基于IL-17探讨补肾中药优化肾虚RIF患者妊娠结局的临床研究

发布时间：2018-06-01 05:11

本文选题：益肾序贯法 + 体外受精-胚胎移植　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:本研究旨在通过运用二至天癸颗粒与参芪寿胎丸颗粒序贯疗法,观察补肾中药对肾虚反复种植失败患者的中医证候积分、妊娠结局及外周血IL-17因子等方面的影响,以期为补肾中药改善肾虚反复种植失败患者的妊娠结局找到有利的理论根据。方法:选取行体外受精-胚胎移植治疗的RIF患者66例,随机数字表法产生治疗组和对照组各33例,治疗组FET当周期在常规替代周期方案的基础上,予二至天癸颗粒,内膜转化日后改用参芪寿胎丸颗粒至超声下见原始心管搏动日;对照组给予FET周期常规替代周期方案。观察治疗前后各组外周血IL-17的变化程度、肾虚证候积分变化、胚胎种植率、生化妊娠率及临床妊娠率等。结果:治疗组患者于内膜转化日外周血IL-17水平低于对照组(P0.05),FET14天外周血IL-17水平低于对照组(P0.01);中医肾虚证候积分比较治疗组低于对照组(P0.05);妊娠结局统计两组患者胚胎种植率、生化妊娠率、临床妊娠率,治疗组均优于对照组(P均0.05);IL-17水平与中医肾虚证候积分呈正相关(P0.01)。结论:益肾序贯法系列方有效降低了肾虚RIF患者肾虚证候积分,缓解或消除了患者的肾虚症状,提高了患者的生活质量;补肾中药显著降低了外周血清中IL-17的表达,通过调节肾虚RIF患者的生殖免疫,改善了肾虚RIF患者的妊娠结局。
[Abstract]:Objective: the purpose of this study was to observe the effects of Yijitiangui granule and Shenqi Shouti pill on syndrome score, pregnancy outcome and IL-17 factor in peripheral blood of patients with kidney deficiency. In order to improve the kidney deficiency of patients with repeated implantation failure to find a favorable theoretical basis for pregnancy. Methods: 66 RIF patients treated with in vitro fertilization and embryo transfer were selected, 33 cases in the treatment group and 33 cases in the control group, respectively. The treatment group was treated with Erzhi Tiangui granule on the basis of routine replacement cycle. After intimal transformation, Shenqishou Titan Pill was used to the original cardiac tube pulsatile day under ultrasound, while the control group was given FET cycle routine replacement cycle regimen. The changes of IL-17 in peripheral blood, the integral change of kidney deficiency syndrome, embryo implantation rate, biochemical pregnancy rate and clinical pregnancy rate were observed before and after treatment. Results: the level of IL-17 in peripheral blood of the patients in the treatment group was lower than that in the control group on the day of intimal transformation, the level of IL-17 in the peripheral blood on the 14th day was lower than that in the control group (P 0.01), the score of syndrome of kidney deficiency in the treatment group was lower than that in the control group (P 0.05), and the embryo implantation rate in the two groups was counted. The biochemical pregnancy rate, clinical pregnancy rate and the level of IL-17 in the treatment group were better than those in the control group (P < 0.05) and there was a positive correlation between the level of IL-17 and the syndrome score of kidney deficiency in traditional Chinese medicine (P 0.01). Conclusion: Sequential method of tonifying kidney can effectively reduce the syndrome score of kidney deficiency in RIF patients, alleviate or eliminate the symptoms of kidney deficiency, and improve the quality of life of the patients, and the kidney tonifying herbs can significantly reduce the expression of IL-17 in peripheral serum. By regulating the reproductive immunity of RIF patients with kidney deficiency, the pregnancy outcome of RIF patients with kidney deficiency was improved.
【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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