反复体外受精—胚胎移植失败证素特点及其与病史相关性的研究

发布时间：2018-05-04 04:02

本文选题：反复体外受精-胚胎移植失败 + 证素　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:本文通过对反复体外受精-胚胎移植失败患者的证素分布特点及其与年龄、不孕病程、流产次数、不孕相关病史的相关性研究,初步探讨证形成的病理基础,以期更好地指导本病在临床上的防与治。方法:采用临床流行病学调研的方法,对92例反复IVF-ET失败患者的个人基本信息及中医证素四诊信息采集,运用证素积分法及统计方法对采集信息进行数据分析,明确证素分布特点,以及其与年龄、不孕病程、流产次数、既往病史的关系。结果:1.反复体外受精-胚胎移植失败常见病位证素为:肾、肝、胞宫、脾、心,其中证素肾共88例,占95.7%,占比最大,胞宫、肝次之,分别共80例、79例,分别占87.0%、85.9%。常见的病性证素为阴虚、血瘀、气滞、湿、痰、阳虚、气虚,其中证素血瘀共90例,占97.8%,占比最大,阴虚、气滞次之,分别共85例、71例,分别占92.4%、77.2%。2.证素特点与年龄、不孕病程、流产次数具有相关性,具体如下:年龄越大,肾脏的功能失调表现以及阴虚的病机变化越突出;不孕病程越长,肾脏的功能失调表现以及气滞的病机变化越突出;流产次数越多,肾脏的功能失调表现以及血瘀的病机变化越突出。3.反复体外受精-胚胎移植失败患者曾患子宫腺肌病、子宫内膜异位症病史及免疫性疾病者表现为肾脏的功能失调以及血瘀的病机变化;曾患内分泌疾病者表现为肾、肝、胞宫的功能失调以及血瘀、阴虚的病机变化;曾患宫腔病变者表现为肾、肝、胞宫的功能失调;曾患炎症性疾病者表现为肾的功能失调。结论:反复体外受精-胚胎移植失败常见病位证素依次为:肾、胞宫、肝、脾、心。常见病性证素依次为:血瘀、阴虚、气滞、湿、阳虚、痰、气虚。证素特点与年龄、不孕病程、流产次数均具有相关性。反复体外受精-胚胎移植失败患者曾患子宫腺肌病或子宫内膜异位症病史及免疫性疾病者表现为肾脏的功能失调以及血瘀的病机变化;曾患有内分泌性疾病者表现为肾、肝、胞宫的功能失调以及血瘀、阴虚的病机变化;曾患有宫腔病变者表现为肾、肝、胞宫的功能失调;曾患有炎症性疾病者表现为肾的功能失调。
[Abstract]:Objective: to study the distribution of syndromes in patients with repeated in vitro fertilization and embryo transfer failure and their correlation with age, course of infertility, times of abortion and history of infertility. In order to better guide the disease in clinical prevention and treatment. Methods: the basic personal information of 92 patients with repeated failure of IVF-ET and the four diagnosis information of TCM syndromes were collected by the method of clinical epidemiological investigation. The collected information was analyzed by the integration of syndromes and statistical methods. The distribution characteristics of syndromes and their relationship with age, course of infertility, times of abortion and past history were clarified. The result is 1: 1. The most common syndromes of failure of repeated in vitro fertilization and embryo transfer were kidney, liver, uterus, spleen and heart, of which 88 cases were syndromes and kidney, accounting for 95.775% of the total, followed by cystonia and liver, respectively 80 cases (87.0%) and 85.9 cases (87.0%). The common syndromes were yin deficiency, blood stasis, qi stagnation, dampness, phlegm, yang deficiency and qi deficiency. There were 90 cases of syndromes and blood stasis, accounting for 97.8%, accounting for the largest proportion, Yin deficiency and Qi stagnation were followed by 85 cases (71 cases), accounting for 92.4% (77.2%). The characteristics of syndromes are correlated with age, course of infertility, number of miscarriages, as follows: the older the age, the more prominent the maladjustment of kidney function and the pathogenesis of yin deficiency; the longer the course of infertility, the longer the course of infertility. The more the number of miscarriages, the more prominent the dysfunction of kidney and the pathogenesis of blood stasis. Patients with repeated in vitro fertilization and embryo transfer failure had adenomyosis, history of endometriosis and immunological diseases as kidney dysfunction and blood stasis, and those with endocrine diseases presented with kidney and liver. The dysfunction of the uterus and the changes of the pathogenesis of blood stasis and yin deficiency; the dysfunction of the kidney, liver and uterus; the dysfunction of the kidney in the patients with inflammatory diseases. Conclusion: the most common syndromes of repeated in vitro fertilization and embryo transfer failure are kidney, uterus, liver, spleen and heart. Common disease syndrome factors in turn are: blood stasis, Yin deficiency, Qi stagnation, dampness, Yang deficiency, phlegm, Qi deficiency. The characteristics of syndromes were correlated with age, course of infertility and times of abortion. Patients with recurrent in vitro fertilization and failed embryo transfer had a history of adenomyosis or endometriosis and immunological disorders, characterized by dysfunction of the kidney and changes in the pathogenesis of blood stasis; people with endocrine diseases presented with kidney and liver. The dysfunction of the uterus and the changes of the pathogenesis of blood stasis and yin deficiency; the dysfunction of the kidney, liver and uterus in the patients with intrauterine diseases; the dysfunction of the kidney in the patients with inflammatory diseases.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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