中西医结合治疗卵巢功能低下性不孕症的临床疗效

 目的 观察中西医结合治疗卵巢功能低下性不孕症患者的临床疗效。方法 收集2016年2月至2017年12月在复旦大学附属妇产科医院就诊的不孕症患者，根据纳入标准筛选出符合条件的卵巢功能低下性不孕症患者316例，根据治疗方法不同分为3组：中药治疗（TCM）组（n=115）、西药治疗（WM）组（n=50）和中西医结合治疗（ITCWM）组（n=151）。3组均连续治疗6个月经周期，疗程结束后观察3组患者治疗前后中医证候积分、基础血清卵泡刺激素（follicule-stimulating hormone，FSH）、黄体生成素（luteinizing hormone，LH）、FSH/LH、雌二醇（estradiol，E₂）、睾酮（testosterone，T）水平的改变，并统计3组患者治疗后的成功妊娠率。结果 3组患者治疗前年龄、中医证候积分、基础血清FSH、LH、FSH/LH、T、E₂水平差异均无统计学意义。3组患者治疗后中医证候积分、血清FSH水平、FSH/LH均显著低于治疗前（P<0.05），血清T水平显著高于治疗前（P<0.05）。3组患者治疗后组间比较，ITCWM组中医证候治疗总有效率明显高于TCM组、WM组（P<0.05）；ITCWM组血清FSH、FSH/LH水平下降较TCM组、WM组明显（P<0.05）；血清T、E₂水平上升较TCM组、WM组明显（P<0.05）；ITCWM组成功妊娠率明显高于TCM组及WM组（P<0.05）。结论 中西医结合治疗卵巢功能低下性不孕症疗效明显。血清T水平可以在一定程度上反映卵巢功能，可以作为评价卵巢功能的一个重要指标。

Clinical research on the effect of integrated traditional Chinese and Western medicine in treatment of infertile patients with diminished ovarian reserve function

Objective To observe the clinical effect of integrated traditional Chinese and Western medicine in treatment of infertile patients with diminished ovarian reserve function. Methods Total 316 infertile patients with diminished ovarian reserve function were chosen according to the standards in the Obstetrics and Gynecology Hospital,Fudan University from Feb.2016 to Dec.2017.According to the different treatment,the patients were divided into traditional Chinese medicine (TWM) group (n=115),Western medicine (WM) group (n=50),integrated traditional Chinese and Western medicine (ITCWM) group (n=151).After 6 months' treatment,the 3 groups of patients' TCM syndrome score, serum follicule-stimulating hormone (FSH),luteinizing hormone (LH),FSH/LH,estradiol (E₂) and testosterone (T) levels before and after treatment were observed.The pregnancy rates were calculated for patients in the 3 groups. Results The comparison of the 3 groups in age,TCM symptom scores,serum FSH,LH,FSH/LH,T and E₂ levels was statistically indistinguishable.After treatment,TCM symptom scores,serum FSH and FSH/LH levels were obviously declined,and serum T levels were obviously increased in the 3 groups.After treatment,the total effective rate of TCM syndrome treatment in ITCWM group was significantly higher than that in TCM group and WM group.Serum FSH and FSH/LH levels in ITCWM group declined more significantly than those in TCM group and WM group (P<0.05).Serum E₂ and T levels increased more significantly in ITCWM group than those in TCM group and WM group (P<0.05).The pregnancy rate was higher in ITCWM group than that in TCM group and WM group(P<0.05). Conclusions The curative effect of integrated Chinese and Western medicine therapy in the treatment of infertile patients with diminished ovarian reserve function was obvious.Testosterone level could reflect the ovarian function to some degree,which can be regarded as an important index estimating the ovarian reserve function.