五子养泡汤联合隔姜灸治疗肾气虚型卵泡发育不良不孕症的临床观察

发布时间：2018-02-13 14:22

本文关键词： 五子养泡汤隔姜灸卵泡发育不良不孕症临床疗效　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察五子养泡汤加隔姜灸治疗肾气虚型卵泡发育不良不孕症的疗效,经过统计分析,比较治疗前后卵泡发育情况、子宫内膜厚度、卵泡期结局、中医证候疗效,并观察治疗后临床妊娠率等情况,探讨其临床疗效及作用机制。方法:本课题选择符合入选标准为卵泡发育不良不孕症患者125例,中医辨证为肾气虚证,随机分为治疗组与对照组,治疗组63例,对照组62例。治疗过程中,因各种因素共有4例病例中途中止实验,治疗组2例,对照组2例,实际治疗组完成61例研究病例,对照组完成60例研究病例。治疗组给予五子养泡汤联合隔姜灸治疗,中药每日1剂,分早、晚两次服,月经周期第5天开始,根据排卵监测结果,若有排卵,服药至排卵后3天,若未排卵,服药至月经周期第15天,连服3个周期,服药同时加用隔姜灸神阙、关元穴,服药止时停隔姜灸治疗;对照组用克罗米芬治疗,每日50mg,连用5天,月经周期第5天开始服用,若排卵效果不佳,第2个周期,改为每日100mg。治疗期间,于月经周期第10天行开始用阴道B超监测卵泡发育,监测时间固定在每日上午,卵泡直径10mm,每3天检查1次,10~15mm时隔日检查1次,15mm时每日检查1次,直至排卵(卵泡消失或骤然缩小5mm以上),监测3个月经周期。治疗后,观察比较两组病例的卵泡发育情况、子宫内膜厚度、卵泡期结局、临床妊娠率及中医证候在治疗前后的变化。用SPSS17.0分析所有数据。病例来源:广西中医药大学附属瑞康医院(国家三级甲等医院)妇科门诊。结果:五子养泡汤联合隔姜灸治疗组总有效率达到76.67%,西药对照组总有效率73.33%,两组差异无统计学意义(P0.05)。两组治疗后最大卵泡平均直径均大于治疗前最大卵泡平均直径,差异有统计学意义(P0.05);两组间比较治疗后最大卵泡平均直径、血清FSH值的差异无统计学意义(P0.05)。围排卵期的排卵率、尿LH阳性率两组间比较,二者差异无统计学意义(P0.05)。围排卵期子宫内膜厚度比较,五子养泡汤联合隔姜灸治疗组平均内膜厚度优于西药对照组平均内膜厚,差异有统计学意义(P0.05)。五子养泡汤联合隔姜灸治疗组的血清E2值与西药对照组的血清E2值比较,二者差异有统计学意义(P0.05)。五子养泡汤联合隔姜灸治疗组的排卵率与西药对照组的排卵率比较,二者差异有统计学意义(P0.05)。五子养泡汤联合隔姜灸治疗组妊娠率与西药对照组妊娠率比较,二者差异有统计学意义(P0.05)。结论:五子养泡汤加隔姜灸治疗能改善肾气虚型卵泡发育不良不孕症患者的卵巢功能和卵泡质量,促进卵泡生长发育,提高成熟卵泡排卵率,其疗效等同于克罗米芬对照组,五子养泡汤加隔姜灸治疗组的子宫内膜厚度优于克罗米芬对照组,避免克罗米芬在促排卵治疗中卵泡生长发育与子宫内膜生长不同步的缺点。隔姜灸操作简单、取材方便,疗效显著,值得临床推广。
[Abstract]:Objective: to observe the curative effect of Wuzi Yangbao decoction plus ginger separated moxibustion on follicular dysplasia of kidney qi deficiency type. After statistical analysis, the development of follicle, the thickness of endometrium, the outcome of follicular phase and the curative effect of TCM syndrome were compared before and after treatment. The clinical pregnancy rate after treatment was observed and the clinical curative effect and mechanism were discussed. Methods: 125 cases of follicular dysplasia infertility were selected according to the selected criteria, and the syndrome differentiation of TCM was deficiency of kidney qi. There were 63 cases in treatment group and 62 cases in control group. In the course of treatment, there were 4 cases of halting experiment because of various factors, 2 cases in treatment group, 2 cases in control group, 61 cases in actual treatment group. In the control group, 60 cases were studied. The treatment group was treated with Wuzi Yangbao decoction combined with ginger-separated moxibustion. The treatment group was given 1 dose of traditional Chinese medicine once a day, taking it early and twice, starting from the 5th day of menstrual cycle, according to the results of ovulation monitoring, if there was ovulation, Take medicine until 3 days after ovulation, if not ovulation, take medicine until the 15th day of menstrual cycle, take 3 cycles, take medicine and add ginger moxibustion Shenque, Guan Yuan point, stop ginger moxibustion treatment when taking medicine, and control group with clomiphene treatment, 50 mg daily, continuous use for 5 days, the fifth day of menstrual cycle began to take, if the ovulation effect is not good, the second cycle, changed to 100 mg daily. During treatment, on the 10th day of menstrual cycle, using vaginal B ultrasound to monitor follicle development, The monitoring time is fixed in the morning, the follicle diameter is 10mm, every 3 days the follicle diameter is 1015mm, every 3 days, 1015mm, every other day, 15mm every other day, until ovulation (follicle disappear or suddenly shrink more than 5mm), monitor 3 menstrual cycles. After treatment, The follicular development, endometrial thickness and follicular outcome were observed and compared between the two groups. Clinical pregnancy rate and changes of TCM syndromes before and after treatment. All data were analyzed by SPSS17.0. Case source: gynecological outpatient department of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine (National Grade 3A Hospital). The total effective rate of the ginger-separated moxibustion group was 76.67 and that of the western medicine control group was 73.33. There was no significant difference between the two groups (P 0.05). The mean diameter of the largest follicle in the two groups was larger than that before the treatment. There was no significant difference in the mean diameter of the largest follicle and serum FSH between the two groups. The ovulation rate and urinary LH positive rate in the periovulation period were compared between the two groups. There was no significant difference between the two groups (P 0.05). The mean endometrial thickness of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was better than that of western medicine control group. The difference was statistically significant (P 0.05). The serum E _ 2 value of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. The difference was statistically significant (P 0.05). The ovulation rate of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. The pregnancy rate of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. Conclusion: the combination of Wuzi Yangbao decoction and ginger moxibustion can improve the ovarian function and follicular quality, promote follicular growth and increase the ovulation rate of mature follicles in infertile patients with deficiency of kidney qi. The effect was equal to that of clomiphene control group, and the endometrial thickness of the treated group was better than that of the clomiphene control group. To avoid the disadvantage of not synchronizing follicle growth and endometrial growth in ovulation promotion therapy with clomiphene. Ginger-separated moxibustion is easy to operate, easy to take, and effective, which is worth popularizing clinically.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.14

【相似文献】