补肾促排卵汤治疗体外受精-胚胎移植助孕的PCOS肾虚证患者的临床研究

目的 观察补肾促排卵汤对体外受精-胚胎移植（IVF-ET）助孕的多囊卵巢综合征（PCOS）肾虚证患者的临床疗效及对血清性激素水平的影响。方法 入组50例行黄体期长方案IVF-ET助孕的PCOS肾虚证患者，其中治疗组和对照组各25例，治疗组使用补肾促排卵汤及生活指导3个周期后进入黄体期长方案IVF-ET周期，对照组生活指导3个周期后进入黄体期长方案IVF-ET周期。观察治疗组及对照组干预前后血清抗苗勒管激素（AMH）、睾酮（T）、促黄体生成素（LH）、体质量指数（BMI）、痤疮及多毛积分、中医证候积分的变化；比较IVF-ET结束后2组的获卵数、促性腺激素（GN）总量、GN天数、双原核受精（2PN）率、2PN卵裂率、优质胚胎率、中重度卵巢过度刺激综合征（OHSS）发生率、冻胚移植（FET）临床妊娠率以及早期流产率。结果 治疗组经过治疗后，血清AMH、T、LH水平较治疗前明显下降，痤疮多毛积分与治疗前比较明显好转，中医证候积分较治疗前明显下降，均有统计学差异（P<0.01）。治疗组GN天数及GN总量低于对照组，治疗组2PN率、卵裂率、优质胚胎率高于对照组，均具有统计学意义（P<0.01）。治疗组OHSS发生率低于对照组，FET临床妊娠率高于对照组，早期流产率低于对照组，有统计学差异（P<0.05）。结论 补肾促排卵汤可有效改善PCOS患者基础内分泌激素，改善卵子质量，提高优质胚胎率，提高临床妊娠率及降低流产率，降低GN使用天数及总量，降低OHSS发生率。 

Clinical Study of Bushen Cupailuan Decoction in the Treatment of Polycystic Ovarian Syndrome Patients with Kidney Deficiency Symptom in vitro Fertilization-Embryo Transfer

OBJECTIVE To observe the clinical effect of Bushen Cupailuan decoction on polycystic ovarian syndrome (PCOS) patients with kidney deficiency symptom in vitro fertilization-embryo transfer (IVF-ET). METHODS 50 PCOS patients with kidney deficiency symptom who were given long protocol in luteal phase with IVF-ET were enrolled. They were divided into the treatment group and the control group， with 25 cases each group. The treatment group was given Bushen Cupailuan decoction and life guidance for three cycles， followed by the cycle of long protocol in luteal phase with IVF-ET. The control group was given a three-cycle life guidance before the cycle of long protocol in luteal phase with IVF-ET. The serum anti-mullerian hormone (AMH)， testosterone (T)， luteinizing hormone (LH)， body mass index (BMI)， acne and hirsutism score， and traditional Chinese medicine (TCM) syndrome score in the two groups were observed. After IVF-ET， the number of ovums harvested， total gonadotropin (GN)， GN days， 2PN rate， 2PN cleavage rate， high qualified embryo rate， moderate and severe ovarian hyperstimulation syndrome (OHSS) rate， frozen embryo transfer (FET) clinical pregnancy rate and early miscarriage rate were compared. RESULTS After treatment， as for the treatment group， the levels of serum AMH， T， LH and TCM syndrome score decreased significantly compared with levels before treatment. The acne and hirsutism scores in the treatment group were improved significantly compared with those before treatment. The GN days and total GN were lower than those in the control group. The 2PN rate， cleavage rate， and high qualified embryo rate were higher than those in the control group， which had statitistical differences (P<0.01). The incidence of OHSS was lower than that in the control group. The clinical pregnancy rate of frozen embryo transplantation was higher than that in the control group， and the early miscarriage rate was lower than that in the control group (P<0.05). CONCLUSION In terms of PCOS patients， Bushen Cupailuan decoction can effectively improve the basic endocrine hormones， ovum quality， the embryonic rate and the clinical pregnancy rate. In addition， it can reduce the miscarriage rate， the number of days and total amount of gonadotropins and the incidence of OHSS.