葛根黑苏汤改善克罗米芬促排卵后子宫内膜容受性低下的疗效观察

发布时间：2019-04-30 06:11

【摘要】：目的探讨葛根黑苏汤改善克罗米芬促排卵后子宫内膜容受性低下的临床疗效及其可能机制。方法将90例排卵障碍性不孕症患者,应用随机数字表法分为阴性对照组、阿司匹林治疗组(简称阿司匹林组)、联合治疗组,每组30例。各组均采用克罗米芬+人绒毛膜促性腺激素促排卵治疗;阿司匹林组于月经第5天开始加服阿司匹林肠溶片100mg/d;联合治疗组月经第3天开始加服葛根黑苏汤(药物组成:葛根、紫苏梗、菟丝子、巴戟天、当归、黑豆等),每日1剂,早、晚口服,月经第5天开始加服阿司匹林肠溶片;各组均连续用药至排卵后第14天。比较各组排卵日子宫内膜厚度、回声类型、子宫动脉阻力指数、宫颈黏液评分及周期排卵率、临床妊娠率。结果 (1)联合治疗组的周期排卵率82.54%(52/63)和妊娠率36.51%(23/63)高于阴性对照组65.67%(44/67)、20.90%(14/67)及阿司匹林组66.67%(48/72)、20.83%(15/72),差异均有统计学意义(P0.05);(2)阿司匹林组及联合治疗组的排卵日子宫内膜厚度高于阴性对照组(P0.05,P0.01);联合治疗组子宫内膜厚度高于阿司匹林组(P0.01);(3)联合治疗组排卵日A+B型子宫内膜率高于阴性对照组(P0.05);(4)联合治疗组的宫颈黏液评分高于阴性对照组及阿司匹林组(P0.05);(5)联合治疗组、阿司匹林组的子宫动脉阻力指数低于阴性对照组(P0.01,P0.05);联合治疗组子宫动脉阻力低于阿司匹林组(P0.05)。结论以温肾暖宫、养血活血为主要功效的葛根黑苏汤能辅助改善子宫内膜厚度、类型及血流阻力,提高宫颈黏液评分,改善子宫内膜容受性,提高周期排卵率及临床妊娠率。
[Abstract]:Objective to investigate the clinical effect and possible mechanism of Gegen Heisu decoction in improving endometrial receptivity after clomiphene-induced ovulation. Methods 90 cases of infertility with ovulation disorder were randomly divided into negative control group, aspirin treatment group (aspirin group) and combined treatment group (30 cases in each group). All groups were treated with clomiphene human chorionic gonadotropin for ovulation, aspirin group was given aspirin enteric-coated tablets 100mg / d on the 5th day of menstruation, and the other two groups were treated with clomiphene. The combined treatment group began to take Pueraria Heisu decoction on the 3rd day of menstruation (drug composition: Pueraria root, perilla stem, dodder, Morinda officinalis, Angelica sinensis, black beans, etc.) 1 dose per day, early, late oral, 5 days of menstruation to add aspirin enteric-coated tablets; All the patients in each group were treated continuously until the 14th day after ovulation. Endometrial thickness, echo type, uterine artery resistance index, cervical mucus score, cycle ovulation rate and clinical pregnancy rate were compared in each group. Results (1) the cycle ovulation rate and pregnancy rate in the combined treatment group were 82.54% (52 / 63) and 36.51% (23 / 63) respectively, which were higher than those in the negative control group (65.67% (44 / 67). 20.90% (14 / 67) and 66.67% (48 / 72) in aspirin group and 20.83% (15 / 72) in aspirin group (P 0.05). (2) the endometrial thickness on ovulation day in aspirin group and combined therapy group was higher than that in negative control group (P0.05, P0.01), and the endometrial thickness in combined treatment group was higher than that in aspirin group (P0.01). (3) the endometrial rate of type A B in the combined treatment group was higher than that in the negative control group (P0.05); (4), and the cervical mucus score in the combined treatment group was higher than that in the negative control group and aspirin group (P0.05). (5) in the combined treatment group, the uterine artery resistance index in the aspirin group was lower than that in the negative control group (P0.01, P0.05), and the uterine arterial resistance in the combined treatment group was lower than that in the aspirin group (P0.05). Conclusion Gegen Heisu decoction, which is mainly effective in warming the kidney and warming the uterus and nourishing blood circulation, can improve endometrial thickness, type and resistance of blood flow, improve cervical mucus score, improve endometrial receptivity, increase cycle ovulation rate and clinical pregnancy rate.
【作者单位】：浙江省温州市中医院中医妇科;
【基金】：浙江省中医药科学研究基金项目(No.2016ZA182) 浙江省温州市科技计划项目(No.Y20130194)
【分类号】：R711.6

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