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归芍地黄汤联合人绒毛膜促性腺激素治疗黄体功能不全性不孕症疗效观察
引用本文:杨石慧,王玮. 归芍地黄汤联合人绒毛膜促性腺激素治疗黄体功能不全性不孕症疗效观察[J]. 中华全科医学, 2020, 18(7): 1204-1206. DOI: 10.16766/j.cnki.issn.1674-4152.001465
作者姓名:杨石慧  王玮
作者单位:河南中医药大学第三附属医院康复科;
基金项目:浙江省中医药科技计划项目(2016ZQ030)
摘    要:目的 探讨归芍地黄汤联合人绒毛膜促性腺激素(HCG)治疗黄体功能不全性不孕症临床疗效及对子宫内膜发育、卵巢动脉血流变参数的影响。 方法 将2017年1月—2019年3月在温州市中西医结合医院接受治疗的86例黄体功能不全性不孕症女性作为研究对象,采用随机数字法将其分为2组,每组43例,对照组进行肌注HCG治疗,观察组在对照组治疗基础上再给予归芍地黄汤进行治疗,2组均治疗1个疗程,疗程结束随访3个月。比较2组临床疗效及症状评分、子宫内膜厚度及卵泡发育情况、卵巢动脉血流变参数变化(搏动指数、阻力指数、舒张期最低流速及收缩期峰值流速)。 结果 治疗后,观察组总有效率(95.34%)高于对照组(79.07%,χ2=5.108,P=0.024);治疗后,2组子宫内膜厚度增加、主卵泡直径增大(均P<0.05),且观察组子宫内膜厚度、主卵泡直径改善程度更显著(P<0.05);治疗后,2组搏动指数(PI)、阻力指数(RI)、舒张末期流速(EDV)及收缩期峰值流速(PSV)均得到改善(均P<0.05),且观察组改善程度明显优于对照组(P<0.05)。 结论 采用归芍地黄汤联合人绒毛膜促性腺激素治疗黄体功能不全性不孕症疗效显著,患者临床症状显著改善,改善下丘脑-垂体-卵巢轴的调节功能,增加子宫内膜厚度、有效调节卵泡发育及卵巢动脉血流参数。 

关 键 词:黄体功能不全   人绒毛膜促性腺激素   归芍地黄汤   子宫内膜厚度   激素水平   卵巢动脉血流参数
收稿时间:2019-07-09

The clinical efficacy of Yellow soup of paeoniae combined with human chorionic gonadotropin in the treatment of female infertility caused by luteal phase defect
Affiliation:Department of Traditional Chinese Medicine Gynecology, Wenzhou Integrated Traditional Chinese and Western Medicine Hospital, Wenzhou, Zhejiang 325000, China
Abstract:Objective To explore the clinical efficacy of Yellow soup of paeoniae combined with human chorionic gonadotropin in the treatment of female infertility caused by luteal phase defect and its influence on endometrial development, hormone levels and ovarian arterial blood rheology parameters. Methods Eighty-six cases of luteal infertility women treated in Wenzhou City Hospital of Integrated Traditional Chinese and Western Medicine, from January 2017 to March 2019, were divided into 2 groups by random number method, 43 cases in each group. The main follicles were detected human chorionic gonadotropin, and the observation group was given the treatment of Yellow soup of paeoniae and human chorionic gonadotropin. The two groups were treated for one course of treatment, and the treatment was followed for three months. After treatment, the clinical efficacy and symptom score, endometrial thickness and changes of hormone levels in ovarian arterial blood rheology parameters (pulsation index, resistance index, end-diastolic velocity and peak systolic velocity) between observation group and control group were compared. Results After treatment, the total effective rate of the control group was 79.07%, the total effective rate of the observation group was over 95.34%, and the total effective rate of the observation group was higher than that of the control group (χ2=5.108, P=0.024). The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the uterus thickness and main follicle diameter of both groups were significantly increased (all P<0.05), and the endometrial thickness and main follicle diameter of the observation group were significantly higher than the control group (P<0.05). After treatment, the pulsation index, end-diastolic velocity and peak systolic velocity of the two groups were improved (all P<0.05), and the improvement degree of the observation group was significantly better than that of the control group (P<0.05). Conclusion The use of Yellow soup of paeoniae combined with human chorionic gonadotropin in the treatment of luteal phase defect infertility has a significant effect. The clinical symptom score is significantly improved, the regulation function of the hypothalamic-pituitary-ovarian axis is improved, and the function of the corpus luteum and endometrial thickness are improved, effective regulation ovarian artery blood flow parameters. 
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