清热化瘀法辅助治疗体外受精—胚胎移植中宫腔积液的临床观察

发布时间：2018-01-27 17:41

本文关键词： 体外受精-胚胎移植宫腔积液清热化瘀　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:体外受精-胚胎移植等辅助生育技术不断发展,我们认识到移植周期中的宫腔积液会使子宫内膜的微环境发生改变,影响子宫内膜对胚胎的容受性,降低辅助生育技术的胚胎种植率。因此,处理宫腔积液成为亟待解决的问题,在众多处理方式中,治疗效果不甚满意等问题困扰着我们,中医药可发挥其优势,对宫腔积液的消除有一定效果。本研究应用中医药清热化瘀法辅助治疗体外受精-胚胎移植过程中移植周期的宫腔积液,提高子宫内膜容受性,进而降低移植周期取消率、提高临床妊娠率。方法:本研究的研究对象为行体外受精-胚胎移植助孕的患者,就诊时间段为2015年3月至2016年12月,年龄在22岁～42岁之间,冻融胚胎移植周期中阴道B超诊断为宫腔积液的患者,共60例,随机分为两组:中药联合抽吸治疗组、单纯抽吸对照组,每组各30例。中药联合抽吸治疗组:月经周期第10～12天或激素替代治疗的第10～12天,阴道B超发现宫腔积液,随即在阴道B超监视下行宫腔抽吸术,术后内服清热化瘀中药方至移植日停药。单纯抽吸对照组:月经周期第10～12天或激素替代治疗的第10～12天,阴道B超发现宫腔积液,随即在阴道B超监视下行宫腔抽吸术。移植胚胎日移植前复查阴道B超,观察宫腔积液是否消失。复查阴道B超时宫腔积液消失者进行胚胎移植,观察两组的移植取消率、临床妊娠率。结果:1.治疗后宫腔积液发生率的比较,治疗组与对照组进行比较有显著性差异(P0.05)。2.两组的移植取消率比较有显著性差异(P0.05),临床妊娠率比较无统计学差异(P0.05)。结论:1.清热化瘀疗法可明显减少宫腔积液发生率。2.清热化瘀疗法在不影响临床妊娠率的基础上,可减少移植取消率。
[Abstract]:Objective: assisted fertility techniques such as in vitro fertilization and embryo transfer have been developed. We recognize that the uterine cavity effusion in the transfer cycle will change the microenvironment of the endometrium and affect the endometrial receptivity to the embryo. Therefore, the treatment of uterine cavity effusion has become a problem to be solved urgently. Among the many ways of treatment, the treatment effect is not satisfactory and so on. Chinese medicine can play its advantage. This study used traditional Chinese medicine to clear heat and remove blood stasis in the treatment of in vitro fertilization and embryo transfer period of uterine effusion in order to improve endometrial receptivity. In order to reduce the cancellation rate of transplantation cycle and improve the clinical pregnancy rate. Methods: the study object of this study was the patients who were assisted by IVF and embryo transfer. From March 2015 to December 2016, 60 patients, aged from 22 years to 42 years old, were diagnosed as intrauterine effusion by B-ultrasound in the frozen and thawed embryo transfer cycle. They were randomly divided into two groups: the Chinese medicine combined with aspiration treatment group and the simple aspiration control group with 30 cases in each group. The Chinese medicine combined aspiration therapy group: the menstrual cycle 1012 days or the 10th day of hormone replacement therapy. Vaginal B ultrasound found intrauterine effusion, and then vaginal B-ultrasound monitoring of uterine cavity aspiration. Simple aspiration control group: menstrual cycle 10 days 12 days or hormone replacement therapy 10 days 12 days, vaginal B ultrasound found intrauterine effusion. Then the uterine cavity aspiration was performed under the monitoring of vaginal B-ultrasound. Before the embryo transfer day the vaginal B-mode ultrasound was reexamined to observe whether the uterine cavity effusion disappeared or not. The embryo transfer was carried out when the uterine cavity effusion disappeared during the re-examination of vaginal B-mode ultrasound. The transplant cancellation rate and clinical pregnancy rate of the two groups were observed. Results: 1. The incidence of intrauterine effusion was compared after treatment. There was a significant difference between the treatment group and the control group (P 0.05). 2. There was a significant difference between the two groups in the cancellation rate of transplantation (P0.05). There was no statistical difference in clinical pregnancy rate (P 0.05). Conclusion 1. The incidence of uterine effusion can be significantly reduced by removing heat and removing blood stasis. 2. The treatment of clearing heat and removing blood stasis can not affect the clinical pregnancy rate. The transplant cancellation rate can be reduced.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.8

【参考文献】