滋肾疏肝汤对子宫腺肌病伴不孕患者IVF-ET早期妊娠的影响

发布时间：2018-05-27 22:02

本文选题：滋肾疏肝汤 + 子宫腺肌病　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:探讨滋肾疏肝汤对肾虚肝郁型子宫腺肌病伴不孕患者IVF-ET早期妊娠的影响。方法:将2015年6月至2016年2月就诊于河南中医药大学第一附属医院生殖医学科门诊的100例肾虚肝郁型子宫腺肌病伴不孕欲于超长方案促排卵后行自然周期冻融胚胎移植的患者,随机分为治疗组与对照组,每组各50例。治疗组采用滋肾疏肝汤治疗,对照组不予任何处理。观察两组研究对象在冻融胚胎移植日子宫内膜厚度、形态;两组移植后14天的-HCG水平、移植后28天的临床妊娠率及胚胎种植率;两组治疗后临床症状的改变情况。结果:(1)治疗组与对照组移植后14天-HCG水平分别是576.38±275.33m IU/ml、410.16±307.47m IU/ml,两组移植后14天的-HCG水平比较,差异有统计学意义(P㩳0.05)。两组移植后28天临床妊娠率、胚胎种植率分别为治疗组57.14%,35.55%,对照组36.00%,21.97%,两组移植后28天的临床妊娠率和胚胎种植率相比较,差异有统计学意义(P㩳0.05)。(2)治疗后治疗组的临床疗效有效率是67.35%,对照组的临床疗效有效率是50.00%,治疗组疗效优于对照组,且差异有统计学意义(P㩳0.05)。(3)移植前子宫内膜厚度比较,治疗组为9.63±1.38mm,对照组为9.02±1.42mm,治疗组子宫内膜厚度较对照组厚,差异有统计学意义(P0.05)。移植前子宫内膜形态比较,治疗组较对照组A型子宫内膜多,且差异有统计学意义(P0.05)。(4)治疗组治疗后中医证候积分为9.22±1.57,有效率为93.88%,对照组治疗后中医证候积分为17.60±3.93,有效率为14.00%,两组治疗后证候疗效比较,差异有统计学意义(P㩳0.05)。结论:(1)滋肾疏肝汤可以明显提高肾虚肝郁型子宫腺肌病伴不孕患者行IVF-ET患者移植后14天的 HCG水平、临床妊娠率、胚胎种植率,且疗效优于对照组。(2)滋肾疏肝汤可以明显改善肾虚肝郁型子宫腺肌病伴不孕行IVF-ET患者移植前子宫内膜厚度、形态。(3)滋肾疏肝汤能明显改善肾虚肝郁型子宫腺肌病伴不孕患者的临床症状。
[Abstract]:Objective: to investigate the effect of Zishen Shugan decoction on early pregnancy with IVF-ET in patients with uterine adenomyosis with kidney deficiency and liver depression. Methods: from June 2015 to February 2016, 100 patients with kidney deficiency and liver depression type uterine adenomyosis and infertility who were undergoing natural cycle frozen-thawing embryo transfer after ovulation promotion by super long plan were selected from the Department of Reproductive Medicine, first affiliated Hospital of Henan University of traditional Chinese Medicine, who were admitted to the clinic of Department of Reproductive Medicine, Henan University of traditional Chinese Medicine, from June 2015 to February 2016. They were randomly divided into treatment group and control group with 50 cases in each group. The treatment group was treated with Zishen Shugan decoction, while the control group was not treated. The thickness and morphology of endometrium on the day of frozen thawed embryo transfer, the level of -HCG on the 14th day after transplantation, the clinical pregnancy rate and embryo implantation rate at 28 days after transplantation, and the changes of clinical symptoms in the two groups were observed. Results the levels of -HCG in treatment group and control group were 576.38 卤275.33m / ml 410.16 卤307.47m / ml 14 days after transplantation respectively, and the difference was statistically significant (P 0.05). The clinical pregnancy rate and embryo implantation rate in the two groups were 57.14 and 35.55, respectively. The clinical pregnancy rate and embryo implantation rate in the control group were 36.00 and 21.97, respectively. The clinical pregnancy rate and embryo implantation rate in the two groups were compared 28 days after transplantation. The difference was statistically significant (P < 0.05).) the effective rate of the treatment group was 67.35 and that of the control group was 50.00.The curative effect of the treatment group was better than that of the control group, and the difference was statistically significant. The thickness of endometrium in the treatment group was 9.63 卤1.38 mm and that in the control group was 9.02 卤1.42 mm. The thickness of endometrium in the treatment group was thicker than that in the control group (P 0.05). The number of type A endometrium in the treatment group was higher than that in the control group. The difference was statistically significant (P 0.05). The score of TCM syndromes was 9.22 卤1.57 and the effective rate was 93.88 in the treatment group, and 17.60 卤3.93 and 14.00 respectively in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion (1) Zishen Shugan decoction can significantly increase the level of HCG, clinical pregnancy rate and embryo implantation rate 14 days after transplantation in patients with adenomyosis with infertility due to kidney deficiency and liver depression. And the curative effect was better than that of control group. (2) Zishen Shugan decoction could obviously improve the endometrial thickness before transplantation in patients with kidney deficiency and liver depression type of uterine adenomyosis and infertility. Zishen Shugan decoction can obviously improve the clinical symptoms of patients with uterine adenomyosis complicated with infertility due to kidney deficiency and liver depression.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.14

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