女贞孕育汤治疗无排卵不孕症及其对卵巢、子宫血供和内膜受体影响临床与实验研究

Effect of Nvzhen Yunyu Decoction on Anovulatory Infertility,Blood Supply of Ovary and Uterus and Expression of Intimal Receptor

关键词:  无排卵不孕症  肾虚  女贞孕育汤  卵巢  子宫  实验研究  血管生成  受体

Key words:  anovulatory infertility  NZYYD  ovary  uterus  receptor

摘要:

[目的]探讨女贞孕育汤治疗无排卵不孕症的作用机制。[方法]1)选择肾虚型或兼血瘀证无排卵性不孕症患者45例,口服女贞孕育汤,与对照组口服克罗米芬对照,测定卵巢、子宫血流参数,阻力指数、搏动指数等。2)服女贞孕育汤的无排卵患者采静脉血,选用鸡胚绒毛尿囊膜(CAM)模型,检测女贞孕育汤促血管生成作用。3)无排卵性不孕症患者服药前后,取子宫内膜测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E₂)、孕激素(P)、催乳素(PRL)、睾酮(T)。[结果]1)治疗组、对照组妊娠率分别为55.55%、52.17%,卵巢子宫血流参数:收缩期最大血流流速(Vmax)、舒张期最小血流流速(Vmin)、时间平均血流最高流速(Tmax)排卵侧优于非排卵侧,阻力指数(RI)、搏动指数(PI)排卵倒比非排卵后降低。2)中药组、西药组在血管生成表现和形式,及血管计数方面好于对照组。3)服女贞孕育汤后卵泡增大、内膜增厚、子宫内膜雌激素受体(ER)、孕激素受体(PR)着色强度和阳性细胞数目明显高于服药前,增殖细胞核抗原(PCNA)明显增强。[结论]女贞孕育汤对肾虚型无排卵不孕症效较佳,可改善卵巢血供,促进血管的生成与子宫内膜的生长发育。

Abstract:

[Objective] To discuss the mechanism of Nvzhen Yunyu(pregnancy accelerating) decoction(NZYYD) on anovulatory infertility.[Methods] Forty-three patients with infertility in treatment group were administered by NZYYD. Twenty-three in control group were given by clomiphene. The parameters of blood flow,resistance index and pulse index were measured in ovaries and uterus. Blood samples were harvested in NZYYD administered patients to determine the effect on angipoiesis. The TSH,LH,E₂ P,PRL and T of the endometrium before and after treatment were also measured.[Reaults] The pregnancy rate of the treatment and control group was 55.55% and 52.17% respectively. The blood flow of ovaries and uterus in ovulation side was obviously superior than that of non-ovulation side. NZYYD can enlarge the volume of follicle and the thickness of endometrium,enhance the ER and PR-staining after treatment.[Conclusion] NZYYD has a better clinical effect on kidney deficiency syndrome in patients with anovulatory infertility. NZYYD may improve the blood supply of ovaries,accelerate the agiogenesis,growth and development of endometrium.