滋阴补阳序贯治疗联合促排卵对PCOS不孕症患者子宫内膜HOXA10的调控
发布时间：2018-12-06 07:26
【摘要】：目的研究滋阴补阳序贯治疗对多囊卵巢综合征(PCOS)不孕症患者的子宫内膜容受性影响的临床疗效及对其子宫内膜组织同源框基因(HOXA10)的调控。方法选取前来江苏省中医院生殖医学科就诊的PCOS不孕症患者共80例,按照随机数字表法分为治疗组和对照组。对照组给予克罗米芬(clomiphene,CC)+人绝经期促性腺激素(human menopausal gonadotropin,HMG)+人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)治疗,治疗组给予CC+HMG+HCG+滋阴补阳序贯治疗。疗程均为3个周期,观察2组患者以下指标:测量子宫内膜增生中晚期及分泌中期子宫内膜厚度(Em);检测黄体中期子宫内膜螺旋动脉搏动指数(PI)、阻力指数(RI);检测黄体中期患者血清中雌二醇(E2)、孕酮(P)的水平;检测黄体中期2组患者子宫内膜组织中的HOXA10 mRNA表达情况;比较2组的临床妊娠率、流产率。结果治疗组与对照组比较,治疗组卵泡中晚期及黄体中期Em均增加,卵泡中晚期Em 2组比较有统计学差异(P0.05),黄体中期Em 2组比较无统计学意义(P0.05);治疗组与对照组比较,治疗组E2及P数值均升高,有统计学意义(P0.05);与对照组比较,治疗组PI和RI均降低,有统计学意义(P0.05);治疗组HOXA10 mRNA表达升高,有统计学意义(P0.01);与对照组比较,治疗组妊娠率升高,有统计学差异(P0.05),流产率降低,无统计学意义(P0.05)。结论滋阴补阳序贯治疗可提高PCOS患者的妊娠率,降低其流产率,其机制可能与增加PCOS患者的HOXA10 mRNA的表达,降低PCOS患者的子宫螺旋动脉PI、RI,健全黄体功能治疗有关,从而改善子宫内膜容受性,值得在临床上进一步推广运用。
[Abstract]:Objective to study the effect of sequential therapy of nourishing yin and nourishing yang on endometrial receptivity in (PCOS) infertility patients with polycystic ovary syndrome (PCOS) and the regulation of homobox gene (HOXA10) in endometrium. Methods A total of 80 patients with PCOS infertility were selected and divided into treatment group and control group according to the method of random digital table. The control group was treated with clomiphene (clomiphene,CC), human menopausal gonadotropin (human menopausal gonadotropin,HMG), human chorionic gonadotropin (human chorionic gonadotropin,HCG), and the treatment group was treated with CC HMG HCG. The course of treatment was 3 cycles. The following indexes were observed: (Em); was used to measure the endometrial thickness in the middle and late stage of endometrial hyperplasia and the middle phase of endometrial secretion to detect (PI), resistance index (RI);) of endometrial spiral artery pulsatility index in middle luteal phase. The levels of estradiol (E2) and progesterone (P) in serum of patients with middle luteal phase were detected. The expression of HOXA10 mRNA in endometrium of patients with middle luteal phase was detected. The clinical pregnancy rate and abortion rate were compared between the two groups. Results compared with the control group, the Em of the treatment group was increased in the late follicle and middle luteal phase, the difference between the two groups was statistically significant (P0.05), but there was no significant difference in the Em 2 group in the middle luteal phase (P0.05). Compared with the control group, the value of E2 and P in the treatment group increased significantly (P0.05); compared with the control group, the PI and RI in the treatment group decreased significantly (P0.05). Compared with the control group, the pregnancy rate of the treatment group increased, there was statistical difference (P0.05), the abortion rate decreased, there was no statistical significance (P0.05). Conclusion the sequential therapy of nourishing yin and tonifying yang can increase the pregnancy rate and decrease the abortion rate of PCOS patients. The mechanism may be related to increasing the expression of HOXA10 mRNA in PCOS patients and decreasing the luteal function of PI,RI, of uterine spiral artery in PCOS patients. In order to improve endometrial receptivity, it is worthy of further clinical application.
【作者单位】： 江苏省中医院;南京中医药大学;
【基金】：江苏省科技厅临床医学科技专项(SBL201320056) 江苏省中医院2014年院级课题(Y14036)
【分类号】：R711.75
本文编号：2365657
[Abstract]:Objective to study the effect of sequential therapy of nourishing yin and nourishing yang on endometrial receptivity in (PCOS) infertility patients with polycystic ovary syndrome (PCOS) and the regulation of homobox gene (HOXA10) in endometrium. Methods A total of 80 patients with PCOS infertility were selected and divided into treatment group and control group according to the method of random digital table. The control group was treated with clomiphene (clomiphene,CC), human menopausal gonadotropin (human menopausal gonadotropin,HMG), human chorionic gonadotropin (human chorionic gonadotropin,HCG), and the treatment group was treated with CC HMG HCG. The course of treatment was 3 cycles. The following indexes were observed: (Em); was used to measure the endometrial thickness in the middle and late stage of endometrial hyperplasia and the middle phase of endometrial secretion to detect (PI), resistance index (RI);) of endometrial spiral artery pulsatility index in middle luteal phase. The levels of estradiol (E2) and progesterone (P) in serum of patients with middle luteal phase were detected. The expression of HOXA10 mRNA in endometrium of patients with middle luteal phase was detected. The clinical pregnancy rate and abortion rate were compared between the two groups. Results compared with the control group, the Em of the treatment group was increased in the late follicle and middle luteal phase, the difference between the two groups was statistically significant (P0.05), but there was no significant difference in the Em 2 group in the middle luteal phase (P0.05). Compared with the control group, the value of E2 and P in the treatment group increased significantly (P0.05); compared with the control group, the PI and RI in the treatment group decreased significantly (P0.05). Compared with the control group, the pregnancy rate of the treatment group increased, there was statistical difference (P0.05), the abortion rate decreased, there was no statistical significance (P0.05). Conclusion the sequential therapy of nourishing yin and tonifying yang can increase the pregnancy rate and decrease the abortion rate of PCOS patients. The mechanism may be related to increasing the expression of HOXA10 mRNA in PCOS patients and decreasing the luteal function of PI,RI, of uterine spiral artery in PCOS patients. In order to improve endometrial receptivity, it is worthy of further clinical application.
【作者单位】： 江苏省中医院;南京中医药大学;
【基金】：江苏省科技厅临床医学科技专项(SBL201320056) 江苏省中医院2014年院级课题(Y14036)
【分类号】：R711.75
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