促孕温巢汤联合氯米芬治疗多囊卵巢综合征性不孕症患者的临床观察  

Clinical Observation of Cuyun Wenchao Decoction Combined with Clomiphene in Treatment of Patients with Polycystic Ovary Syndrome Infertility

作　　者：兰代群 莫培晖 林丽慧 LAN Daiqun;MO Peihui;LIN Lihui(Department of Obstetrics and Gynecology,Hainan West Central Hospital,Danzhou 571700,China)

机构地区：[1]海南西部中心医院妇产科,海南儋州571700

出　　处：《医学综述》2021年第10期2056-2060,共5页Medical Recapitulate

摘　　要：目的观察促孕温巢汤联合氯米芬治疗多囊卵巢综合征(PCOS)性不孕症患者的临床疗效。方法选择2018年1月至2019年1月海南西部中心医院收治的120例PCOS性不孕症患者为研究对象,按照随机数字法分为中医组、西医组、联合组,各40例。其中中医组给予促孕温巢汤治疗,西医组给予氯米芬治疗,联合组给予促孕温巢汤联合氯米芬治疗。观察记录三组患者的临床疗效,治疗前后的性激素(血清睾酮、黄体生成素、卵泡刺激素和雌二醇)水平、卵巢体积、卵泡数目,妊娠率及不良反应发生率。结果治疗后,联合组的总有效率明显高于中医组、西医组[92.50%(37/40)比72.50%(29/40)、70.00%(28/40)](P <0.05)。睾酮、黄体生成素、卵泡刺激素、雌二醇的组间与时点间存在交互作用(P <0.01)。治疗后,三组患者的睾酮、黄体生成素水平降低,且联合组明显低于中医组、西医组(P <0.05);卵泡刺激素、雌二醇水平升高,且联合组明显高于中医组、西医组(P <0.05)。卵巢体积、卵泡数目的组间与时点间存在交互作用(P <0.01)。治疗后,三组患者的卵巢体积、卵泡数目明显减小,且联合组明显小于中医组、西医组(P <0.05)。联合组的临床妊娠率明显高于中医组、西医组[67.50%(27/40)比37.50%(15/40)、35.00%(14/40)](P <0.01)。西医组的高排卵发生率明显高于中医组[20.00%(8/40)比0.00%(0/40)](P <0.05),联合组的高排卵发生率明显低于西医组[2.50%(1/40)比20.00%(8/40)](P <0.05)。结论与单纯促孕温巢汤、氯米芬治疗相比,促孕温巢汤联合氯米芬治疗PCOS性不孕症患者在提高临床疗效、调节性激素水平、改善卵巢和卵泡发育及提高临床妊娠率等方面具有明显优势。Objective To observe the clinical effects of Cuyun Wenchao Decoction combined with clomiphene in the treatment of patients with polycystic ovary syndrome( PCOS) infertility. Methods A total of 120 patients with PCOS infertility treated in Hainan Western Central Hospital from Jan. 2018 to Jan. 2019 were divided into a traditional Chinese medicine( TCM) group,a western medicine group and a combined group according to the random number method,40 cases in each group. The TCM group was treated with Cuyun Wenchao decoction,the western medicine group was treated with clomiphene,and the combined group was treated with Cuyun Wenchao decoction combined with clomiphene. The clinical effects of the three groups were observed and recorded,as well as the levels of sex hormones( serum testosterone,luteinizing hormone,follicle stimulating hormone and estradiol),ovarian volume,number of follicles before and after treatment,pregnancy rate and incidence of adverse reactions. Results After treatment,the total effective rate of the combined group was significantly higher than that of the TCM group and the western medicine group[92. 50%( 37/40) vs 72. 50%( 29/40),70. 00%( 28/40) ]( P <0. 05). There were interactions in testosterone,luteinizing hormone,follicle stimulating hormone and estradiol between groups and time points( P < 0. 01). After treatment,the levels of testosterone and luteinizing hormone in the three groups showed decreasing trends,and the combined group had significantly lower levels than the other two groups( P < 0. 05).The levels of follicle stimulating hormone and estradiol showed increasing trends,and the combined group had significantly higher levels than the other two groups( P < 0. 05). There were interactions in ovarian volume and follicle count between groups and time points( P < 0. 01). After treatment,the ovarian volume and follicle count in the three groups were significantly reduced,and the combined group had significantly smaller ovarian volume and follicle count than the other two groups( P < 0. 05). The

关 键 词：多囊卵巢综合征 不孕症 促孕温巢汤 氯米芬 

分 类 号：R711.75[医药卫生—妇产科学]