Effects of different Chinese medicine prescriptions treating at different stages of menstrual cycle on ovarian function and pregnancy in infertile women with polycystic ovary syndrome
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摘要: 目的 探讨月经周期各阶段不同中药方剂辅助治疗对多囊卵巢综合征(PCOS)不孕患者卵巢功能、妊娠的影响。 方法 选取2013年2月-2015年2月于金华市中心医院接受治疗并符合纳入标准的90例PCOS不孕患者,按随机数字表分为对照组和联用组,各45例,2组患者均于月经周期第5天开始口服炔雌醇环丙孕酮,连续服用21 d,停药7 d后继续服药,连续使用3个月经周期。之后对照组于第4个月经周期第5 d开始服用枸橼酸盐氯米芬片,连续服用5 d,持续治疗3个月经周期;联用组在对照组的基础上按照月经周期各阶段给予不同中药方剂进行辅助治疗,观察2组患者性激素水平、中医症候积分、子宫内膜厚度、优势卵泡率、妊娠率及临床疗效。 结果 治疗后,对照组LH、T、FSH、E2水平与治疗前相比差异无统计学意义(P>0.05),观察组LH、T、E2水平均明显降低(P<0.05),FSH水平明显升高(P<0.05),且治疗后观察组各性激素水平与对照组比较,差异均具有统计学意义(P<0.05)。联用组治疗后,LH、T、E2水平均显著低于对照组(P<0.05),FSH水平显著高于对照组(P<0.05);联用组中医症候积分显著低于对照组(P<0.05),子宫内膜厚度、优势卵泡率及妊娠率显著高于对照组(P<0.05);联用组临床疗效显著高于对照组(P<0.05)。 结论 运用不同中药方剂在月经周期各阶段进行辅助治疗PCOS不孕症具有一定优势,能改善患者卵巢功能,提高妊娠率,值得临床推广应用。Abstract: Objective To observe the efficacy of different Chinese medicine prescriptions treating at different stages of menstrual cycle on ovarian function and pregnancy in infertile women with polycystic ovary syndrome. Methods Ninety patients with infertility PCOS who were diagnosed and met in our hospital from February, 2013 to February, 2015 were divided into control group (45 cases) and combined group (45 cases) according to the random number table method. Two groups of patients began oral estradiol cyproterone at 5th day of menstrual cycle, continuous taking 21 days, then stopping for 7 days, insisting on taking 3 menstrual cycle. After that, the control group started using citrate clomiphene tablets at 5th day of 4th menstrual cycle, insisting on taking 3 menstrual cycles. The combined group was supplemented by different Chinese medicine prescriptions according to menstrual cycle on the basis of the control group. The Sex hormone level, TCM syndrome score, endometrial thickness, dominant follicular rate, pregnancy rate and clinical efficacy between two groups were compared. Results After treatment, the levels of LH, T, FSH and E2 in the control group were not statistically significant compared with those before treatment (P>0.05), the levels of LH, T and E2 were significantly decreased in the observation group (P<0.05), and the FSH level was significantly increased (P<0.05), and the differences between the two groups were statistically significant (P<0.05). The clinical efficacy of the combined group was significantly higher than that of the control group (P<0.05), the endometrial thickness, the dominant follicular rate and the pregnancy rate were significantly higher than those in the control group (P<0.05). Conclusion The use of different traditional Chinese medicine prescriptions in the different stages of the menstrual cycle for the treatment of PCOS infertility has certain advantages, can improve the patients' ovarian function, improve pregnancy rate. It is worthy of clinical application.
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