益肾活血汤联合来曲唑用于多囊卵巢综合征促排卵治疗的临床研究(1)
【摘要】 目的：探讨肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者行益肾活血汤联合来曲唑促排卵治疗的临床效果。方法：选择笔者所在医院2016年1月-2018年6月收治的80例肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者作为研究对象，按照随机数字表法分为两组，每组40例。对照组给予来曲唑，观察组给予来曲唑联合益肾活血汤。比较两组临床疗效、排卵率、性激素水平、排卵前子宫内膜厚度、妊娠率、流产率。结果：观察组临床总有效率为90.00%，排卵率为87.50%，高于对照组的70.00%、67.50%(P<0.05);观察组基础LH低于对照组，黄体中期P、E2高于对照组(P<0.05);观察组排卵前子宫内膜厚度、妊娠率均优于对照组(P<0.05);两组均未发生流产。结论：益肾活血汤联合来曲唑在肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者治疗中效果显著。
【关键词】 多囊卵巢综合征 排卵障碍 不孕症 来曲唑 益肾活血汤
[Abstract] Objective： To investigate the clinical effect of Yishen Huoxue Decoction combined with Letrozole on ovulation promotion in infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis. Method： A total of 80 cases of infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis were selected as the study subjects from January 2016 to June 2018. According to the random number table method， patients were divided into two groups， with 40 cases in each group. The control group was given Letrozole， while the observation group was given Letrozole combined with Yishen Huoxue Decoction. The clinical efficacy， ovulation rate， sex hormone level， endometrial thickness before ovulation， pregnancy rate and abortion rate were compared between the two groups. Result： The total clinical effective rate was 90.00% and ovulation rate was 87.50% in the observation group， which were higher than 70.00% and 67.50% of the control group (P<0.05). The basal LH of the observation group was lower than that of the control group， and P and E2 in the mid-luteal phase were higher than those of the control group (P<0.05). The endometrial thickness before ovulation and pregnancy rate of the observation group were better than those of the control group (P<0.05). No abortion occurred in the two groups. Conclusion： Yishen Huoxue Decoction combined with Letrozole has a significant effect in infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis.
多囊卵巢综合征占排卵障碍性不孕症的90%，肾虚血瘀是主要病机之一[1]。多囊卵巢综合征可严重影响育齡女性的生殖健康、身心健康。来曲唑是临床常用的促排卵药物。本研究针对2016年1月-2018年6月收治的80例肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者进行前瞻性研究，探讨益肾活血汤联合来曲唑在肾虚血瘀型多囊卵巢综合征患者促排卵治疗中的应用前景。
1 资料与方法
1.1 一般资料
选择笔者所在医院2016年1月-2018年6月收治的80例肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者为研究对象。诊断标准：(1)西医多囊卵巢综合征鹿特丹诊断标准：稀发排卵或无排卵;存在高雄激素血症表现(多毛、痤疮等);超声检查显示单侧或双侧卵巢存在≥12个直径为2～9 mm的卵泡，卵巢体积>10 ml[2]。(2)肾虚血瘀型诊断标准：主症为月经稀发、经血颜色暗淡、经质稀薄、小腹疼痛;次症为面色黯斑、头晕耳鸣、口干、腰膝酸软、舌淡暗或有瘀点、脉沉细或脉弦涩。具备以上全部主症且≥3项次症即可确诊[3]。纳入标准：(1)经临床辅助检查，符合多囊卵巢综合征鹿特丹诊断标准，且排卵障碍由多囊卵巢综合征所致;(2)符合中医肾虚血瘀型诊断标准;(3)已婚、育龄期女性，夫妻性生活正常，未采取避孕措施。排除标准：(1)合并不适合妊娠的内科或外科系统疾病;(2)配偶患有不育症;(3)由免疫、子宫等因素导致不孕;(4)研究中途失访或脱落研究。按照随机数字表法分为两组，每组40例。对照组年龄21～35岁，平均(28.05±5.49)岁。观察组年龄22～36岁，平均(28.31±5.32)岁。两组一般资料对比，差异均无统计学意(P>0.05)，具可比性。研究经医学伦理学委员会批准，患者对治疗方案知情同意，签署知情同意协议。, http://www.100md.com(王锦华)
【关键词】 多囊卵巢综合征 排卵障碍 不孕症 来曲唑 益肾活血汤
[Abstract] Objective： To investigate the clinical effect of Yishen Huoxue Decoction combined with Letrozole on ovulation promotion in infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis. Method： A total of 80 cases of infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis were selected as the study subjects from January 2016 to June 2018. According to the random number table method， patients were divided into two groups， with 40 cases in each group. The control group was given Letrozole， while the observation group was given Letrozole combined with Yishen Huoxue Decoction. The clinical efficacy， ovulation rate， sex hormone level， endometrial thickness before ovulation， pregnancy rate and abortion rate were compared between the two groups. Result： The total clinical effective rate was 90.00% and ovulation rate was 87.50% in the observation group， which were higher than 70.00% and 67.50% of the control group (P<0.05). The basal LH of the observation group was lower than that of the control group， and P and E2 in the mid-luteal phase were higher than those of the control group (P<0.05). The endometrial thickness before ovulation and pregnancy rate of the observation group were better than those of the control group (P<0.05). No abortion occurred in the two groups. Conclusion： Yishen Huoxue Decoction combined with Letrozole has a significant effect in infertility patients with polycystic ovary syndrome with ovulation disorder due to kidney deficiency and blood stasis.
多囊卵巢综合征占排卵障碍性不孕症的90%，肾虚血瘀是主要病机之一[1]。多囊卵巢综合征可严重影响育齡女性的生殖健康、身心健康。来曲唑是临床常用的促排卵药物。本研究针对2016年1月-2018年6月收治的80例肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者进行前瞻性研究，探讨益肾活血汤联合来曲唑在肾虚血瘀型多囊卵巢综合征患者促排卵治疗中的应用前景。
1 资料与方法
1.1 一般资料
选择笔者所在医院2016年1月-2018年6月收治的80例肾虚血瘀型多囊卵巢综合征排卵障碍性不孕症患者为研究对象。诊断标准：(1)西医多囊卵巢综合征鹿特丹诊断标准：稀发排卵或无排卵;存在高雄激素血症表现(多毛、痤疮等);超声检查显示单侧或双侧卵巢存在≥12个直径为2～9 mm的卵泡，卵巢体积>10 ml[2]。(2)肾虚血瘀型诊断标准：主症为月经稀发、经血颜色暗淡、经质稀薄、小腹疼痛;次症为面色黯斑、头晕耳鸣、口干、腰膝酸软、舌淡暗或有瘀点、脉沉细或脉弦涩。具备以上全部主症且≥3项次症即可确诊[3]。纳入标准：(1)经临床辅助检查，符合多囊卵巢综合征鹿特丹诊断标准，且排卵障碍由多囊卵巢综合征所致;(2)符合中医肾虚血瘀型诊断标准;(3)已婚、育龄期女性，夫妻性生活正常，未采取避孕措施。排除标准：(1)合并不适合妊娠的内科或外科系统疾病;(2)配偶患有不育症;(3)由免疫、子宫等因素导致不孕;(4)研究中途失访或脱落研究。按照随机数字表法分为两组，每组40例。对照组年龄21～35岁，平均(28.05±5.49)岁。观察组年龄22～36岁，平均(28.31±5.32)岁。两组一般资料对比，差异均无统计学意(P>0.05)，具可比性。研究经医学伦理学委员会批准，患者对治疗方案知情同意，签署知情同意协议。, http://www.100md.com(王锦华)
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