补肾活血方对不孕症患者子宫内膜容受性及妊娠率的影响  

Effect of Bushen Huoxue decoction on endometrial receptivity and pregnancy rate in patients with infertility

作　　者：刘颖 林晓华[2] 赵玉娇 曹文 贾书娜 芦艳红 王瑞云 何元曼 王振东 祝佩芹[2] LIU Ying;LIN Xiaohua;ZHAO Yujiao;CAO Wen;JIA Shuna;LU Yanhong;WANG Ruiyun;HE Yuanman;WANG Zhendong;ZHU Peiqin(Hebei College of Traditional Chinese Medicine,Shijiazhuang 050091,Hebei,China;Hebei Academy of Chinese Medical Sciences,Shijiazhuang 050011,Hebei,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北中医学院,河北石家庄050091 [2]河北省中医院,河北石家庄050011 [3]河北省中医药科学院,河北石家庄050011

出　　处：《现代中西医结合杂志》2020年第2期135-138,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金青年科学基金项目(81403428)

摘　　要：目的观察补肾活血方对肾虚血瘀型不孕症患者子宫内膜容受性及妊娠率的影响。方法选择2016年6月—2018年6月在河北省中医院妇科门诊就诊且中医辨证为肾虚血瘀型不孕症患者60例,将患者随机分为2组,中药组30例予补肾活血方加减口服,西药组30例予戊酸雌二醇口服。2组均于月经周期(或撤退性出血)第9天起监测排卵情况,当卵泡平均直径≥1.8 cm时(即HCG日)予人绒毛膜促性腺激素肌肉注射。无特殊情况,2组均服药至HCG日后1周。若服药21 d后仍未见优势卵泡,则予黄体酮胶丸睡前服,连服5 d后停药,于撤退性出血第5天进入下个疗程。2组患者均治疗3个月经周期,患者用药过程中妊娠则停止用药。分别于治疗前及治疗结束后HCG日后6~8 d采用B超监测子宫内膜情况,记录2组Salle评分、PI得分、子宫内膜厚度,统计2组患者治疗结束3个月后的受孕情况。结果2组治疗后Salle评分及子宫内膜厚度均明显高于治疗前(P均<0.05),PI得分均明显低于治疗前(P均<0.05),且中药组各指标改善情况均明显优于对照组(P均<0.05)。治疗后中药组受孕率为46.7%(14/30),西药组为20.0%(6/30),中药组受孕率明显高于西药组(P<0.05)。结论在常规治疗基础上联合应用自拟补肾活血方可以明显改善肾虚血瘀型不孕症患者的子宫内膜容受性,提高受孕率。Objective It is to observe the effect of Bushen Huoxue decoction on endometrial receptivity and pregnancy rate in patients with infertility of type of kidney deficiency and blood stasis.Methods Sixty patients with infertility of type of kidney deficiency and blood stasis treated in the gynecological clinic of Hebei Provincial Hospital of Traditional Chinese Medicine from June 2016 to June 2018 were randomly divided into 2 groups,30 patients in the Chinese medicine group were treated with Bushen Huoxue decoction by oral administration,30 patients in the western medicine group were treated with estradiol valerate by oral administration.Ovulation was monitored from the 9th day of the menstrual cycle(or withdrawal bleeding)in both groups.Human chorionic gonadotropin was injected intramuscularly when the average follicle diameter was≥1.8 cm(ie HCG day).Both groups were treated until 1 week after HCG when no special events occurred.If the dominant follicles were not found after treating for 21 days,the patients were treated with progesterone capsules before bedtime for 5 days,and the next course of treatment was performed on the 5th day of withdrawal bleeding.All the patients in both groups were treated for 3 menstrual cycles.The treatment was stopped when the patients were pregnant.The endometrial condition was monitored by B-ultrasound before treatment and in 6 to 8 days after HCG day at end of treatment.The Salle scores,PI scores,and endometrial thickness of the two groups were recorded,and the pregnancy status of the two groups was counted 3 months after treatment.Results After treatment,the Salle scores and endometrial thickness of the two groups were significantly higher while PI scores were significantly lower than those before treatment(P<0.05),and the improvements of all indicators of the Chinese medicine group were significantly better than those in the control group(P<0.05).After treatment,the conception rate of the traditional Chinese medicine group was 46.7%(14/30),and that of the western medicine group

关 键 词：补肾活血方 肾虚血瘀 子宫内膜容受性 不孕症 

分 类 号：R711.6[医药卫生—妇产科学]