补肾增膜方与富血小板血浆宫腔灌注对薄型子宫内膜干预研究  

Interventional Study of Bushen Zengmo Decoction and Platelet-Rich Plasma Intrauterine Perfusion on Thin Endometrium

作　　者：钟秀芳 张武文 尹萍[1] 迟令侃[1] 任春霞 李玉倩 童国庆[1] ZHONG Xiufang;ZHANG Wuwen;YIN Ping;CHI Lingkan;RENChunxia;L I Yuqian;TONG Guoqing(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai University of Trarlitional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海中医药大学,上海201203

出　　处：《辽宁中医药大学学报》2020年第7期78-82,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81170571);四明青年基金(SGKJ-201815)。

摘　　要：目的研究补肾增膜方与富血小板血浆(Platelet-rich plasma,PRP)宫腔灌注对薄型子宫内膜的作用,探讨其对子宫内膜容受性的影响,研究其对体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVF-ET)的作用。方法将符合纳入标准的肾气虚型薄型子宫内膜患者93例,按随机分组原则分为A组(中药组)与B组(PRP组)。两组患者均采用激素替代治疗(Hormone replacement therapy,HRT)周期治疗,中药组口服补肾增膜方至移植日前1 d。PRP组于月经周期第7天进行PRP宫腔灌注1次,5~7 d后根据内膜厚度选择是否再次进行PRP宫腔灌注。两组患者子宫内膜厚度达移植要求内膜转化后移植。结果中药组与PRP组患者本次周期的子宫内膜厚度均较前次周期显著提高,差异具有统计学意义(P<0.05)。两组患者在HRT周期第7天,中药组内膜血流优于PRP组,差异有统计学意义(P<0.05);在HRT周期第12~14天,中药组的子宫内膜形态、血流优于PRP组,差异有统计学意义(P<0.05)。两组患者的同源框基因10(HOXA10)、血管内皮生长因子(VGEF)、白血病抑制因子(LIF)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)表达较对照组明显升高,差异均有统计学意义(P<0.05)。中药组、PRP组均取得可接受的妊娠率,但两种治疗方式之间比较差异无统计学意义(P>0.05)。结论补肾增膜方、PRP宫腔灌注治疗均可提高肾气虚型薄型子宫内膜患者内膜转化日的子宫内膜厚度,显著增加子宫内膜容受性相关因子(HOX10、VEGF、LIF、IL-8、IL-6)的表达,补肾增膜方还可提高内膜转化日的雌激素水平。补肾增膜方、PRP宫腔灌注治疗均取得可接受的妊娠率。Objective To research the mechanism of Bushen Zengmo Decoction and platelet-rich plasma caused by intrauterine infusion on the improvement of thin endometrial receptivity,and to study its effect on in vitro fertilization-embryo transfer(IVF-ET).Methods This study was designed as a randomized,parallel-controlled,assessor-and statistician-blinded trial.Participants will be included from the assited reproduction center of Shuguang hospital,affiliated to Shanghai university of traditional Chinese medicine from June 2017 to June 2019.Included patients will be randomly divided into two groups:the Chinese medicine(A)group and the PRP(B)group(n=93).Both of groups were treated with hormone replacement therapy(HRT).A group was given Bushen Zengmo Decoction until the day before the transplantation.B group received PRP intrauterine infusion on the 7 th day of menstrual cycle.According to endometrial thickness,PRP intrauterine infusion was selected if performed after 5-7 days.Once the endometrial thickness of the two groups of patients reached the requirement of transplantation,combined with the level of related sex hormones(estradiol,progesterone),progesterone drugs were used to transform the endometrium.Results The thickness of endometrium in this cycle of Chinese medicine group and PRP group was significantly higher than that in the previous cycle(P<0.05).On the 7 th day of HRT cycle,endometrial blood flow of TCM group was better than that of PRP group(P<0.05);on the 12 th-14 th day of HRT cycle,endometrial morphology and blood flow of TCM group were better than that of PRP group(P<0.05).The expressions of HOXA10,VGEF,LIF,IL-8 and IL-6 in the two groups were significantly higher than those in the control group(P<0.05).There was no significant difference between the two treatments(P>0.05).Conclusion Bushen Zengmo Decoction and PRP intrauterine infusion treatment can improve the thickness of kidney Qi deficiency type thin endometrium,increase the expression levels of endometrial receptivity-related factors(HOX10,VEGF,LIF,IL-

关 键 词：补肾增膜方 富血小板血浆功宫腔灌注 体外受精-胚胎移植 肾气虚型 子宫内膜容受性 

分 类 号：R711.7[医药卫生—妇产科学]