摘要
目的观察调更益经方对体外受精—胚胎移植技术(IVF-ET)中肾虚血瘀证卵巢低反应(POR)患者子宫内膜容受性和妊娠结局的影响。方法将42例POR患者随机分为治疗组21例、对照组21例,剔除脱落病例后,治疗组20例、对照组20例。治疗组自月经第7 d予口服调更益经方。连续治疗14 d,调理3个月经周期,进入下次微刺激促排卵周期。对照组无任何治疗,直接进入微刺激促排卵周期。观察种植窗子宫内膜相对灰度值,子宫内膜厚度、内膜形态、血流指数,胚胎种植率、临床妊娠率。结果治疗组治疗后子宫内膜整合素αvβ3,转化生长因子(TGF-β10),血管内皮生长因子(VEGF)蛋白表达高于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后A型子宫内膜比例、子宫内膜血流阻力指数(RI)和搏动指数(PI),与对照组比较,差异均有统计学意义(P<0.05)。治疗组治疗后临床妊娠率与对照组比较,差异有统计学意义(P<0.05),治疗组妊娠率高于对照组。结论调更益经方可改善POR患者的子宫内膜容受性,提高种植窗期子宫内膜整合素αvβ3,TGF-β1,VEGF蛋白的表达,改善POR患者子宫内膜形态,降低子宫内膜RI和PI,从而提高临床妊娠率。
Objective To observe the effect of Tiaogeng Yijing Formula on the receptivity of endometrium and pregnancy outcomes of the poor ovarian response(POR)patients with kidney deficiency and blood stasis syndrome during in vitro fertilization and embryo transfer(IVF-ET).Methods A total of 42 POR patients were randomly and equally assigned to the treatment group(21 cases)and control group(21 cases).After the withdrawals excluded,there were 20 left both in the treatment group and the control group.Patients in the treatment group received Tiaogeng Yijing Formula for 14 days of 3 consecutive menstrual cycles in addition to microstimulation from the seventh day of menstruation,while patients in the control group received no treatment for three months before undergoing microstimulation.Western blotting was used to determine integrinαvβ3,transforming growth factor-β(TGF-β1),LIF,granulocyte colony stimulating factor(G-CSF),vascular endothelial growth factor(VEGF)in the two groups during planting window phase of endometrium.Endometrial thickness,proportion of type A endometrium,blood flow index,planting rate and pregnancy rate were compared between the two groups.Results Endometrium relative grey value of planting window phase,integrinαvβ3,TGF-β1 and VEGF protein expression were significantly higher in the treatment group than in the control group(P<0.05).Proportion of type A endometrium,endometrial resistance index and pulsatility index were significantly higher in the treatment group than in the control group(P<0.05).There was a significant difference in clinical pregnancy rate between two groups(P<0.05).Conclusions Tiaogeng Yijing Formula can improve the receptivity of endometrium,upr-regulate the expressions of integrinαvβ3,TGF-β1 and VEGF protein in planting window phase of endometrium,improve the type of endometrium and decrease the blood flow index to increase embryo implantation and pregnancy rate.
作者
薛辉
曲正
任秀英
刘峰
闫倩
XUE Hui;QU Zheng;REN Xiuying;LIU Feng;YAN Qian(Department of Gynaecology,Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser Hospital),Qingdao 266000;Clinical Pharmacy,Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser Hospital))
出处
《现代中医临床》
2022年第1期5-10,共6页
Modern Chinese Clinical Medicine
基金
山东省中医药科技发展计划项目(No.2019-0595)。
关键词
调更益经方
IVF-ET
卵巢低反应
子宫内膜容受性
Tiaogeng Yijing Formula
in vitro fertilization and embryo transfer
poor ovarian response
receptivity of endometrium
作者简介
薛辉,女,博士,副主任医师;通信作者:闫倩,女,主管护士,E-mail:94197244@qq.com。
