调经益卵方改善卵巢储备功能低下并薄型子宫内膜的疗效观察  

Clinical Observation of Tiaojing Yiluan Recipe for Improving Thin Endometrium of Decreased Ovarian Reserve Patients

作　　者：李靖雯 张帆 LI Jing-Wen;ZHANG Fan(Graduate School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Maoming Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Maoming 525000 Guangdong,China)

机构地区：[1]广州中医药大学研究生院,广东广州510405 [2]广州中医药大学附属茂名中医院,广东茂名525000

出　　处：《广州中医药大学学报》2021年第1期36-41,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察调经益卵方改善脾肾两虚夹瘀型卵巢储备功能低下(DOR)并薄型子宫内膜患者的临床疗效。【方法】将60例脾肾两虚夹瘀型DOR并薄型子宫内膜患者随机分为治疗组和对照组,每组各30例。对照组给予西医常规治疗,治疗组在对照组基础上加用调经益卵方治疗,共治疗3个月经周期并随访3个月,观察2组患者治疗前后中医证候积分、血清性激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗缪勒氏管激素(AMH)]水平及子宫内膜厚度、子宫内膜动脉血流参数[阻力指数(RI)及搏动指数(PI)]的变化情况,评价2组患者的临床疗效、随访情况及安全性。【结果】(1)疗效方面:治疗3个月经周期后,治疗组的总有效率为86.7%(26/30),对照组为63.3%(19/30),治疗组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)中医证候积分方面:治疗后,2组患者的月经评分、非月经评分和中医证候总分均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组(P<0.05)。(3)血清性激素方面:治疗后,2组患者FSH、LH水平明显降低,E2、AMH水平明显提高(P<0.05),且治疗组在降低FSH水平及提高E2、AMH水平方面均明显优于对照组(P<0.05)。(4)子宫内膜厚度方面:治疗后,2组患者子宫内膜厚度均较治疗前明显增加(P<0.05),且治疗组的子宫内膜厚度较对照组增加更明显(P<0.05)。(5)子宫内膜动脉血流参数方面:治疗后,2组患者的PI和RI均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组(P<0.05)。(6)随访情况:治疗结束3个月后,治疗组的妊娠率为33.3%(10/30),明显高于对照组的10.0%(3/30),差异有统计学意义(P<0.05)。(7)治疗过程中,2组患者均无明显的不良反应发生。【结论】调经益卵方治疗DOR并薄型子宫内膜患者疗效确切,能改善临床症状,调整月经周期,改善女性内分泌功能,提升AMH水平,增加子宫内膜厚�Objective To investigate the clinical effect of Tiaojing Yiluan Recipe on improving the thin endometrium of decreased ovarian reserve(DOR) patients with the syndrome of spleen-kidney deficiency complicated with blood stasis. Methods Sixty DOR patients with thin endometrium differentiated as the syndrome of spleen-kidney deficiency complicated with blood stasis were randomly divided into treatment group and control group,each group having 30 cases. The control group was treated with conventional western medicine therapy,and the treatment group was given Tiaojing Yiluan Recipe combined with conventional western medicine therapy.The two groups were treated for 3 periods of menstrual cycle,and then were followed up for another 3 months.Before and after treatment,we examined the scores of traditional Chinese medicine(TCM)syndrome,the serum levels of sex hormones such as follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Mullerian hormone(AMH),endometrial thickness,and endometrial arterial blood flow parameters of resistance index(RI)and pulsatility index(PI). Meanwhile, the clinical efficacy and safety and the results of follow-up in the two groups were also compared. Results(1)After the treatment for 3 periods of menstrual cycle,the total effective rate of the treatment group was 86.7%(26/30), and that of the control group was 63.3%(19/30). The intergroup comparison showed that the clinical efficacy of the treatment group was superior to that of the control group, and the difference was statistically significant between the two groups(P<0.05).(2)After treatment,the menstruation scores,non-menstruation scores,and the TCM syndrome scores in the two groups were obviously decreased in comparison with those before treatment(P<0.05). And the decrease in the treatment group was superior to that in the control group,the difference being statistically significant between the two groups(P<0.05).(3)After the treatment,serum levels of FSH and LH in the two groups were decreased and the levels of E2

关 键 词：调经益卵方 卵巢储备功能低下 薄型子宫内膜 脾肾两虚夹瘀型 妊娠率 

分 类 号：R271.14[医药卫生—中医妇科学]