补肾调冲方对肥胖型多囊卵巢综合征不孕患者疗效及对子宫内膜容受性的影响

目的:探讨补肾调冲方对肥胖型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)不孕患者疗效及对子宫内膜容受性的影响。方法:2014年6月—2016年7月新疆维吾尔自治区中医医院共收治147例肥胖型PCOS不孕患者,以该批患者为研究对象,按随机数字表法分为治疗组(73例),对照组(74例)。对照组PCOS不孕患者给予达英-35+来曲唑治疗,治疗组在此基础上给予补肾调冲方,两组均进行3个月经周期的治疗,结束后对两组患者疗效、生殖内分泌激素水平、身体质量指数(body mass index,BMI),脂肪细胞因子以及子宫内膜容受性进行比较。结果:治疗组患者总有效率为90.41%,对照组为79.73%,治疗组优于对照组(P0.05);经过治疗后两组患者均较治疗前促黄体生成激素(luteotropic hormone,LH),卵泡刺激素(follicle-stimulating hormone,FSH),LH/FSH水平明显降低,雌二醇(estradiol,E2)水平明显升高,且治疗组患者效果优于对照组(P0.05);通过治疗,两组患者均较治疗前内脂素(visfatin,VF),瘦素(leptin,LEP),BMI水平明显降低,脂联素(adiponectin,APN)水平明显升高,且治疗组患者明显优于对照组(P0.05);经过治疗,两组患者均较治疗前子宫内膜厚度明显升高,子宫内膜螺旋动脉搏动指数(pulsatility index,PI)与阻力指数(resistance index,RI)明显降低,且治疗组效果优于对照组(P0.05)。结论:补肾调冲方对肥胖型PCOS不孕患者具有积极的治疗效果,可以调节患者生殖内分泌激素水平,降低患者体质量,改善子宫内膜容受性,治疗不孕安全有效,值得在临床上推广。

Clinical Efficacy of Bushen Tiaochong Decoction in Obesity Patients with Polycystic Ovary Syndrome and Effect on Endometrial Receptivity

Objective:To study the clinical efficacy of Bushen Tiaochong decoction in the obesity patients with polycystic ovarian syndrome (PCOS) and investigate its effect on endometrial receptivity. Method:The 147 obesity patients with PCOS treated in our hospital from June 2014 to July 2016 were selected in the study and divided into two groups according to the random number table, with 73 cases in treatment group and 74 cases in control group. Patients in control group were treated with ethinylestradiol cyproterone combined with letrozole; on this basis, patients in treatment group received additional Bushen Tiaochong decoction. Both groups were treated for 3 menstrual cycles, then the treatment efficacy, reproductive endocrine hormone levels, body mass index (BMI), fat cell factors and endometrial receptivity were compared. Result:The total effective rate was 90.41% in treatment group, higher than 79.73% in control group (P<0.05). After treatment, the levels of luteotropic hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH were significantly decreased while Estradiol (E₂) was increased in both groups, and the effect in treatment group was more obvious (P<0.05). After treatment, te levels of visfatin (VF), leptin (LEP) and BMI were significantly decreased while adiponectin (APN) was increased in both groups, and the effect was more obvious in treatment group (P<0.05). As compared with conditions before treatment, pulsatility index (PI) and resistance index (RI) were decreased in both groups after treatment, while endometrial thickness was increased, and the effect was more obvious in treatment gorup (P<0.05). Conclusion:As a safe and potential method for PCOS, Bushen Tiaochong decoction has better effect on obesity PCOS and can significantly improve reproductive endocrine hormone levels, reduce body mass, and improve endometrial receptivit.