从子宫内膜容受性角度探讨中西医结合治疗IVF-ET中反复种植失败的临床观察  

The clinical observation on repeated implantation failure in IVF-ET treated with integrated traditional Chinese and Western medicine from the perspective of endometrial receptivity

作　　者：王美霞 田小英 胡慧娟 陈仙秋 陈浩波 滕依丽[2] Wang Meixia

机构地区：[1]温州市中西医结合医院,325000 [2]温州医科大学附属第一医院,325000

出　　处：《浙江临床医学》2023年第3期347-349,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省中青年临床名中医人才项目(浙中医药(2021)22号);温州市科技计划项目(Y20220006)。

摘　　要：目的探讨中西医结合治疗在反复种植失败患者中对子宫内膜容受性的作用及妊娠结局的影响。方法选取2019年7月至2022年1月就诊于温州市中西医结合医院的反复种植失败(RIF)患者60例,根据随机原则采用数字表法分为中西医结合组30例,常规西药组30例,两组均予以常规人工替代周期内膜准备方案,中西医结合组在常规方案基础上于进周后开始服用增膜助孕汤,内膜转化后改为口服益肾安胎方,两组均在移植后常规静脉滴注间苯三酚针3d,比较两组患者的一般资料、移植日的内膜厚度、容积、内膜血流灌注情况、异常内膜蠕动波以及临床妊娠情况。结果两组患者在一般资料上无统计学差异,经过治疗,中西医结合组在移植日子宫内膜、容积上优于常规西药组(P<0.05),负向子宫内膜蠕动波次数明显少于常规西药组(P<0.05),而子宫内膜血流灌注情况无明显统计学差异(P>0.05)。与常规西药组比较,中西医结合组的生化妊娠率以及临床妊娠率均明显增加(P<0.05)。结论中医药在改善RIF患者的妊娠结局具有显著的效果,其作用机制可能通过增加子宫内膜厚度、容积,也可能通过减少负向子宫内膜蠕动波次数,可以作为临床治疗RIF的有效方法。Objective To evaluate the effect of integrated traditional Chinese and western medicine on endometrial receptivity and pregnancy outcome in patients with repeated implantation failure(RIF).Methods 60 RIF patients were selected to be treated in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2019 to January 2022.All the patients were randomly divided into the combined Chinese and Western medicine group(n=30)and the phloroglucinol group(n=30)with the principle of randomization.Both groups were given the hormone replacement therapy cycle before embryo transplantation,the combined medicine group were treated with the Zengmo Zhuyun decoction after the menstruation,and the Yishen Antai decoction after the endometrial transformation.Both groups were given phloroglucinol for 3 days after the transplantation.The general data,intimal thickness,volume,intimal blood perfusion,abnormal intimal peristaltic wave,and clinical pregnancy were compared between the two groups.Results It was comparable that there was no statistical difference in general data between the two groups.After the treatment,the endometrium and volume of the combined Chinese and Western medicine group were better than those of the control group on the transplantation day(P<0.05).The frequency of negative endometrial peristaltic wave was significantly lower than that of the control group(P<0.05).There was no significant difference in endometrial blood perfusion(P>0.05).The biochemical pregnancy rate and clinical pregnancy rate of the combined medicine group were significantly increased comparing with the phloroglucinol group(P<0.05).Conclusion TCM has a significant effect on improving pregnancy outcomes in patients with RIF.The mechanism of TCM may be through increasing endometrial thickness,volume,or reducing the frequency of negative endometrial peristaltic waves.Based on this research,TCM can be considered to be a powerful strategy for the treatment of RIF.

关 键 词：子宫内膜容受 反复种植失败 中医药 间苯三酚 

分 类 号：R714.8[医药卫生—妇产科学]