补肾助孕方联合促排卵治疗多囊卵巢综合征不孕症(肾阳虚证)的临床疗效研究  

Clinical study on the efficacy of Bushen Zhuyun Formula combined with ovulation induction in treating infertility due to polycystic ovary syndrome(Kidney-Yang deficiency syndrome)

作　　者：李贺琦 赵爱丽 LI He-qi;ZHAO Ai-li(Department of Obstetrics and Gynecology,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,Henan,CHINA;Department of Traditional Chinese Medicine,Nanyang Wolong Maternal and Child Health Hospital,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市中医院妇产科,河南南阳473000 [2]南阳市卧龙区妇幼保健院中医科,河南南阳473000

出　　处：《海南医学》2025年第8期1114-1120,共7页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20232975)。

摘　　要：目的观察补肾助孕方联合促排卵治疗多囊卵巢综合征(PCOS)不孕症(肾阳虚证)的疗效,并探讨其对患者内分泌代谢指标、C1q肿瘤坏死因子相关蛋白(CTRP)、肠道菌群及妊娠率的影响。方法选取2021年3月至2023年3月南阳市中医院收治的106例PCOS不孕症(肾阳虚证)患者作为研究对象,按随机数表法分为对照组和研究组各53例。对照组患者采用促排卵治疗,研究组患者采用补肾助孕方联合促排卵治疗,两组患者均治疗3个月经周期。治疗后比较两组患者的治疗效果,以及治疗前后的中医证候积分、子宫内膜容受性评分、肠道菌群指标(乳酸杆菌数量、双歧杆菌数量、肠杆菌数量、肠球菌数量)、性激素[促黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E2)]、胰岛素抵抗指数(HOMA-IR)和生化指标(CTRP3、CTRP9、CTRP12),同时比较两组患者治疗期间的不良反应发生率。治疗结束后随访1年,比较两组患者的妊娠情况。结果研究组患者的治疗总有效率为90.57%,明显高于对照组的75.47%,差异有统计学意义(P<0.05)。治疗前,两组患者的腰膝酸软、月经紊乱、头晕耳鸣、畏寒积分及子宫内膜容受性评分比较差异均无统计学意义(P>0.05);治疗后两组患者的腰膝酸软、月经紊乱、头晕耳鸣、畏寒积分均低于治疗前,子宫内膜容受性评分均高于治疗前,且研究组腰膝酸软、月经紊乱、头晕耳鸣、畏寒积分分别为(1.96±0.31)分、(2.18±0.25)分、(2.08±0.26)分、(0.86±0.15)分,明显低于对照组的(2.64±0.36)分、(2.76±0.30)分、(2.71±0.24)分、(1.17±0.19)分,差异均有统计学意义(P<0.05),但两组患者治疗后的子宫内膜容受性评分比较差异无统计学意义(P>0.05)。治疗前,两组患者的乳酸杆菌、双歧杆菌、肠杆菌、肠球菌数量比较差异均无统计学意义(P>0.05);治疗后对照组患者的肠道菌群数量与治疗前比较差异无统计学意义(P>0.05);治疗后�Objective To observe the efficacy of Bushen Zhuyun Formula combined with ovulation induction in treating infertility due to polycystic ovary syndrome(PCOS;Kidney-Yang deficiency syndrome)and to explore its ef-fects on endocrine-metabolic indices,C1q/tumor necrosis factor-related proteins(CTRPs),gut microbiota,and pregnan-cy rates.Methods A total of 106 PCOS infertility patients(Kidney-Yang deficiency syndrome)admitted to Nanyang Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were selected and randomly divided into a control group(n=53,ovulation induction alone)and a study group(n=53,ovulation induction combined with Bushen Zhuyun Formula).Both groups were treated for three menstrual cycles.Post-treatment comparisons included therapeutic efficacy,TCM syndrome scores,endometrial receptivity scores,gut microbiota(Lactobacillus,Bifidobacterium,Entero-bacteria,Enterococcus counts),sex hormones(LH,FSH,E2),insulin resistance index(HOMA-IR),biochemical markers(CTRP3,CTRP9,CTRP12),and adverse reaction rates.A 1-year follow-up was performed to assess pregnancy out-comes.Results The total effective rate of treatment in the study group was 90.57%,which was significantly higher than 75.47%in the control group(P<0.05).Before treatment,there was no significant difference in the scores of sore-ness and weakness of the waist and knees,menstrual disorders,dizziness and tinnitus,and cold intolerance between the two groups(P>0.05).After treatment,the scores of soreness and weakness of the waist and knees,menstrual disor-ders,dizziness and tinnitus,and fear of cold in both groups were lower than those before treatment,and the endometri-al receptivity scores were higher than those before treatment.The scores of soreness and weakness of the waist and knees,menstrual disorders,dizziness and tinnitus,and fear of cold in the study group were(1.96±0.31)points,(2.18±0.25)points,(2.08±0.26)points,and(0.86±0.15)points,respectively,which were significantly lower than(2.64±0.36)points,(2.76±0.30)points,(2.71±0.24)

关 键 词：多囊卵巢综合征 不孕症 肾阳虚证 补肾助孕方 C1q肿瘤坏死因子相关蛋白 肠道菌群 妊娠率 

分 类 号：R711.75[医药卫生—妇产科学]