补肾调周法联合低剂量雌孕激素序贯疗法治疗多囊卵巢综合征不孕症的临床研究

发布时间：2018-04-27 05:05

本文选题：多囊卵巢综合征 + 不孕　；参考：《南京中医药大学》2017年硕士论文

【摘要】：研究目的观察运用补肾调周法联合低剂量雌孕激素序贯疗法治疗多囊卵巢综合征不孕症的临床疗效,并探索其作用机制,为临床推广及应用提供依据。研究方法本研究采用自身前后对照的方法,选取符合纳入标准的肾虚型多囊卵巢综合征不孕症患者35例,运用补肾调周法联合低剂量雌孕激素序贯疗法治疗2个疗程,观察并记录治疗前后患者妊娠与排卵情况、月经周期及基础体温变化,同时记录卵巢最大平面直径、子宫内膜厚度及卵泡直径、血清性激素水平及中医临床症状积分的变化,并随访6个月。结果:1.妊娠率及排卵率在纳入的35例患者中,14例患者自然妊娠,占40.0%。经2疗程治疗后,排卵率为82.8%,总有效率为82.8%。2.血清性激素水平治疗后T、LH水平及LH/FSH比值均较治疗前下降,E2水平较治疗前明显升高,差异均具有统计学意义;而治疗前后FSH水平差异无统计学意义。3.临床症状及体征治疗后临床症状总积分较治疗前明显下降,差异具有统计学意义。除了多毛症状改善不明显外,其他各组治疗后积分均较治疗前下降,具有统计学意义;另外,治疗后子宫内膜厚度增厚、卵泡直径增大、卵巢最大平面直径减小,治疗前后差异有统计学意义。结论:对于多囊卵巢综合征不孕症患者,采用补肾调周法联合低剂量雌孕激素序贯疗法治疗,疗效确切。治疗后患者的临床妊娠率、全身症状及血清性激素水平得到明显的改善。应用低剂量的雌孕激素序贯疗法可以有效地控制患者的月经周期,且能帮助恢复排卵,为治疗多囊卵巢综合征不孕症提供了新思路。
[Abstract]:Objective to observe the clinical effect of the therapy of tonifying kidney and regulating week combined with low-dose estrogen and progesterone in the treatment of infertility with polycystic ovary syndrome (PCOS), and to explore its mechanism, and to provide the basis for clinical popularization and application. Methods in this study, 35 patients with polycystic ovary syndrome (PCOS) with kidney deficiency were selected by using self-control method before and after treatment, and two courses of treatment were treated by tonifying kidney and regulating weeks combined with low-dose sequence therapy of estrogen and progesterone. To observe and record the changes of pregnancy and ovulation, menstrual cycle and basal body temperature before and after treatment, and to record the changes of the maximum planar diameter of ovary, the thickness of endometrium and the diameter of follicle, the level of serum sex hormone and the clinical symptom score of TCM. The patients were followed up for 6 months. The result is 1: 1. The pregnancy rate and ovulation rate were 40.0% (14 / 35). After two courses of treatment, the ovulation rate was 82.8% and the total effective rate was 82.8%. The levels of serum sex hormone after treatment were significantly higher than those before treatment (P < 0.05), but there was no significant difference in FSH levels before and after treatment. The total score of clinical symptoms and signs after treatment was significantly lower than that before treatment, and the difference was statistically significant. In addition, the scores of the other groups were significantly decreased after treatment, in addition, the thickness of endometrium was thickened, the diameter of follicle was enlarged, and the diameter of ovary was decreased after treatment. The difference before and after treatment was statistically significant. Conclusion: for the infertility patients with polycystic ovary syndrome, the therapy of tonifying kidney and regulating week combined with low dose of estrogen and progesterone is effective. After treatment, the clinical pregnancy rate, systemic symptoms and serum sex hormone levels were significantly improved. Low dose of estrogen and progesterone sequential therapy can effectively control the menstrual cycle of patients, and can help to restore ovulation, which provides a new idea for the treatment of polycystic ovary syndrome infertility.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.75;R711.6

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