中药人工周期联合克罗米芬治疗肾阳虚型排卵障碍性不孕症的临床观察

发布时间：2018-06-29 04:57

本文选题：排卵障碍性不孕 + 肾阳虚型不孕　；参考：《湖北中医药大学》2014年硕士论文

【摘要】：目的：本研究通过对临床病例资料收集统计，进行中药人工周期联合克罗米芬治疗肾阳虚型排卵障碍性不孕症的临床观察。在研究过程中，通过基础体温(BBT)测定、B超监测卵泡发育情况、中医症状等的观察，与对照组(克罗米芬)相比较，评价其临床疗效。方法：所有观察病例均来源于武汉市中医医院2012年3月-2013年5月妇科门诊的患者，根据病例的纳入标准、排除标准以及中医辨证标准，共收集62例作为观察病例，按照随机分配的原则，分为治疗组(中药人工周期联合克罗米芬)32例和对照组(克罗米芬)30例。通过观察两组治疗后的临床总体疗效结果、妊娠率、卵泡生长改善情况、性激素激素水平改善情况、中医症状改善情况等，对上述资料进行数据分析和临床研究。结果：(1)治疗后两组总体疗效结果的对比，治疗组90.1%，对照组70.08%，经统计学分析，两组结果有明显的统计学差异(P0.05)，治疗组总体疗效高与对照组；(2)治疗后两组妊娠率的对比，治疗组37.5%，对照组20.0%，经统计学分析，两组结果有统计学差异(P0.05)，治疗组妊娠率高于对照组；(3)治疗前后，两组中医症状积分均较前有所下降，有统计学的差异(P0.05)，且治疗组较对照组中医症状积分的下降的情况表现的更加显著；(4)治疗前后两组B超监测卵泡直径比较，两组卵泡直径均有所增长，且治疗组卵泡生长更好，经统计有显著性差异(P0.05)；(5)治疗后，两组黄体期血清孕酮(P)和雌二醇(E2)结果比较，经统计学分析，有明显性差异(P0.05)，治疗组黄体期P、E2的上升情况较对照组更明显；(6)两组患者在妊娠后先兆流产发生率进行比较，，治疗组7.14%，对照组16.67%，经过统计学分析，没有显著性差异(P0.05)；在治疗期间，两组病例的卵巢过度刺激征(OHSS)发生率进行比较，治疗组6.30％，对照组26.67％，经过数据的分析具有统计学差异(P0.05)。结论：从治疗后妊娠率，中医症状积分的改善、卵泡发育大小及血清性激素情况等相关指标的统计结果来看，得出中药人工周期联合克罗米芬组治疗肾阳虚型排卵障碍性不孕症效果优于克罗米芬对照组，并且能够有效改善机体的整体状况。
[Abstract]:Objective: to investigate the clinical effect of combination of traditional Chinese medicine and clomiphene in the treatment of ovulatory infertility with deficiency of kidney yang. In the course of the study, the basic body temperature (BBT) was measured, the follicle development was monitored by B-ultrasound, the symptoms of traditional Chinese medicine were observed, and compared with the control group (clomiphene), the clinical efficacy was evaluated. Methods: all the observed cases were from the outpatient department of gynecological department of Wuhan traditional Chinese Medicine Hospital from March 2012 to May 2013. According to the criteria of inclusion, exclusion and differentiation of symptoms and signs of TCM, 62 cases were collected as observation cases. According to the principle of random distribution, the patients were divided into treatment group (32 cases) and control group (30 cases). By observing the overall clinical curative effect, pregnancy rate, follicle growth improvement, sex hormone level improvement, TCM symptom improvement and so on, the above data were analyzed and studied. Results: (1) after treatment, there was a significant difference between the two groups (P0.05), the total curative effect of the treatment group was higher than that of the control group, (2) the pregnancy rate of the two groups was higher than that of the control group, and (2) the pregnancy rate of the two groups was higher than that of the control group. Treatment group 37.5, control group 20.0, the results of statistical analysis, the two groups have statistical differences (P0.05), the pregnancy rate in the treatment group is higher than the control group; (3) before and after treatment, the scores of TCM symptoms in the two groups are lower than before, There was statistical difference (P0.05), and the treatment group than the control group in the decline of the symptoms of more significant performance; (4) before and after the treatment of two groups of ultrasound monitoring follicle diameter, the two groups of follicle diameter increased, and the treatment group follicular growth better, After treatment with); (5, the results of progesterone (P) and estradiol (E 2) in the luteal phase of the two groups were compared, and the difference was significant (P0.05). The increase of serum progesterone (P) and estradiol (E 2) in the treatment group was more obvious than that in the control group. (6) the incidence of threatened abortion after pregnancy was compared between the two groups. The incidence of ovarian hyperstimulation (OHSS) was compared between the treatment group (7.14%) and the control group (16.67%) (P0.05). Treatment group 6.30 and control group 26.67, the data analysis has statistical difference (P0.05). Conclusion: according to the statistical results of pregnancy rate, improvement of TCM symptom score, follicular development and serum sex hormone status after treatment, The results showed that the efficacy of combination of traditional Chinese medicine and clomiphene in the treatment of ovulatory infertility with deficiency of kidney yang was better than that in clomiphene control group, and it could effectively improve the overall condition of the body.
【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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