中药三步治疗对反复移植失败患者再次激素替代冻融胚胎移植妊娠率影响的临床研究  

Effect of three-step Chinese herbal medicine on pregnancy rate of frozen-embryo embryo transfer in patients with repeated transplantation failure

作　　者：王晨晔[1] 丁彩飞[1] 张伟[1] 鲍严钟[1] WANG Chenye;DING Caifei;ZHANG Wei;Bao Yanzhong(Zhejiang Province Chinese and Western Medicine Hospital,Reproductive Medicine Department,Hangzhou 310003,China)

机构地区：[1]浙江省中西医结合医院生殖医学科,杭州310003

出　　处：《中国性科学》2018年第8期90-93,共4页Chinese Journal of Human Sexuality

基　　金：浙江省杭州市科技发展计划项目基金(20170533B68);国家中医药管理局全国名老中医药专家鲍严钟传承工作室建设项目([2012]149号)

摘　　要：目的:冻融胚胎移植周期中,仍然有患者出现优质胚胎多次移植失败的情况,提高此类患者的移植成功率是业界为之努力的目标。本课题通过对反复移植失败再次行激素替代冻融胚胎移植患者辅助以独特的中药三步治疗,观察子宫内膜厚度、子宫内膜下血流参数的变化,以此探讨中药三步治疗辅助激素替代方案助孕反复移植失败患者的可能作用机制。方法:选择反复移植失败患者60例,将其随机分为治疗组和对照组,每组30例。对照组给予冻融胚胎移植激素替代常规西药,治疗组在常规用药基础上实施中药三步治疗(移植前月经期给予自拟益肾化瘀方加减治疗;月经干净后至移植前1d给予毓麟珠方加减治疗;移植后给予毓麟珠合寿胎丸方加减治疗至移植后22d),检测移植日子宫内膜厚度,子宫内膜螺旋动脉血流参数PI、RI值,移植后12d血清人绒毛膜促性腺激素(β-HCG)、雌二醇(E2)、孕酮(P)水平,观察两组患者妊娠率、着床率和异位妊娠率。结果:治疗后,治疗组患者妊娠率63. 3%、着床率66. 7%,均明显优于对照组(均P <0. 05);治疗组患者子宫内膜厚度与对照组比较,差异无统计学意义(P> 0. 05);治疗组患者子宫内膜螺旋动脉血流参数PI、RI值均明显低于对照组,差异具有统计学意义(均P <0. 05);两组患者移植后第12d血清β-HCG、E2、P水平比较,差异无统计学意义(P> 0. 05)。结论:中药三步治疗辅助激素替代方案可以通过改善子宫内膜血供途径,提高反复移植失败患者再次行冻融胚胎移植的临床妊娠率和着床率,达到真正意义上的中西结合助孕的目的。Objective：In the frozen thawed embryo transfer cycle, there are still many cases of high quality embryos failed to transplant repeatedly. How to improve the transplant success rate of these patients has become the purpose of this research. In this study, patients who are repeated transplantation failed to repeat hormone replacement cycle thawing embryo transfer, after three steps of treatment with unique Chinese medicine, to observe the changes in the thickness of the endometrium and the parameters of the blood flow under the endometrium, to explore the possible mechanism of the three step treatment of adjuvant hormone replacement cycles in patients with recurrent pregnancy failure. Methods： Sixty- cases of repeated transplant failure were selected. They were randomly divided into treatment group and control group, 30 cases in each group. The control group was treated with frozen thawed embryo transfer instead of conventional western medicine. The treatment group received three steps of traditional Chinese medicine on the basis of routine medication. Before embryo transfer, during menstruation, give homemade Yishen Huayu Fang addition and subtraction treatment; From the menstruation clean period to first day before the embryo transfer, Yu Lin Zhu Fang was treated with addition and subtraction. After embryo transfer, Yulin zhu he Shou Tai pill Fang addition and subtraction treatment to 22 days after transplantation. ） The thickness of endometri- um and the blood flow parameters of endometrium PI and RI were measured on the day of transplantation. The serum levels of human chorionic gonadotropin （beta-HCG）, estradiol （E2） and progesterone （P） were monitored on twelve days after transplantation. The pregnancy rate, the rate of implantation and the rate of ectopic pregnancy wereobserved in two groups. Results： After treatment, the pregnancy rate was 63.3% , the implantation rate was 66. 7%, significantly better than the control group （all P 〈 0.05 ） ; the treatment group endometrial thicknes

关 键 词：反复移植失败 冻融胚胎移植 妊娠率 中药三步治疗 

分 类 号：R714.8[医药卫生—妇产科学]