摘要
目的:探讨不同中医证候反复种植失败(RIF)的临床特征和临床结局,为中药辅助治疗RIF提供辨证依据。方法:收集2017年3月至2019年6月中国科学技术大学附属第一医院(安徽省立医院)生殖中心行体外受精/卵胞浆内单精子显微注射-胚胎移植(IVF/ICSI-ET)的268例RIF患者,分析调查RIF患者的中医证候特征,并比较不同中医证候RIF患者临床特征和妊娠结局。结果:经调查分析后最终确定7类符合临床的中医证候类型,分别为肾虚证、肝郁证、血瘀证、脾虚证、痰湿证、血热证、湿热证。不同中医证候间的卵泡刺激素(FSH)、雌二醇(E2)水平比较,差异无统计学意义;黄体生成素(LH)、睾酮(T)在肾虚证中显著高于其他证候类型(P<0.05);肝郁证PRL显著高于其他证候类型(P<0.05);抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(Aβ2-GP1)、D-二聚体(D-D)、同型半胱氨酸(Hcy)异常的RIF患者中血瘀证所占比例显著偏高(P<0.05);糖耐量减低、胰岛素抵抗RIF患者脾虚证和痰湿证所占比例显著较高(P<0.05)。肾虚证生化妊娠率、胚胎种植率及临床妊娠率显著低于肝郁证及血瘀证(P<0.05)。结论:基础性激素LH、T、PRL及ACA、Aβ2-GP1、Hcy、D-D异常的RIF患者的中医证候类型存在差异,肾虚证RIF患者临床妊娠率明显低于血瘀证及肝郁证。
Objective: To investigate the clinical characteristics and pregnancy outcomes of patients with recurrent implantation failure with different TCM syndromes, and to provide syndrome differentiation basis for the adjuvant treatment of RIF with TCM. Methods: From March 2017 to June 2019, 268 RIF patients who were assisted with IVF/ICSI-ET in the reproductive center of The First Affiliated Hospital of USTC(Anhui Provincial Hospital) were collected. Analyze and investigate the TCM syndrome characteristics of RIF patients, and compare the clinical characteristics and pregnancy outcomes of RIF patients with different TCM syndromes. Results: The syndrome types of RIF patients are mainly kidney deficiency, liver depression, blood stasis, spleen deficiency, phlegm dampness, blood heat, damp heat. There was no significant difference in the levels of FSH and E2 between different TCM syndromes;LH and T in kidney deficiency syndrome were significantly higher than other syndromes(P<0.05);PRL of RIF patients with liver depression syndrome was significantly higher than that of other syndrome types(P<0.05);The proportion of blood stasis in RIF patients with abnormal ACA, Aβ2-GP1, Hcy and D-Dimer was significantly higher(P<0.05);The proportion of spleen deficiency syndrome and phlegm dampness syndrome in patients with impaired glucose tolerance and insulin resistance was significantly higher(P<0.05);The biochemical pregnancy rate, embryo implantation rate and clinical pregnancy rate of RIF patients with kidney deficiency syndrome were significantly lower than those of patients with liver stagnation syndrome and blood stasis syndrome(P<0.05). Conculsion: There are differences in TCM syndrome types of RIF patients with abnormal LH, T, PRL, ACA, Aβ2-GP1, Hcy and D-Dimer. The pregnancy rate of RIF patients with kidney deficiency syndrome was lower than that of patients with blood stasis syndrome and liver depression syndrome.
作者
刘芬
吴丽敏
刘雨生
栾红兵
王岩石
LIU Fen;WU Li-min;LIU Yu-sheng;LUAN Hong-bing;WANG Yan-shi(The First Affiliated Hospital of USTC(Anhui Provincial Hospital),Hefei 230001,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2021年第7期4412-4416,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金面上项目(No.81971446,No.81373671)。
关键词
反复种植失败
中医证候
临床特征
妊娠结局
不孕
Recurrent implantation failure
TCM syndrome
Clinical features
Pregnancy outcome
Infertility
作者简介
通信作者:吴丽敏,安徽省合肥市庐阳区庐江路17号中国科学技术大学附属第一医院(安徽省立医院),邮编:230001,电话:0551-62283165,Е-mаіІ:wuliminmail@126.com。
