三促汤联合绒促性素对FM/TE不孕症患者排卵率、妊娠率的影响及对临床疗效的探究

Study on effect and clinical efficacy of Sancu Decoction combined with HCG on ovulation rate and pregnancy rate in FM/TE infertility patients

关键词:  不孕症  三促汤  绒促性素  卵泡发育不良  薄型子宫内膜  排卵率  妊娠率

Key words:  infertility  Sancu Decoction  HCG  follicular dysplasia  thin endometrium  ovulation rate  pregnancy rate

摘要:

[目的] 探究三促汤联合绒促性素对卵泡发育不良（FM）/薄型子宫内膜（TE）不孕症患者排卵率、妊娠率的影响及对临床的疗效。[方法] 选取广西中医药大学附属瑞康医院2022年7—10月于门诊就诊的105例不孕症患者为研究对象，随机数字表法将105例患者分为35例中药组，35例西药组和35例试验组。中药组：促卵泡汤+促排卵汤+促黄体汤；西药组：克罗米芬（CC）+绒促性素（HCG）2 000 IU肌肉注射；试验组：（促卵泡汤+CC）+（促排卵汤+HCG 2 000 IU肌肉注射+促黄体汤。以此检测各组患者排卵率、妊娠率、卵泡的最大直径、子宫内膜的厚度、血液流变学指标、卵泡刺激素（FSH）、促黄体生成素（LH）、雌二醇（E₂）水平、中医证候评分、临床疗效的情况变化。[结果] 与中药组、西药组比较，试验组患者排卵率、妊娠率、临床疗效升高，不良反应发生率较低（P＜0.05）。与治疗前比较，治疗后各组患者卵泡的最大直径、子宫内膜的厚度、FSH、E₂水平升高，血沉、全血低切黏度、血浆黏度、全血高切黏度、胸闷胀痛、月经不调、心烦不舒、易怒烦躁、小腹胀痛、乳房胀痛评分降低（P＜0.05），与中药组、西药组治疗后比较，试验组患者治疗后卵泡的最大直径、子宫内膜的厚度、FSH、E₂有所上升（P＜0.05），治疗后试验组患者血沉、全血低切黏度、血浆黏度、全血高切黏度、胸闷胀痛、月经不调、心烦不舒、易怒烦躁、小腹胀痛、乳房胀痛评分及总积分降低（P＜0.05），而LH表达差异无统计学意义（P＞0.05）。[结论] 通过使用三促汤联合HCG治疗，可有效改善患者妊娠率及排卵率，调节机体性激素及血液流变学相关指标水平，提高临床疗效。

Abstract:

[Objective] To explore the effect of Sancu Decoction combined with HCG on ovulation rate and pregnancy rate in infertile patients with follicular maldevelopment（FM）/thin endometrium（TE）. [Methods] The 105 infertility patients treated in the Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine outpatient clinic from July to October 2022 were selected as the study objects, and 105 patients were divided into 35 traditional Chinese medicine group, 35 Western medicine group and 35 experimental group by random number table method. Traditional Chinese medicine group：Promoting Ovulation Decoction+Promoting Ovulation Decoction+Luteinizing Body Decoction. Western medicine group：clomiphene cltrate（CC）+human chorionic gonadotropin（HCG） 2000 units intramuscular injection. Experimental group：（Ovulation Promoting Decoction+CC）+（Ovulation Promoting Decoction+HCG 2000 units intramuscular injection）+Luteinizing Decoction. In this way，the changes of ovulation rate，pregnancy rate，maximum diameter of follicles，endometrial thickness，blood rheological index，follicle stimulating hormone（FSH），luteinizing hormone（LH），estradiol（E₂） level，traditional Chinese medicine syndrome score，and clinical efficacy were tested in each group of patients. [Results] Compared with the Chinese medicine group and Western medicine group，the ovulation rate，pregnancy rate and clinical efficacy of the experimental group were increased，and the incidence of adverse reactions was lower（P＜0.05）. Compared with pre-treatment，the maximum diameter of follicles，endometrial thickness，FSH，E₂ levels increased，blood sedimentation，whole blood low resection viscosity，plasma viscosity，chest tightness，irregular menstruation，upset，irritability，abdominal distension pain，breast pain score decreased（P＜0.05）. Compared with traditional Chinese medicine and Western medicine group，the maximum diameter，endometrial thickness，FSH，E₂，increased（P＜0.05）.blood sinking，low blood viscosity，plasma viscosity，high viscosity，chest tightness，menstruation，upset，irritability，abdominal distension，breast pain and total integral score decreased（P＜0.05）. However，there was no significant difference in LH expression（P＞0.05）. [Conclusion] Through the use of Sancu Decoction combined with HCG for treatment，it can effectively improve the pregnancy rate and ovulation rate of patients，adjust the level of sex hormones and blood rheology related indicators，so as to improve the clinical efficacy.