解郁育胞丸对107例肝郁型不明原因不孕患者子宫内膜容受性及妊娠的影响

目的：观察解郁育胞丸对肝郁型不明原因不孕患者子宫内膜容受性及妊娠率的影响。方法：采用随机数字法将107例就诊的肝郁型不明原因不孕患者分为2组，治疗组54例和对照组53例。治疗组于月经第5 d起口服解郁育胞丸30粒/次，3次/d，连续服用21 d；同时于经第5 d起口服克罗米芬，50 mg/次，1次/d，连用5 d。对照组单用克罗米芬，用法同治疗组。两组均治疗3个月经周期。观察两组患者肝郁症候评分，子宫内膜血流、内膜厚度、内膜形态类型，妊娠率及用药安全性。结果：（1）肝郁症候评分：治疗组治疗后积分（2.1±0.6）较对照组（5.1±0.6）明显降低（P<0.01），两组间总积分下降指数有明显差异（P<0.01）。（2）子宫内膜血流：治疗后治疗组患者子宫内膜螺旋动脉PI（1.99±0.29）较对照组（1.47±0.32）相比有显著提高（P<0.05）；治疗后两组RI无明显差异。（3）内膜厚度及形态类型：治疗后治疗组患者的子宫内膜厚度与对照组相比无明显差异（P>0.05），治疗组患者内膜类型以A型为主，对照组内膜类型以B型为主，Salle评分显示治疗组（16.54±2.09）明显优于对照组（11.36±2.33），差异有显著统计学意义（P<0.01）。（4）妊娠率：治疗组患者周期妊娠率8.39%，临床妊娠率24.07%，妊娠数13例，均较对照组有显著差异（P<0.05）。（5）安全性：治疗过程中除治疗组1例患者出现恶心，腹痛，腹泻症状外，其余患者未见明显副作用。结论：解郁育胞丸无明显毒副作用，能够减轻患者肝郁症状，对子宫内膜厚度、内膜A型率及Salle评分具有明显改善，提高PI指数，提高周期妊娠率和临床妊娠率。解郁育胞丸通过改善不孕患者的子宫内膜容受性，促进受精卵着床，从而提高妊娠率。

Impact of Jieyuyubao pills on endometrial receptivity and pregnancy rate of in 107 cases of unexplained infertility with stagnation of liver-QI

OBJECTIVE To observe impact of Jieyuyubao pills on endometrial receptivity and pregnancy rate in unexplained infertility patients with stagnation of liver-QI.METHODS A total of 107 cases of unexplained infertility with stagnation of liver-QI were divided into two groups by using random number method, 54 cases in treatment group and 53 cases in control group. From the fifth day of menstruation, patients in treatment group received 30 pills tid for 21days, and orally received clomiphene citrate since the fifth day of menstruation at 50mg qd for 5 days. Patients in control group received clomiphene citrate by using the same method. Patients of both groups were treated for 3 menstrual periods. Stagnation of liver-QI symptom scores, endometrial blood flow, endometrial thickness, endometrial morphological types, pregnancy and drug safety were observed.RESULTS (1)Stagnation of liver-QI score: treatment group had significantly lower score (2.1±0.6) than control group (5.1±0.6) (P<0.01), and the two groups had significant difference in decrease of total score (P<0.01). (2)Endometrial blood flow: after treatment, PI of endometrial spiral arteries in treatment group (1.99±0.29) was significantly increased compared to control group (1.47±0.32) (P<0.05). No significant difference was observed in RI between two groups after treatment. (3)Endometrial thickness and morphologies: after treatment, no significant difference was observed in endometrial thickness between treatment group and control group (P>0.05). Patients mainly had type A endometrium in treatment group and type B endometrium in control group, Salle score showed that treatment group (16.54±2.09) was significantly superior to control group (11.36±2.33) (P<0.01). (4)Pregnancy: patients had a cycle pregnancy rate of 8.39% and clinical pregnancy rate of 24.07% in treatment group with, 13 patients had pregnancy, all of them showed significant difference (P<0.05). (5)Security: except 1 patient in treatment group suffered from nausea, abdominal pain and diarrhea, no patient showed significant side effects.CONCLUSION Jieyuyubao pills have no significant side effects, can reduce symptoms in patients with stagnation of liver-QI, improve endometrial thickness, endometrial type A rate and Salle scores, improve PI index, cycle pregnancy rate and clinical pregnancy rate. Jieyuyubao pills can improve pregnancy rate by improving endometrial receptivity to promote implantation.