疏肝补肾汤联合双丹养血胶囊治疗多囊卵巢综合征对卵巢储备功能和受孕功能的影响

目的研究疏肝补肾汤联合双丹养血胶囊治疗多囊卵巢综合征(PCOS)对患者卵巢储备和受孕功能的影响结局。方法选取PCOS患者96例,按照门诊就诊顺序,根据单双号分为研究组和对照组,每组48例。对照组予枸橼酸氯米芬胶囊,观察组予疏肝补肾汤与双丹养血胶囊,3个月经周期为1个疗程,连续2个疗程。比较两组研究对象治疗前及治疗后卵巢储备功能[基础卵泡刺激素(bFSH)、基础雌二醇(bE2)、抗苗勒氏管激素(AMH)水平、基础窦卵泡计数(AFC)]、卵泡状况(卵泡直径、体积)、卵巢间质血流动力学指数[搏动指数(RI)、阻力指数(PI)]和随访半年受孕率及不良事件率。结果研究组排卵率77.08%,低于对照组的81.25%,但差异无统计学意义(P>0.05);受孕率72.92%高于对照组的41.67%,差异有统计学意义(P<0.05)。治疗后,研究组bFSH水平低于对照组,bE2、AMH水平高于对照组,差异均有统计学意义(P<0.05);且治疗后两组研究对象bFSH水平均低于同组治疗前,bE2、AMH水平高于同组治疗前,差异均有统计学意义(P<0.05)。治疗后,研究组卵巢体积、卵泡数量、PI水平低于对照组,优势卵泡直径、RI水平高于对照组,差异均有统计学意义(P<0.05);且治疗后研究组卵巢体积、卵泡数量、PI水平低于同组治疗前,优势卵泡直径、RI水平高于同组治疗前,差异均有统计学意义(P<0.05);治疗后对照组卵泡数量少于同组治疗前,差异均有统计学意义(P<0.05);而优势卵泡直径、RI高于同组治疗前,卵巢体积、PI小于同组治疗前,但差异无统计学意义(P>0.05)。随访半年研究组不良事件3例、发生率6.25%,对照组11例、发生率22.92%,二者比较差异有统计学意义(χ^2=4.751,P<0.05)。结论疏肝补肾汤联合双丹养血胶囊能有效改善PCOS患者卵巢储备功能,利于提高患者受孕率,且效果显著、安全可靠。

Effect of Shugan Bushen Decoction Combined with Shuangdan Yangxue Capsule on Ovarian Reserve Function and Conception Function of PCOS Patients

Objective To study the effect of Shugan Bushen Decoction combined with Shuangdan Yangxue Capsule on the ovarian reserve and conception of patients with polycystic ovary syndrome(PCOS).Methods From August 2017 to September 2018,96 patients with PCOS were divided into study group and control group according to the order of outpatient consultation,48 cases in each group.The control group was combined with clomiphene citrate capsules.The observation group was combined with Shugan Bushen Decoction and Shuangdan Yangxue Capsule.The 3-month menstrual cycle was a course of treatment for two consecutive courses.Ovarian reserve function[basal follicle stimulating hormone(bFSH),basal estradiol(bE2),anti-Mullerian hormone(AMH)level,basal sinus follicle count(AFC)],follicles conditions(follicular diameter,volume)and ovarian interstitial hemodynamics index[pulsation index(RI),resistance index(PI)]before and after treatment in both groups and pregnancy rate and adverse event rate were compared for half a year.Results The ovulation rate of the study group was 77.08%,which was lower than that of the control group(81.25%),but the difference was not statistically significant(P>0.05).The pregnancy rate was 72.92%in the study group,which was higher than that of the control group(41.67%).The difference was statistically significant(P<0.05).After treatment,the level of bFSH in the study group was lower than that in the control group,and the levels of bE2 and AMH were higher than those in the control group(P<0.05).After treatment,the bFSH levels in the two groups were lower than those before treatment.The levels of bE2 and AMH were higher than those before treatment(P<0.05).After treatment,the ovarian volume,follicle number and PI level of the study group were lower than those of the control group.The dominant follicle diameter and RI level of the study group were higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the ovarian volume,follicle number and PI level of the study group were lower than those before treatment.The dominant follicle diameter and RI level of the two groups were higher than those before treatment(P<0.05).After treatment,the number of follicles in the control group was less than that before treatment(P<0.05).The diameter of dominant follicles and RI were higher than those before treatment.The volume of ovary and PI were less than that before treatment,but there was not a statistical difference(P>0.05).During the follow-up of the study group,3 cases had adverse events in the study group and the incidence rate was 6.25%.There were 11 cases with adverse events in the control group and the incidence rate was 22.92%.The difference was statistically significant(χ^2=4.751,P<0.05).Conclusion Shugan Bushen Decoction combined with Shuangdan Yangxue Capsule can effectively improve the ovarian reserve function of PCOS,and it is beneficial to improve the conception rate of patients,and the effect is remarkable,safe and reliable.