摘要
目的:观察加味五子衍宗丸周期分期治疗对卵巢低反应(POR)肾虚证患者助孕结局的影响研究。方法:将104例患者按随机数字表法分为观察组和对照组各52例。两组均给予促性腺激素释放激素(GnRH)拮抗剂方案。对照组口服滋肾育胎丸,5 g/次,3次/d。观察组口服加味五子衍宗丸,于排卵前期和排卵后期进行治疗,1剂/d。两组疗程均为3个月经周期(或至临床妊娠后终止)。记录获卵数、可利用胚胎数、受精数、优质胚胎数、胚胎种植数、周期取消数和临床妊娠情况;注射人绒毛膜促性腺激素(HCG)日测量促卵泡激素(FSH),促黄体生成激素(LH),雌激素(E_(2)),抗苗勒管激素(AMH),基础窦卵泡数(AFC)和子宫内膜厚度;记录GnRH使用天数和用量,进行治疗前后肾虚证评分;记录研究期间的不良反应。结果:观察组患者获卵数、获卵率、可利用胚胎数、可利用胚胎率、优质胚胎数、优质胚胎率和受精率均高于对照组(P<0.05,P<0.01);周期取消率低于对照组,胚胎种植率、临床妊娠率均高于对照组,但差异无统计学意义;在HCG日,观察组患者FSH,FSH/LH均低于对照组(P<0.01),E_(2),AMH,AFC和子宫内膜厚度均多于对照组(P<0.01);观察组肾虚证评分低于对照组(P<0.01);Gn的使用天数和用量均少于对照组(P<0.01)。结论:加味五子衍宗丸周期分期配合GnRH拮抗剂方案治疗POR肾虚证患者,可调节内分泌激素水平,有利于促进卵泡发育,提高卵巢储备功能,增加了获卵数量,提高卵子质量,有助于改善妊娠结局,增加了辅助生殖技术助孕的成功机会,值得临床进一步的研究。
Objective:To observe the effect of modified Wuzi Yanzongwan periodic staging treatment on the outcome of assisted pregnancy in patients with poor ovarian response(POR)and kidney deficiency syndrome.Method:One hundred and four patients were randomly divided into observation group and control group,with 52 cases in each group.Both groups received gonadotropin releasing hormone(GnRH)antagonist regimen.The patients in control group additionally took Bushen Yutaiwan orally,5 g/time,3 times/day.The patients in observation group additionally took modified Wuzi Yanzongwan during pre-ovulation and postovulation periods,1 dose/day.The treatment courses were 3 menstrual cycles(or termination after clinical pregnancy)in both groups.The number of eggs obtained,the number of available embryos,the number of fertilization,the number of high-quality embryos,the number of embryos implanted,the number of cycles cancelled,and the clinical pregnancy were recorded.Human chorionic gonadotropin(HCG)was injected,and then follicle-stimulating hormone(FSH),luteinizing hormone(LH),estrogen(E_(2)),anti-Müllerian hormone(AMH),basal antral follicle count(AFC)and endometrial thickness were measured daily.The number of days and dosage of Gn used,scores of kidney deficiency syndrome were recorded before and after treatment,and the adverse reactions during the study period were recorded.Result:The number of eggs captured,rate of harvested eggs,number of available embryos,rate of available embryos,number of high-quality embryos,rate of high-quality embryos,and fertilization rate in observation group were higher than those in control group(P<0.05 or P<0.01).The cycle cancellation rate was lower than that in the control group;the embryo implantation rate and clinical pregnancy rate were superior than those in control group,but the difference was not statistically significant.The FSH level and FSH/LH ratio in observation group were lower than those in control group during HCG day(P<0.01),while E_(2),AMH,AFC and endometrial thickness were higher than those in control group(P<0.01).Simultaneously,the number of days and amount of Gn used in observation group was lower than that in control group(P<0.01).Conclusion:The Modified Wuzi Yanzongwan periodic staging treatment combined with GnRH antagonist scheme for patients with POR kidney deficiency syndrome,can regulate the level of endocrine hormones,promote follicular development,improve ovarian reserve,increase the number of eggs obtained,improve egg quality,help improve pregnancy outcomes,and increase the chances of successful pregnancy with assisted reproductive technology.It is worthy of further clinical research.
作者
纪利娜
张秀艳
梁紫影
施保柱
JI Li-na;ZHANG Xiu-yan;LIANG Zi-ying;SHI Bao-zhu(The Second Affiliated Hospital of Chengde Medical University,Chengde 067000,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2021年第14期106-110,共5页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河北省中医药管理局科研计划项目(2018051)。
关键词
卵巢低反应
肾虚证
五子衍宗丸
卵巢储备功能
周期分期论治
辅助生殖
poor ovarian response
kidney deficiency syndrome
Wuzi Yanzongwan
ovarian reserve
periodic staging treatment
assisted reproduction
作者简介
通信作者:纪利娜,主治医师,从事妇科肿瘤等妇科疾病诊疗工作,E-mail:58348398@qq.com。
