补肾促排卵汤对卵泡未破裂黄素化综合征治疗作用的临床研究

发布时间：2019-04-12 20:19

【摘要】：目的：本研究通过观察补肾促排卵汤对卵泡未破裂黄素化综合征(luteinized unruptured follicle syndrome, LUFS)所致不孕症患者促排卵周期的临床疗效,研讨其作用机制,为中西医结合最优化防治LUFS和有效提高临床妊娠率提供依据。方法：将纳入的45例LUFS患者随机分为三组,每组15例,药物干预连续三个月经周期,A组：补肾促排卵汤+人绒毛膜促性腺激素(humane chorionic gonadotropine, HCG),B组：血府逐瘀口服液+HCG, C组：单纯HCG。比较三组排卵率、LUF周期复发率、临床妊娠率等,研讨补肾促排卵汤对该病的治疗机制以及其与血府逐瘀口服液在协助排卵作用上的异同。同时,观察既往促排卵治疗史及原发疾病对LUFS复发的影响。结果：①三组排卵率分别为：A组70.7%,B组75%,C组47.5%；三组LUF周期复发率分别为：A组29.3%,B组25%,C组52.5%。三组排卵率、LUF周期复发率均有显著性差异(P0.05)。②三组临床妊娠率分别为：A组33.3%,B组6.7%,C组13.3%,差异不显著(P0.05)。③三组促排卵治疗总有效率分别为：A组86.7%,B组80%,C组66.7%,总疗效差异不显著(P0.05)。④既往有促排卵治疗史患者LUF周期复发率较无者高,但差异不显著(P0.05)。⑤原发病为子宫内膜异位症(endometriosis, EMS)患者较原发病为多囊卵巢综合征(polycystic ovary syndrome, PCOS)、无或其他者更易发生LUFS,差异显著(P0.01)。结论：①补肾促排卵汤、血府逐瘀口服液分别联合HCG在LUFS所致不孕症患者促排卵周期中运用均可显著提高排卵率,效果均优于单纯使用HCG；②补肾促排卵汤也许对提高LUFS所致不孕症患者的临床妊娠率更有益；③行气活血法可有效帮助排卵,加以补肾可能更有助于妊娠；④对于LUFS所致不孕症患中原发病为EMS者,可于促排卵前改善原发病病症,同时在促排卵周期及早采取治疗措施,有效防止LUFS以“治未病”。
[Abstract]:Objective: to observe the clinical effect of Bushen inducing ovulation decoction on infertility induced by unruptured follicular luteinization syndrome (luteinized unruptured follicle syndrome, LUFS), and to explore its mechanism. It provides the basis for the optimal prevention and treatment of LUFS and the effective improvement of clinical pregnancy rate with integrated traditional Chinese and western medicine. Methods: forty-five patients with LUFS were randomly divided into three groups, each group (15 cases). The drug intervention lasted for three consecutive menstrual cycles. Group A: (humane chorionic gonadotropine, HCG), B group with Bushen inducing ovulation decoction human chorionic gonadotropin (humane chorionic gonadotropine, HCG), B) group: Xuefu Zhuyu oral liquid HCG, group. Group C: simple HCG. The ovulation rate, LUF cycle recurrence rate and clinical pregnancy rate were compared among the three groups. The therapeutic mechanism of Bushen Zhuyu decoction and Xuefu Zhuyu Oral liquid in assisting ovulation were discussed. At the same time, the history of ovulation induction therapy and the effect of primary diseases on the recurrence of LUFS were observed. Results: 1the ovulation rates of the three groups were 70.7% in Group A, 75% in Group B, 47.5% in Group C, and 29.3% in Group A, 25% in Group B and 52.5% in Group C. the recurrence rates of LUF in Group A, Group B and Group C were 29.3%, 25% and 52.5%, respectively. There was significant difference in ovulation rate and LUF cycle recurrence rate among the three groups (P0.05). 2 the clinical pregnancy rates of the three groups were 33. 3% in group A, 6. 7% in group B, 13. 3% in group C, respectively. The total effective rates of the three groups were 86.7% in group A, 80% in group B, 66.7% in group C, respectively. There was no significant difference in total curative effect (P0.05) .4The recurrence rate of LUF cycle in patients with previous history of ovulation induction therapy was higher than that in non-patients, but there was no significant difference (P0.05). 5 the primary onset of endometriosis (endometriosis,) was not significant (P0.05). Patients with EMS were more likely to develop LUFS, than patients with primary polycystic ovary syndrome without or without (polycystic ovary syndrome, PCOS), (P0.01). Conclusion: 1 Bushen ovulation inducing decoction and Xuefu Zhuyu Oral liquid combined with HCG in the ovulatory induction cycle of LUFS patients can significantly improve ovulation rate, and the effect is better than that of HCG; alone. (2) Bushen ovulation inducing decoction may be more beneficial to improve the clinical pregnancy rate of LUFS-induced infertility patients, 3) Qi-activating and blood-activating method can effectively help ovulation, and tonifying the kidney may be more helpful to pregnancy; (4) if the infertility caused by LUFS is EMS, the primary disease can be improved before ovulation induction, and the treatment measures should be taken as early as possible in the ovulation induction cycle to effectively prevent LUFS from being "treated without disease".
【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】：R271.9

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