补肾益气和血法中药对IVF-ET妇女子宫内膜和子宫血流的影响
发布时间：2018-08-12 12:24
【摘要】：目的本研究的目的是通过对补肾益气和血法中药介入不孕患者IVF-ET治疗过程,评价补肾益气和血法中药改善IVF-ET妇女子宫内膜和子宫血流状态的效果。方法本研究将60例输卵管性不孕IVF-ET患者随机分为中药组(30例)和对照组(30例),治疗方法中药组采用COH+IVF-ET+中药,对照组采用COH+IVF-ET,两组COH+IVF-ET方法相同。中药治疗以补肾益气和血为治法,分两个治疗阶段:第一阶段为胚胎移植前整体调理,以补肾益气活血为治法,给予补肾益气活血法基本方辨证加减治疗;第二阶段为胚胎移植后助孕保胎治疗,以补肾益气养血为治法,给予补肾益气养血法基本方辨证加减治疗。中药每日一剂煎服,早晚各一次,每次200ml,移植后给予补肾益气养血方加减的同时,联合使用黄体酮注射液60mg,每日肌肉注射一次,至移植后14天,之后根据患者血β-HCG、P值调整剂量。移植前与移植后中药治疗的疗程均为1~3个月,根据患者具体症状变化,每1~2周复诊调整药物。采用阴道B超检测hCG日两组患者的子宫内膜厚度、类型及hCG日和ET日双侧子宫动脉血流参数,并进行统计学分析。结果本研究两组患者的一般情况,如平均年龄、平均不孕年限、BMI、基础性激素、Gn用量等比较均无显著统计学差异(P0.05)。hCG日子宫内膜厚度中药组(10.92±1.59)mm高于对照组(10.43±1.58)mm,但两组比较无显著性差异(P0.05),A型内膜在中药组所占比例为80.0%(24/30),在对照组为53.3%(16/30),两组比较有显著性差异(P0.05);中药组患者h CG日和ET日双侧子宫动脉搏动指数(PI)及阻力指数(RI)均明显低于对照组,差异有显著统计学意义(P0.01)。结论补肾益气和血法中药联合IVF-ET治疗时,移植前给予中药补肾益气活血方加减,移植后给予补肾益气养血方加减,可能有利于改善子宫内膜厚度和形态,增强子宫内膜容受性,调节子宫动脉血流状态。
[Abstract]:Objective the purpose of this study was to evaluate the effect of traditional Chinese medicine (TCM) for tonifying kidney and tonifying qi and blood on improving endometrium and uterine blood flow in women with IVF-ET by interventional therapy with traditional Chinese medicine (TCM) in the course of IVF-ET treatment of infertile women. Methods 60 cases of oviduct infertility with IVF-ET were randomly divided into Chinese medicine group (30 cases) and control group (30 cases). The Chinese medicine group was treated with COH IVF-ET Chinese medicine, the control group was treated with COH IVF-ET.The two groups had the same COH IVF-ET method. The traditional Chinese medicine therapy takes tonifying kidney and supplementing qi and blood as the treatment method, which is divided into two stages: the first stage is the whole conditioning before embryo transfer, the method of tonifying kidney and invigorating qi and activating blood as the treatment method, and the basic prescription of tonifying kidney benefiting qi and activating blood circulation is added and subtracted; The second stage is the treatment of pregnancy and fetal preservation after embryo transfer, and the treatment of tonifying kidney and nourishing qi and nourishing blood is the basic prescription of tonifying kidney and invigorating qi and nourishing blood. Traditional Chinese medicine was decoction once a day, one time in the morning and evening, 200ml each time. After transplantation, the decoction for tonifying kidney and tonifying qi and nourishing blood was added or subtracted, and at the same time, the injection of progesterone was combined with 60 mg of progesterone injection once a day until 14 days after transplantation, and then the dosage was adjusted according to the value of 尾 -HCG P in the patient's blood. The course of treatment was 1 ~ 3 months before and after transplantation. The endometrial thickness, type and blood flow parameters of bilateral uterine arteries on hCG day and et day were measured by vagina B ultrasound in two groups on the day of hCG, and statistical analysis was carried out. Results the general conditions of the two groups, such as average age, There was no significant difference in BMIand Gn dosage of basic sex hormone between the two groups (P0.05). The thickness of endometrium in the TCM group was (10.92 卤1.59) mm higher than that in the control group (10.43 卤1.58) mm, but there was no significant difference between the two groups (P0.05) the proportion of type A endometrium in the TCM group was 80.0% (24 / 30). In the control group, 53.3% (16 / 30), there was a significant difference between the two groups (P0.05), the bilateral uterine artery pulsatility index (PI) and resistance index (RI) in the traditional Chinese medicine group were significantly lower than those in the control group on hCG day and et day. The difference was statistically significant (P0.01). Conclusion in the treatment of tonifying kidney and tonifying qi and blood therapy combined with IVF-ET, adding or decreasing of Bushen Yiqi Huoxue prescription before transplantation and Bushen Yiqi nourishing blood prescription after transplantation may help to improve the thickness and morphology of endometrium and enhance endometrial receptivity. Regulate uterine artery blood flow.
【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】：2017
【分类号】：R714.8
本文编号：2179045
[Abstract]:Objective the purpose of this study was to evaluate the effect of traditional Chinese medicine (TCM) for tonifying kidney and tonifying qi and blood on improving endometrium and uterine blood flow in women with IVF-ET by interventional therapy with traditional Chinese medicine (TCM) in the course of IVF-ET treatment of infertile women. Methods 60 cases of oviduct infertility with IVF-ET were randomly divided into Chinese medicine group (30 cases) and control group (30 cases). The Chinese medicine group was treated with COH IVF-ET Chinese medicine, the control group was treated with COH IVF-ET.The two groups had the same COH IVF-ET method. The traditional Chinese medicine therapy takes tonifying kidney and supplementing qi and blood as the treatment method, which is divided into two stages: the first stage is the whole conditioning before embryo transfer, the method of tonifying kidney and invigorating qi and activating blood as the treatment method, and the basic prescription of tonifying kidney benefiting qi and activating blood circulation is added and subtracted; The second stage is the treatment of pregnancy and fetal preservation after embryo transfer, and the treatment of tonifying kidney and nourishing qi and nourishing blood is the basic prescription of tonifying kidney and invigorating qi and nourishing blood. Traditional Chinese medicine was decoction once a day, one time in the morning and evening, 200ml each time. After transplantation, the decoction for tonifying kidney and tonifying qi and nourishing blood was added or subtracted, and at the same time, the injection of progesterone was combined with 60 mg of progesterone injection once a day until 14 days after transplantation, and then the dosage was adjusted according to the value of 尾 -HCG P in the patient's blood. The course of treatment was 1 ~ 3 months before and after transplantation. The endometrial thickness, type and blood flow parameters of bilateral uterine arteries on hCG day and et day were measured by vagina B ultrasound in two groups on the day of hCG, and statistical analysis was carried out. Results the general conditions of the two groups, such as average age, There was no significant difference in BMIand Gn dosage of basic sex hormone between the two groups (P0.05). The thickness of endometrium in the TCM group was (10.92 卤1.59) mm higher than that in the control group (10.43 卤1.58) mm, but there was no significant difference between the two groups (P0.05) the proportion of type A endometrium in the TCM group was 80.0% (24 / 30). In the control group, 53.3% (16 / 30), there was a significant difference between the two groups (P0.05), the bilateral uterine artery pulsatility index (PI) and resistance index (RI) in the traditional Chinese medicine group were significantly lower than those in the control group on hCG day and et day. The difference was statistically significant (P0.01). Conclusion in the treatment of tonifying kidney and tonifying qi and blood therapy combined with IVF-ET, adding or decreasing of Bushen Yiqi Huoxue prescription before transplantation and Bushen Yiqi nourishing blood prescription after transplantation may help to improve the thickness and morphology of endometrium and enhance endometrial receptivity. Regulate uterine artery blood flow.
【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】：2017
【分类号】：R714.8
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