补肾活血方周期疗法联合来曲唑及克罗米芬治疗肾虚血瘀型排卵障碍性不孕的临床观察

发布时间：2018-03-25 09:21

本文选题：补肾活血方　切入点：肾虚血瘀型　出处：《湖北中医药大学》2014年硕士论文

【摘要】：目的: 通过观察补肾活血方周期疗法联合来曲唑及克罗米芬治疗肾虚血瘀型排卵障碍性不孕的临床疗效，客观评价补肾活血方周期疗法在促进卵泡生长、提高排卵率，改善临床症状、促进子宫内膜生长、提高妊娠率方面的作用。为临床治疗该病提供可靠的客观依据。方法: 将诊断为肾虚血瘀型排卵障碍性不孕症的60例患者，随机分为A组(治疗组)、B组（对照组），每组各30例。对照组予以来曲唑（LE）、克罗米芬（CC）口服，，人绒毛膜促性腺激素(HCG)肌注治疗；治疗组在对照组治疗方法的基础上,加用补肾活血方周期疗法，3个月经周期为1疗程，均治疗2个疗程。观察治疗前后两组的临床症状、卵泡发育、排卵率、妊娠率、子宫内膜厚度、中医症候积分等方面的变化,进行统计学分析，对两组方法的临床疗效进行评价。结果: 1、两组治疗后卵泡大小、排卵率比较，治疗组明显优于对照组（P＜0.05）；2、两组促排卵综合疗效对比,显愈率差异有显著性(P＜0.05)；3、中医证候积分比较，有显著性差异（P＜0.05）；4、两组子宫内膜的厚度比较,治疗组明显优于对照组（P＜0.05）；5、两组妊娠率比较，有显著性差异（P＜0.05）。结论: 1、补肾活血方周期疗法能提高卵巢对垂体促性腺激素的反应性，从而促进卵泡发育,调节黄体功能。2、LE、CC、补肾调周法联合使用可以促进卵泡的生长、诱发排卵、改善子宫内膜厚度、提高患者的妊娠率并改善临床症状，既发挥了西药高效促排卵作用,同时也弥补了西药相关的副作用。3、补肾活血方周期疗法，重在补肾壮阳、活血通络，使机体气血通畅、阴阳平衡、脏腑功能协调，从而充分调动肾-天癸-冲任-胞宫轴的生理功能，提高受孕率。
[Abstract]:Objective:. By observing the clinical efficacy of Bushen Huoxue prescription combined with letrozole and clomiphene in the treatment of ovulatory dysfunction of kidney deficiency and blood stasis type, the objective evaluation of Bushen Huoxue prescription cycle therapy was to promote follicular growth and increase ovulation rate. To improve the clinical symptoms, promote the growth of endometrium, improve the pregnancy rate, and provide a reliable objective basis for clinical treatment of the disease. Methods:. Sixty patients with ovulatory disorder of kidney deficiency and blood stasis type were randomly divided into two groups: group A (control group, 30 cases, each group, 30 cases), control group, oral administration of letrozolide and clomiphene (CCL). The treatment group was treated by intramuscular injection of human chorionic gonadotropin (HCG), the treatment group was treated with Bushen Huoxue prescription on the basis of the treatment method of control group, 3 menstrual cycles were one course of treatment, all of them were treated for 2 courses. The clinical symptoms of the two groups were observed before and after the treatment. The changes of follicular development, ovulation rate, pregnancy rate, endometrial thickness, TCM symptom score and so on were analyzed statistically to evaluate the clinical efficacy of the two groups. Results:. 1. After treatment, the follicle size and ovulation rate in the treatment group were significantly better than those in the control group (P < 0.05). The comprehensive efficacy of the two groups in promoting ovulation was compared with that in the control group (P < 0.05). There was a significant difference in the apparent recovery rate between the two groups (P < 0.05), and the score of TCM syndromes was higher than that in the control group (P < 0.05). There was significant difference in endometrial thickness between the two groups (P < 0.05). The treatment group was better than the control group (P < 0.05). The pregnancy rate of the two groups was significantly higher than that of the control group (P < 0.05). Conclusion:. 1. The periodic therapy of tonifying kidney and activating blood circulation prescription can improve the response of ovary to pituitary gonadotropin, thus promote follicle development, regulate luteal function. The combination of tonifying kidney and regulating week method can promote follicle growth, induce ovulation, and improve endometrial thickness. Increasing the pregnancy rate and improving the clinical symptoms not only play a role in promoting ovulation effectively by western medicine, but also make up for the side-effect of western medicine. The cycle therapy of tonifying kidney and activating blood circulation is focused on invigorating kidney and strengthening yang, activating blood circulation, making body qi and blood unobstructed. The balance of yin and yang and the coordination of viscera function can fully mobilize the physiological function of kidney-Tiangui-Chong Ren-uterus axis and improve the pregnancy rate.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6

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