育肾活血方联合促性腺激素释放激素类似物治疗肾虚型子宫内膜异位症不孕症腹腔镜术后临床疗效观察  

Clinical efficacy observation of Yushen Huoxue Formula combined with gonadotrophin releasing hormone agalogue in the treatment of kidney deficiency type endometriosis infertility after laparoscopic surgery

作　　者：黄家宓 胡国华[2] 张亚楠[2] 王佳云 谷灿灿 孔珏莹 万怡婷 陈静[2] HUANG Jia-mi;HU Guo-hua;ZHANG Ya-nan;WANG Jia-yun;GU Can-can;KONG Jue-ying;WAN Yi-ting;CHEN Jing(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海中医药大学附属市中医医院,上海200071

出　　处：《中华中医药杂志》2023年第4期1892-1896,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市2020年度“科技创新行动计划”医学创新研究专项项目(N o.20Z21900400,No.20Y21901400);上海申康医院发展中心临床三年行动计划(No.SHDC2020CR4056)。

摘　　要：目的:观察育肾活血方联合促性腺激素释放激素类似物(GnRH-a)对肾虚型子宫内膜异位症(EMs)不孕症腹腔镜术后患者的临床疗效。方法:收集2019年12月至2020年12月于上海中医药大学附属市中医医院就诊的肾虚型EMs不孕症腹腔镜术后患者64例,按照随机数表法分为两组:试验组(32例)予中药育肾活血方联合GnRH-a,对照组(32例)予GnRH-a,均治疗3个月。比较两组患者妊娠率、临床疗效、肾虚型中医证候评分、抗缪勒管激素(AMH)含量。结果:在1年随访中,对照组总妊娠率为53.13%(17/32),试验组总妊娠率为78.13%(25/32),试验组显著高于对照组(P<0.05)。两组患者临床症状、体征及实验室检查均改善,对照组总有效率为71.88%(23/32),试验组总有效率为96.88%(31/32),试验组显著高于对照组(P<0.01)。试验组治疗后肾虚型中医证候评分较治疗前显著降低(P<0.01),且较对照组亦显著降低(P<0.01),试验组治疗后血清AMH较治疗前显著升高(P<0.01),且较对照组亦显著升高(P<0.05)。结论:育肾活血方联合GnRH-a治疗肾虚型EMs不孕症腹腔镜术后患者能有效提高自然妊娠率,改善临床症状及体征,降低肾虚型中医证候评分。其作用机制可能与提高患者的卵巢功能有关。Objective:To observe the clinical effect of Yushen Huoxue Formula combined with gonadotrophin releasing hormone agalogue(GnRH-a)on patients with kidney deficiency type endometriosis infertility after laparoscopic surgery.Methods:A total of 64 patients with kidney deficiency type endometriosis and infertility after laparoscopic surgery in Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from December 2019 to December 2020 were collected and divided into two groups according to a random number table.The experimental group(32 patients)was treated with the traditional Chinese medicine Yushen Huoxue Decoction combined with GnRH-a,and the control group(32 patients)was treated with GnRH-a,for 3 months.The pregnancy rate,clinical effcacy,TCM syndrome score of kidney deficiency type,and the content of anti-Mullerian hormone(AMH)were compared between the two groups.Results:During the 1-year follow-up,the total pregnancy rate of the control group was 53.13%(17/32),the total pregnancy rate of the experimental group was 78.13%(25/32);the total pregnancy rate of the experiment group was significantly higher than that of the control group(P<0.05).The clinical symptoms,signs and laboratory examinations of the two groups were significantly improved.The total curative effect of the control group was 71.87%(23/32),and the total curative effect of the test group was 96.88%(31/32),the total curative effect of the experiment group was significantly higher than that of the control group(P<0.01).After treatment,the scores of TCM syndromes of patients with kidney deficiency in the experimental group were lower than before treatment(P<0.01),and was lower than that in the control group(P<0.01).Serum AMH in the experimental group after treatment was higher than before treatment(P<0.01),and was higher than that in the control group(P<0.05).Conclusion:Yushen Huoxue Formula combined with GnRH-a can effectively increase the natural pregnancy rate,improve clinical symptoms and signs,and r

关 键 词：育肾活血方 促性腺激素释放激素类似物 子宫内膜异位症 不孕症 腹腔镜术后 临床疗效 机制 

分 类 号：R711.71[医药卫生—妇产科学] R711.6[医药卫生—临床医学]