补肾调轴方治疗体外受精-胚胎移植反复胚胎着床失败伴慢性子宫内膜炎症的临床研究  

Clinical study of Bushen Tiaozhou prescription on repeated implantation failure of IVF-ET with chronic endometritis

作　　者：张冬梅 杨伟伟 阎慧娟 ZHANG Dongmei;YANG Weiwei;YAN Huijuan(Reproductive Medicine Center of Sanmenxia Hospital of the Yellow River,Sanmenxia,He'nan 472000,China)

机构地区：[1]黄河三门峡医院生殖医学中心,河南三门峡472000

出　　处：《安徽医药》2025年第1期178-183,I0006,共7页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关计划项目(LHGJ20191098)。

摘　　要：目的观察补肾调轴方对体外受精-胚胎移植(IVF-ET)反复胚胎着床失败并且合并慢性子宫内膜炎症病人内膜容受性、胚胎种植率、子宫免疫微环境和妊娠结局的影响。方法选择于黄河三门峡医院生殖医学中心治疗的150例IVF-ET反复胚胎着床失败并且合并慢性子宫内膜炎症病例,治疗时间为2018年2月至2021年2月,采用随机数字表法分组。75例对症组,于IVF-ET失败后第1个月经周期行抗感染治疗,经期停药,经净后继续服药,共服用14 d,75例病人为补肾调轴方组,给予自拟中药补肾调轴方治疗,连续服用30 d。治疗前、后检测两组病人肿瘤坏死因子α(TNF-α)、谷胱甘肽过氧化物酶(GSHPx)、白细胞介素4(IL-4)、超氧化物歧化酶(SOD)、白细胞介素-1β(IL-1β)、抗超氧阴离子自由基(抗O_(2)^(−))活力水平及CD138阳性率,检测病人CD56^(+)表达情况,检测子宫内膜厚度、子宫动脉的血流指数、搏动指数、阻力指数,治疗前、后给予病人Salle及中医证候评分,记录对症组、补肾调轴方组临床妊娠率、移植胚胎数、早期流产率、胚胎种植率及活产率。结果补肾调轴方组病人TNF-α、IL-1β、CD56^(+)含量、CD138阳性率较对症组明显低(P<0.05),补肾调轴方组病人IL-4含量较对症组明显高(P<0.05),补肾调轴方组病人SOD、抗O_(2)^(−)活力、GSH-Px含量较对症组明显高(P<0.05);补肾调轴方组病人子宫内膜厚度、子宫动脉的血流指数较对症组高(P<0.05),补肾调轴方组病人子宫动脉的搏动指数、阻力指数较对症组低(P<0.05),补肾调轴方组中医证候评分较对症组明显低(P<0.05),补肾调轴方组Salle评分较对症组明显高(P<0.05),补肾调轴方组胚胎种植率、临床妊娠率、活产率较对症组高(33.33%、42.67%、41.33%)比(22.36%、26.67%、22.67%)(P<0.05),两组早期流产率比较差异无统计学意义(P>0.05),结论补肾调轴方治疗IVF-ET反复胚胎着床失败伴慢性子宫内�Objective To observe the effects of Bushen Tiaozhou prescription on endometrial receptivity,embryo implantation rate,uterine immune microenvironment and pregnancy outcome in patients with repeated implantation failure in vitro fertilization-embryo transfer(IVF-ET)complicated with chronic endometrial inflammation.Methods A total of 150 IVF-ET cases with repeated embryo implantation failure and chronic endometrial inflammation were selected from Reproductive Medicine Center of Sanmenxia Hospital of the Yellow River from February 2018 to February 2021,and were divided by random number table method.The 75 patients in the symptomatic group received anti-infection treatment in the first menstrual cycle after IVF-ET failure,stopped taking the drug during menstrual period,and continued taking the drug after purification for a total of 14 days,and 75 patients in the Bushen Tiaozhou prescription group were treated with Bushen Tiaozhou prescription for 30 consecutive days.The activity levels of tumor necrosis factor-α(TNF-α),glutathione peroxidase(GSH-Px),interleukin4(IL-4),superoxide dismutase(SOD),interleukin-1β(IL-1β),anti-superoxide anion radical(anti-O_(2)^(−))and the positive rate of CD138 in the two groups were detected before and after treatment.CD56^(+)expression was detected,endometrial thickness,uterine artery blood flow index,pulse index and resistance index were detected,Salle and TCM syndrome scores were given to patients before and after treatment,and clinical pregnancy rate,number of transplanted embryos,early abortion rate,embryo implantation rate and live birth rate were recorded in the treatment group and Bushen Tiaozhou prescription group.Results The contents of TNF-α,IL-1β,CD56^(+)and the positive rate of CD138 in Bushen Tiaozhou prescription were lower than those of the Symptomatic group(P<0.05);the content of IL-4 in Bushen Tiaozhou prescription was higher than Symptomatic group(P<0.05).The contents of SOD,anti-O2−activity and GSH-Px in Bushen Tiaozhou prescription were higher than those of

关 键 词：不育 女(雌)性 体外受精-胚胎移植 胚胎植入 补肾调轴方 慢性子宫内膜炎症 子宫免疫微环境 子宫内膜容受性 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]