻塞性不孕症效果优于常规FTR及单独微导丝贯穿法FTR。

抗核抗体对体外受精-胚胎移植结局的影响研究

目的探讨抗核抗体(ANA)对体外受精(IVF)-胚胎移植(ET)结局的影响,并探讨免疫抗凝治疗的效果。方法回顾性分析2018年1月至2022年11月在浙江省人民医院生殖内分泌科接受IVF-ET治疗的不孕症患者资料,其中818个IVF周期和673个ET周期。根据ANA滴度分为ANA阴性组、ANA弱阳性组(滴度为1∶32)和ANA阳性组(滴度≥1∶100),ANA阳性组进一步分为低滴度阳性组(滴度≥1∶100~<1∶320)和高滴度阳性组(滴度≥1∶320),比较各组获卵、受精和胚胎质量,分析不同ANA分型对上述指标的影响以及免疫抗凝治疗对ANA弱阳性和阳性患者ET结局的影响。结果ANA阳性组获卵率低于ANA阴性组(72.79%比75.90%,P<0.05)。ANA阴性组、ANA弱阳性组和ANA阳性组卵裂率、受精卵在体外发育到第3天(D3)优质胚胎(简称优胚)率比较差异均无统计学意义(均P>0.05)。高滴度阳性组获卵率、D3优胚数、D3优胚率均低于低滴度阳性组[分别为67.18%比75.37%、2.00(1.00,4.00)个比3.00(2.00,5.00)个、42.39%比58.62%,均P<0.05]。抗着丝点抗体(ACA)阳性组IVF受精率低于抗干燥综合征相关抗原A阳性组(48.41%比76.54%,P<0.01)。ANA阴性组、ANA弱阳性组和ANA阳性组ET后人绒毛膜促性膜激素(hCG)阳性率、临床妊娠率、胚胎种植率、临床妊娠流产率和活产率比较差异均无统计学意义(均P>0.05)。ANA阴性未用药组和ANA阳性用药组患者hCG阳性率、临床妊娠率、临床妊娠流产率和活产率比较差异均无统计学意义(均P>0.05)。ANA弱阳性治疗组和ANA弱阳性未治疗组患者hCG阳性率、临床妊娠率、临床妊娠流产率和活产率比较差异均无统计学意义(均P>0.05)。结论ANA高滴度阳性对获卵、受精和胚胎发育有不利影响,其中ACA阳性对受精影响显著。免疫抗凝药物治疗未能显著改善ANA弱阳性患者的IVF-ET结局。

电针周期疗法对卵巢储备功能下降不孕患者子宫内膜容受性及体外受精-胚胎移植的影响

目的探讨电针周期疗法对卵巢储备功能下降(DOR)不孕患者子宫内膜容受性及体外受精-胚胎移植(IVF-ET)结局的影响。方法将2021年4月—2022年4月在柳州市妇幼保健院拟行IVF-ET的78例DOR不孕患者随机分为对照组和试验组,每组39例。2组均行IVF-ET,试验组在移植前行3个月的电针序贯周期治疗。比较2组治疗前后黄体中期的子宫内膜厚度、子宫内膜容积、子宫内膜分型和血流分型及子宫动脉血流参数[双侧子宫动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值/舒张期峰值(S/D)],统计比较2组患者治疗后获卵数、受精数、胚胎数、优质胚胎数及HCG阳性率、胚胎种植率、临床妊娠率。结果与治疗前及对照组比较,试验组患者电针周期干预后子宫内膜厚度、子宫内膜容积均明显增高,内膜C型患者占比降低,内膜A型患者占比增高,血流Ⅰ型患者占比降低,血流Ⅲ型患者占比增高,子宫动脉PI、RI、S/D均明显降低,差异均有统计学意义(P均<0.05);对照组以上指标均未见明显变化(P均>0.05)。试验组获卵数、受精数、胚胎数、优质胚胎数均明显多于对照组(P均<0.05),HCG阳性率、胚胎种植率、临床妊娠率均明显高于对照组[67.56%(25/37)、58.33%(28/48)、51.35%(20/37)比44.74%(17/38)、37.03%(20/54)、31.58%(12/38),P均<0.05]。结论电针周期治疗可以明显改善DOR不孕患者子宫内膜容受性,提高胚胎着床率和临床妊娠率。

崔云教授基于形神合一思想辨治不育症

在现代社会中男性生殖问题越来越突出,不育症不是一种独立疾病,而是由某一种或很多疾病和(或)因素造成的结果。除去先天性因素外,后天继发性因素中生物个体、环境、情绪等因素导致不育的现象占主要部分,因此,从“生物-心理-社会”模式去探讨不育症的治疗有特殊意义。而中医学中“形”和“神”对立统一的思想是这种模式的最初探索,不仅较早认识到先天性原因导致“无子”,也认识到“形神合一”是“成人”的必要条件,崔云教授在不育症临证治疗上,从形神辨证统一入手,结合病证,注重全形调神,取得了较好的临床疗效。

补肾解郁汤配合音乐疗法治疗多囊卵巢综合征不孕症的效果

目的探讨补肾解郁汤配合音乐疗法治疗多囊卵巢综合征(PCOS)不孕症的临床效果。方法选取2019年6月至2021年3月于海南省中医院门诊及病房诊断为PCOS不孕症且中医辨证为肾虚肝郁型的70例患者作为研究对象,将其随机分为观察组和对照组,每组35例。观察组给予补肾解郁汤配合音乐疗法治疗,对照组给予枸橼酸氯米芬胶囊治疗。比较两组的治疗效果。结果治疗后,观察组的卵泡数目少于对照组,优势卵泡直径大于对照组(P<0.05)。治疗后,观察组的睾酮(T)、黄体生成素(LH)水平低于对照组,促卵泡激素(FSH)、雌二醇(E2)水平高于对照组(P<0.05)。两组的优卵排出率比较,差异无统计学意义(P>0.05);观察组的1年妊娠率高于对照组(P<0.05)。观察组的治疗总有效率高于对照组(P<0.05)。结论补肾解郁汤配合音乐疗法对PCOS不孕症患者的助孕具有积极作用和临床意义。