中西医结合治疗合并桥本氏甲状腺炎的多囊卵巢综合征不孕症的临床观察  

Clinical Observation of Infertility of Polycystic Ovary Syndrome with Hashimoto’s Thyroiditis Treated by Traditional Chinese and Western Medicine Integration

作　　者：李兴艳 陈林兴 周瑞彬[2] LI Xing-yan;CHEN Lin-xing;ZHOU Rui-bin(Yunnan University of Traditional Chinese Medicine,Kunming 650500,China;Kunming Hospital of Traditional Chinese Medicine,Kunming 650011,China)

机构地区：[1]云南中医药大学,云南昆明650500 [2]昆明市中医医院,云南昆明650011

出　　处：《云南中医中药杂志》2024年第9期34-38,共5页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：云南省科技厅-云南中医药大学应用基础研究联合专项(202101AZ070001-031)。

摘　　要：目的观察中西医结合治疗合并桥本氏甲状腺炎的多囊卵巢综合征不孕症的临床疗效。方法选择确诊为多囊卵巢综合征(polycystic ovary syndrome,PCOS)PCOS合并桥本氏甲状腺炎(hashimoto s thyroiditis,HT)HT的患者92例,根据随机数字表将患者分为观察组和对照组各46例。对照组给予克罗米芬配合二甲双胍片口服治疗PCOS,左甲状腺素钠片口服治疗HT,观察组在此基础上予本科自拟方口服,共治疗3个月经周期。观察治疗前后2组患者甲状腺功能指标、胰岛素抵抗相关指标和子宫动脉血流指数。对患者进行随访半年,记录统计受孕率和临床妊娠率。结果治疗后,2组患者甲状腺功能、胰岛素抵抗相关指标和子宫动脉血流指数均显著改善(P<0.01),其中观察组以上指标改善更明显(P<0.05或0.01);随访半年,观察组受孕率为41.30%,临床妊娠率为73.68%,而对照组分别为21.74%和40.00%,2组比较,观察组均优于对照组(P<0.05或0.01)。结论中西医结合治疗并HT的PCOS不孕症,可更好地改善患者甲状腺功能、胰岛素功能和子宫动脉血流灌注,从而增加受孕率及临床妊娠率。Objective:To observe the clinical effect of Chinese and western medicine integration on the infertility of polycystic ovary syndrome complicated with Hashimoto s thyroiditis.Methods:A total of 92 patients diagnosed with polycystic ovary syndrome(PCOS)combined with hashimoto's thyroiditis(HT)HT were selected and divided into observation group and control group according to random number table,46 cases respectively.The control group was given clomiphene combined with metformin tablets for the treatment of PCOS,and levothyroxine sodium tablets for the treatment of HT.The observation group was given self-prescribed oral treatment on the basis of the control group,and 3 menstrual cycles were treated.The thyroid function indexes,insulin resistance related indexes and uterine artery blood flow index were observed before and after treatment.The patients were followed up for half a year,and the pregnancy rate and clinical pregnancy rate were recorded.Results:After treatment,the thyroid function,insulin resistance related indexes and uterine artery blood flow index were significantly improved in the 2 groups(P<0.01),and the above indexes were more significantly improved in the observation group(P<0.05 or 0.01).The six-month follow-up showed that the pregnancy rate and clinical pregnancy rate of the observation group were 41.30%and 73.68%,respectively,while those of the control group were 21.74%and 40.00%,respectively.Compared between the two groups,the observation group was superior to the control group(P<0.05 or 0.01).Conclusion:Chinese and western medicine integration in the treatment of PCOS infertility complicated with HT can better improve the thyroid function,insulin function and uterine artery blood perfusion,thus increasing the pregnancy rate and clinical pregnancy rate.

关 键 词：中西医结合 多囊卵巢综合征 桥本氏甲状腺炎 不孕 

分 类 号：R271.14[医药卫生—中医妇科学]