卵巢储备功能下降患者不同中医证候体外受精-胚胎移植妊娠结局比较  

Comparison of pregnancy outcomes of IVF-ET with different TCM syndromes in patients with diminished ovarian reserve

作　　者：孙秀英[1,2] 吴丽敏 刘芬[1,2] 梁慧 SUN Xiu-ying;WU Li-min;LIU Fen;LIANG Hui(Center for Reproductive Medicine,Anhui Provincial Hospital,Hefei 230001,China;Gradute College,Anhui University of Chinese Medicine,Hefei 230038,China)

机构地区：[1]安徽省立医院生殖中心,合肥230001 [2]安徽中医药大学研究生院,合肥230038

出　　处：《中华中医药杂志》2019年第8期3450-3454,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81373671)~~

摘　　要：目的:探讨卵巢储备功能下降(DOR)患者中医证候特点及不同证候之间体外受精(IVF)妊娠结局的差异,为不同证候DOR患者IVF妊娠结局预测提供参考。方法:收集DOR行IVF微刺激方案助孕患者332例,分析患者中医证候分布特征,比较不同证候之间IVF妊娠结局差异。结果:DOR患者常见中医证候为肝郁证、肾阴证、血瘀证、肾阳虚证、脾虚证、痰湿证。与20~35岁比较,36~45岁肾阴虚证、血瘀证和肾阳虚证所占比例增加(P<0.05,P<0.01)。DOR患者复合证候以肾虚肝郁、肾虚血瘀、肝郁血瘀最多见,41~45岁与20~35岁DOR患者比较,肾虚血瘀证、肝郁血瘀和肾虚肝郁血瘀所占比例增加(P<0.01)。年龄小于35岁DOR患者不同证候之间生化妊娠率、胚胎种植率临床妊娠率差异无统计学意义,但年龄在36岁以上的DOR患者肾阴虚证和肾阳虚证临床妊娠率明显低于肝郁证(P<0.05)。结论:肾虚肝郁证是DOR患者最多见的中医证候。随着年龄的增加肾虚证临床妊娠率低于肝郁证。总体虚证临床妊娠率要低于实证。Objective: To explore the characteristics of TCM syndromes and the difference of IVF pregnancy outcome among different syndromes in patients with diminished ovarian reserve, and to provide reference for predicting IVF pregnancy outcome in DOR patients with different syndromes. Methods: To collect 332 patients with infertility due to the diminished ovarian reserve, analyze the distribution characteristics of TCM syndrome in patients with DOR, and compare the difference of IVF pregnancy outcome between different syndromes. Results: The common TCM syndromes of DOR patients are liver depression,kidney yin, blood stasis, kidney yang deficiency, spleen deficiency and phlegm dampness. Compared with 20~35 year old patients,the proportion of kidney yin deficiency syndrome, blood stasis syndrome and kidney yang deficiency syndrome in patients36~45 year old were increased ages(P<0.05, P<0.01). The most common complex syndromes of DOR patients are kidney deficiency and liver stagnation, kidney deficiency and blood stasis, liver stagnation and blood stasis. Compared with DOR patients41~45 years old and 20~35 years old, the proportion of kidney deficiency and blood stasis, liver stagnation and kidney deficiency and liver stagnation is increased in patients over 36 years old(P<0.01). There is no statistical difference in the difference of the biochemical pregnancy rate, implantation rate and clinical pregnancy rate DOR patients with age less than 35 years old(P<0.05),but the clinical pregnancy rate of DOR patients aged over 36 years was significantly lower than that of liver depression syndrome.Conclusion: Kidney deficiency liver depression syndrome is the most common TCM syndrome in DOR patients. With the increase of age, the clinical pregnancy rate of kidney deficiency syndrome was lower than that of liver depression syndrome. In general, the clinical pregnancy rate of total deficiency syndrome is lower than the sthenia syndrome type.

关 键 词：卵巢储备功能下降 体外受精-胚胎移植 中医证候 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]