补肾助孕法对IVF-ET中卵巢储备功能减退相关不孕患者临床结局的影响  

Effect of therapy for tonifying kidney and promoting conception on clinical outcomes of patients with diminished ovarian reserve-related infertility in IVF-ET

作　　者：陈杰 王昕[2] 柴美伶 CHEN Jie;WANG Xin;CHAI Meiling(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《现代中西医结合杂志》2024年第20期2788-2793,2816,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：辽宁省辽派中医学术经验和技能活态传承项目(辽卫综合字[2021]19号)。

摘　　要：目的观察补肾助孕法对肾虚证卵巢储备功能减退(DOR)相关不孕患者体外受精-胚胎移植(IVF-ET)临床结局的影响。方法选取2022年5月—2024年1月于辽宁中医药大学附属医院就诊的拮抗剂方案常规IVF-ET助孕的DOR相关不孕患者64例,按是否应用补肾助孕法治疗分为2组,治疗组32例采用补肾助孕法+拮抗剂方案,对照组32例仅采用拮抗剂方案。比较2组治疗前后的中医证候评分、扳机日血清性激素水平和子宫内膜容受情况、控制性超促排卵中促性腺激素(Gn)使用情况、促排后获卵数及胚胎发育情况及IVF-ET结局指标。结果治疗后治疗组中医证候评分明显低于治疗前及对照组(P均<0.05);扳机日治疗组血清雌二醇(E_(2))水平和子宫内膜厚度均明显高于对照组(P均<0.05),而血清孕激素(P)、黄体生成素(LH)水平及A型内膜比例与对照组比较差异均无统计学意义(P均>0.05);促排卵过程中治疗组Gn总量和Gn时间均少于对照组,但差异均无统计学意义(P均>0.05);取卵后治疗组获卵数、成熟卵数、2PN受精数、正常卵裂数、优质胚胎数和临床妊娠率均明显高于对照组(P均<0.05)。结论在IVF-ET治疗周期中应用补肾助孕法可有效改善肾虚证DOR相关不孕患者的临床症状,提高卵子的数量及质量,改善子宫内膜容受性,优化妊娠结局。Objective It is to observe the effect of therapy for tonifying kidney and promoting conception on clinical outcomes of patients with diminished ovarian reserve(DOR)-related infertility of syndrome of kidney deficiency in vitro fertilization-embryo transfer(IVF-ET).Methods Sixty-four DOR-related infertility patients undergoing antagonist regimen for routine IVF-ET fertilization in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from May 2022 to January 2024 were selected and divided into two groups according to whether or not they were treated with therapy for tonifying kidney and assisting conception,32 cases in the treatment group were treated with therapy for tonifying kidney and promoting conception+antagonist regimen,and 32 cases in the control group were treated with antagonist regimen only.The traditional Chinese medical syndrome scores before and after treatment,serum sex levels of hormones and endometrial tolerance on the trigger day,the use of gonadotropins(Gn)in controlled ovarian hyperstimulation,the number of oocytes and embryo development after ovulation hyperstimulation,and the IVF-ET outcome indexes of the two groups were compared.Results After treatment,the traditional Chinese medical syndrome score of the treatment group was significantly lower than that before treatment and of the control group(both P<0.05);the serum level of estradiol(E_(2))and endometrial thickness of the treatment group on the trigger day were significantly higher than those of the control group(both P<0.05),while the differences in the serum levels of progesterone(P)and luteinizing hormone(LH),and the proportion of A-type endometrium were not statistically significant between the two groups(all P>0.05);the total amount of Gn and the duration of Gn during ovulation hyperstimulation were less in the treatment group than those in the control group,but the differences were not statistically significant(all P>0.05);the number of obtained oocytes,mature oocytes,2PN fertilization,normal cleavage,high-

关 键 词：补肾助孕法 不孕症 卵巢储备功能减退 肾虚证 体外受精-胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]