归芍地黄汤加减对卵泡发育不良性不孕症临床疗效的研究

发布时间：2018-04-17 14:29

本文选题：归芍地 + 黄汤　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：近年来,随着环境的改变以及社会压力的日益增加,不孕的发生率越来越高,其已成为生殖医学亟待解决的问题。临床上发现卵泡发育不良性不孕的发生率逐年升高,但目前对于该疾病尚无明确的治疗方法,因此卵泡发育不良的诊治对不孕症的临床研究有着根本而重大的意义。本文通过临床研究,观察归芍地黄汤对FM性不孕患者卵泡发育、排卵结局及生殖轴的影响,探讨其作用机理及疗效上的独特优势,从而进一步完善中医药治疗排卵障碍性不孕的方案。方法：临床上将因FM导致不孕的患者40例,随机分为两组,每组20例,试验组即中西药结合组(归芍地黄汤加减联合CC),对照组即西药组(CC),连续观察三个周期,进行治疗前后对照及组间对照,通过观察患者治疗前后及两组间临床症状的改善,基础体温,排卵当日卵泡最大平均直径与子宫内膜厚度、卵泡早期及排卵期激素水平(FSH、LH、 E2),以及黄体期激素水平(E、P)的变化,排卵率与妊娠结局,评价归芍地黄汤对FM性不孕症的临床疗效。结果：试验组与对照组虽然总疗效均为90%,但试验组治愈率为60%,妊娠率为30%,明显高于对照组。两组均能促进卵泡生长,提高成熟卵泡直径(P0.05),但试验组增长更明显。试验组可以明显增加子宫内膜厚度(P0.05),对照组在子宫内膜增长上疗效不显(P0.05),两组有显著性差异。试验组药物能显著降低患者中医症候积分,提高基础状态下E2水平,改善患者卵巢功能。结论：归芍地黄汤加减能有效促进卵泡发育、增加排卵日卵泡的直径、子宫内膜的厚度,提高卵子质量及妊娠率,改善患者症状,从而治疗FM性不孕症。与西药组相比,在提高卵泡直径方面差异不明显,但在提高子宫内膜厚度、改善患者症状、提高妊娠率方面,中西医结合组更具优势。
[Abstract]:Objective: in recent years, with the change of environment and the increasing of social pressure, the incidence of infertility is increasing, which has become an urgent problem in reproductive medicine.It is found that the incidence of follicular dysplasia is increasing year by year, but there is no definite treatment for this disease. Therefore, the diagnosis and treatment of follicular dysplasia is of fundamental and great significance to the clinical study of infertility.The effects of Guishao Dihuang decoction on follicle development, ovulation outcome and reproductive axis of FM infertile patients were observed through clinical study.So as to further improve the treatment of Chinese medicine ovulatory infertility program.Methods: clinically, 40 patients with infertility caused by FM were randomly divided into two groups (20 cases in each group). The experimental group was divided into two groups: the experimental group was treated with traditional Chinese medicine combined with western medicine (Guishao Dihuang decoction combined with CCG), the control group was the western medicine group, and the control group was treated with CCG for three consecutive periods.The improvement of clinical symptoms, basal body temperature, maximum mean follicle diameter and endometrial thickness were observed before and after treatment.The changes of hormone levels in early follicle and ovulation stage (FSHLH, E2P, and luteal hormone level), ovulation rate and pregnancy outcome, and the clinical efficacy of Guishaihuang decoction in the treatment of FM infertility were evaluated.Results: although the total curative effect of the test group and the control group was 90, the cure rate and pregnancy rate of the test group were 60 and 30 respectively, which were significantly higher than those of the control group.Both groups could promote follicular growth and increase the diameter of mature follicles (P 0.05), but the growth of the test group was more obvious.The experimental group could significantly increase the endometrial thickness (P 0.05), while the control group had no effect on endometrial growth (P 0.05), and there was a significant difference between the two groups.In the test group, the scores of TCM symptoms were significantly decreased, E2 level was increased and ovarian function was improved in the trial group.Conclusion: Guishaodihuang decoction can effectively promote follicle development, increase follicle diameter, endometrial thickness, improve egg quality and pregnancy rate, and improve the symptoms of patients with FM infertility.Compared with western medicine group, there was no significant difference in increasing follicle diameter, but the combination of traditional Chinese and western medicine had more advantages in increasing endometrial thickness, improving patients' symptoms and increasing pregnancy rate.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.14

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