补肾中药联合避孕药预治疗肾虚型卵巢低反应临床观察

发布时间：2018-07-24 19:21

【摘要】：目的探讨补肾中药联合避孕药预治疗体外受精-胚胎移植(IVF-ET)肾虚型卵巢低反应(POR)患者的临床疗效。方法将180例行IVF-ET的POR患者按照随机数字表法分为联合治疗组、复方口服避孕药(COC)治疗组和对照组,每组60例。3组患者均采用短方案进行IVF-ET治疗。联合治疗组自IVFET超排卵周期的上1个月经周期行补肾中药联合COC预治疗,COC治疗组于同一时期COC治疗,对照组口服等剂量安慰剂。观察3组治疗前后肾虚证候改善情况及予短方案后3组人绒毛膜促性腺激素(HCG)日雌激素(E2)水平、促性腺激素(Gn)用量及天数、获卵数、受精率、可利用胚胎率、优质胚胎率及临床妊娠率。结果与对照组比较,联合治疗组Gn用量及使用天数减少,HCG日E2水平、获卵数、受精率及可利用胚胎率增高(P0.05,P0.01);肾虚证候积分降低(P0.01),且与本组治疗前比较,肾虚症状改善明显(P0.01);与对照组比较,COC治疗组获卵数增高(P0.01);与COC治疗组比较,联合治疗组Gn用量及使用天数减少,HCG日E2水平增高,获卵数及受精率较高,肾虚证候积分降低(P0.01)。结论补肾中药联合口服避孕药预治疗可增加IVF-ET中肾虚型POR患者的获卵数,增加HCG日E2水平,减少Gn用量及天数,提高受精率及可利用胚胎率,改善肾虚症状。
[Abstract]:Objective to investigate the clinical effect of kidney tonifying Chinese medicine combined with contraceptive pill in the treatment of ovarian hyporesponse (POR) patients with kidney deficiency in vitro fertilization and embryo transfer (IVF-ET). Methods 180 POR patients with IVF-ET were randomly divided into combined treatment group, compound oral contraceptive (COC) treatment group and control group. 60 patients in each group were treated with IVF-ET with short regimen. The combined treatment group was treated with tonifying kidney Chinese medicine combined with COC pretreatment in the same period from the last menstrual cycle of IVFET superovulation cycle, and the control group was given the same dose of placebo. To observe the improvement of kidney deficiency syndrome before and after treatment and the level of estrogen (E _ 2), the amount and days of gonadotropin (Gn), the number of eggs acquired, the fertilization rate and the rate of available embryos in the three groups after the treatment. High quality embryo rate and clinical pregnancy rate. Results compared with the control group, the dosage and days of Gn in the combined treatment group decreased the level of E2 on HCG day, increased the number of eggs, fertilization rate and usable embryo rate (P0.01), decreased the score of kidney deficiency syndrome (P0.01), and compared with that before treatment. The symptoms of kidney deficiency were obviously improved (P0.01), the number of oocytes in the treatment group was higher than that in the control group (P0.01), and the dosage and the days of use of Gn in the combined treatment group were lower than those in the control group. The level of E2 was increased, the number of eggs acquired and the fertilization rate were higher in the combined group than in the control group (P0.01), and the score of syndrome of kidney deficiency was lower in the combined group (P0.01). Conclusion the combination of tonifying kidney Chinese medicine and oral contraceptive pretherapy can increase the number of eggs obtained from POR patients with kidney deficiency in IVF-ET, increase the level of E2 on HCG day, decrease the dosage and days of Gn, increase the rate of fertilization and embryo utilization, and improve the symptoms of kidney deficiency.
【作者单位】：山东中医药大学附属医院中西医结合生殖与遗传中心;山东中医药大学第一临床医学院;
【基金】：国家自然科学基金资助项目(No.81273790,No.81473720) 山东省研究生教育创新计划项目(No.sdyc11099)
【分类号】：R714.8

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