中医序贯疗法干预多囊卵巢综合征不孕患者行体外受精-胚胎移植的临床观察  

Clinical observation of sequential therapy of traditional Chinese medicine for intervening infertility patients with polycystic ovary syndrome patients undergoing in vitro fertilization-embryo transfer

作　　者：岑怡[1] 邢长英 梁芳[2] 曲立娟[3] CEN Yi;XING Changying;LIANG Fang;QU Lijuan(Department of Traditional Chinese Medicine,Shanghai Eighth People's Hospital,Shanghai 200235;不详)

机构地区：[1]上海市第八人民医院中医科,上海200235 [2]上海市第六人民医院中医科,上海200233 [3]上海市第八人民医院检验科,上海200235

出　　处：《河北中医》2021年第2期219-222,227,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验继承项目(国中医药人教发〔2017〕29号);上海市卫生和计划生育委员会中医药科研专项课题(编号:2016LP011);江苏大学临床医学科技发展基金项目(编号:JLY20180127)。

摘　　要：目的观察中医序贯疗法干预多囊卵巢综合征(PCOS)不孕患者行体外受精-胚胎移植(IVF-ET)的临床疗效。方法将60例PCOS不孕患者随机分为2组,治疗组30例在IVF-ET基础上予中医序贯疗法干预,对照组30例予IVF-ET治疗。比较2组促性腺激素(Gn)使用情况;比较2组人绒毛膜促性腺激素(HCG)日雌二醇(E 2)、黄体生成激素(LH)、卵泡刺激素(FSH)及子宫内膜厚度变化;比较2组治疗后临床指标(包括获卵数、受精卵数、优质胚胎数、受精率、卵裂率、优质胚胎率、周期移植率)、妊娠结局(包括胚胎种植率、临床妊娠率、活产率、流产率)情况;比较2组妊娠并发症(妊娠高血压、妊娠糖尿病)及不良结局[前置胎盘、产后出血、卵巢过度刺激综合征(OHSS)]发生情况。结果治疗组受精率80.61%(316/392),优质胚胎率54.58%(155/284),对照组受精率71.85%(314/437),优质胚胎率46.05%(134/291),治疗组受精率、优质胚胎率均高于对照组(P<0.05)。治疗组妊娠高血压发病率5.26%(1/19),妊娠糖尿病发病率5.26%(1/19),对照组妊娠高血压发病率23.53%(4/17),妊娠糖尿病发病率17.65%(3/17),治疗组妊娠高血压、妊娠糖尿病发病率均低于对照组(P<0.05)。2组HCG日性激素水平、子宫内膜厚度、妊娠结局和不良结局比较差异均无统计学意义(P>0.05)。结论中医序贯疗法干预PCOS伴不孕患者行IVF-ET,能够有效提高胚胎质量,减少妊娠并发症,是PCOS患者行IVF-ET的有效干预方法。Objective To observe the clinical efficacy of sequential therapy of traditional Chinese medicine(TCM)for intervening infertility patients with polycystic ovary syndrome(PCOS)undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 60 infertility patients with PCOS were randomly divided into the treatment group and the control group with 30 cases each.The treatment group was treated with sequential therapy of Chinese medicine,and the control group was treated with non-Chinese medicine intervention treatment.The index of gonadotropin(Gn),the changes of estradiol(E 2),luteinizing hormone(LH),follicle stimulating hormone(FSH),and endometrial thickness on human chorionic gonadotropin(HCG)daily were compared;the clinical indicators[the number of harvested eggs,fertilized eggs,high-quality embryos,rate of fertilization(number of fertilized eggs/number of harvested eggs),cleavage,high-quality embryos,and cycle transfer],the pregnancy outcome(rate of embryo implantation,clinical pregnancy,live birth and abortion),the complications(pregnancy-induced hypertension and gestational diabetes),and the adverse outcome[placenta previa,postpartum hemorrhage,ovarian hyperstimulation syndrome(OHSS)]were compared between the two groups.Results The rates of fertilization and high-quality embryos in the treatment group were higher than those in the control group[80.61%(316/392)vs 71.85%(314/437),54.58%(155/284)vs 46.05%(134/291);(P<0.05),respectively].The incidence of gestational hypertension and gestational diabetes in the treatment group were lower than those in the control group[5.26%(1/19)vs 23.53%(4/17),5.26%(1/19)vs 17.65%(3/17);(P<0.05),respectively].There was no significant difference in the change of daily sex hormone levels,endometrial thickness,pregnancy outcome,and adverse outcome in HCG between the two groups(P>0.05).Conclusion The Sequential therapy of TCM for intervening infertility patients with PCOS undergoing IVF-ET can effectively improve embryo quality,reduce pregnancy complications.It is an effec

关 键 词：多囊卵巢综合征 胚胎组织移植 体外受精 中医疗法 

分 类 号：R711.75[医药卫生—妇产科学] R287[医药卫生—临床医学]