本文選題：三維能量多普勒超聲 + 多囊卵巢綜合征�。� 參考：《廣州中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:1.運用三維能量多普勒超聲觀察卵巢血流和卵泡發(fā)育情況,定量評估滋腎育胎丸對PCOS患者卵泡發(fā)育及卵巢血流灌注的調(diào)節(jié)作用。2.通過對比治療前后各參數(shù)的變化,探討滋腎育胎丸具有改善PCOS患者卵泡發(fā)育及卵巢血流灌注的臨床療效,為滋腎育胎丸在臨床上的推廣應用提供更確切、直接的影像學依據(jù)。方法:1.27名PCOS患者及20名月經(jīng)正常的健康婦女進行經(jīng)陰道三維能量多普勒超聲檢查,記錄卵巢體積(OV)、卵巢數(shù)目(FN)及卵巢間質(zhì)動脈血流參數(shù)(VI、FI、VFI),結合實驗室性激素水平的檢查,分析比較兩組各參數(shù)的差異。2.在前期研究的基礎上,采取自身前后對照的研究方法,給予納入研究的27例PCOS患者滋腎育胎丸治療6個月經(jīng)周期,并運用三維能量多普超聲觀察治療前后各指標的變化,評估療效。結果:1.治療前PCOS組與正常組結果分析1.1二維超聲特征:PCOS組卵巢體積、卵泡數(shù)顯著高于正常對照組,而最大卵泡直徑則小于正常組,差異有顯著統(tǒng)計學意義(P0.01)。1.2卵巢間質(zhì)動脈三維能量多普勒超聲血流參數(shù):VI、VFI在PCOS組顯著高于正常組,差異有統(tǒng)計學意義(P＜0.05);兩組間FI無明顯差異性(P0.05)。1.3性激素水平:PCOS組血清LH、PRL、T水平以及LH/FSH比值顯著高于正常組,差異有顯著統(tǒng)計學意義(P＜0.0001,P=0.002,P=0.001,P0.05)。兩組血清FSH、E2.P水平無明顯差異(P＞0.05)。1.4各參數(shù)間的相關性:PCOS組卵巢內(nèi)卵泡數(shù)與LH、LH/FSH比值呈正相關(r=0.631,r=0.543,P0.05),正常組與LH、LH/FSH無顯著相關(r=0.123,r=0.102,P0.05)。PCOS 組 VI、VFI 與 LH、LH/FSH 水平均呈正相關(r=0.884,r =0.711;r=0.919,r=0.639,P0.05),正常組則與其無顯著相關(r=0.745,r=0.696;r=0.115,r=0.039,P0.05)。2.治療后PCOS組自身前后對照2.1二維超聲改變:治療后PCOS組卵巢體積縮小,卵泡數(shù)減少,可見增大卵泡。PCOS組治療后OV、FN均低于治療前,最大卵泡直徑明顯大于治療前,差異有統(tǒng)計學意義(P0.05)。2.2血流參數(shù)變化:治療后PCOS組患者卵巢間質(zhì)動脈V1、VFI值較治療前均顯著降低,差異有顯著統(tǒng)計學意義(P0.01);治療前后FI無明顯變化,差異無統(tǒng)計學意義(P0.05)。2.3性激素水平方面:治療后PCOS組血清LH、PRL、T水平及1H/FSH低于治療前,差異有統(tǒng)計學意義(P＜0.05)。治療前后血FSH、E2、P水平無顯著差異(P0.05)。結論:1.三維能量多普勒超聲可通過獲取PC0S患者卵巢血流參數(shù)VI、FI、VFI,定量評估卵巢及卵泡周圍微血管密度及血流灌注情況,可應用于滋腎育胎丸治療PCOS的療效評估。2.血清LH、LH/FSH、T、PRL等激素水平是影響卵巢及卵泡血流灌注的重要因素,與卵巢血流參數(shù)VI、FI、VFI存在一定的相關性。3.滋腎育胎丸能改善腎虛型PC0S患者的內(nèi)分泌環(huán)境,通過降低血清LH、LH/FSH、T、PRL水平,改善卵巢及卵泡周圍血流灌注,有助于促進卵巢排卵功能的恢復。
[Abstract]:Purpose 1. Three-dimensional power Doppler ultrasound was used to observe the ovarian blood flow and follicle development, and to evaluate quantitatively the regulating effect of Zishen Yueye pill on follicular development and ovarian blood perfusion in PCOS patients. By comparing the changes of parameters before and after treatment, we discussed the clinical effect of Zishenyufeiwan on improving follicular development and ovarian blood perfusion in patients with PCOS, and provided a more accurate and direct imaging basis for the clinical application of Zishenyufeiwan. Methods Twenty one hundred and twenty-seven patients with PCOS and 20 healthy women with normal menstruation were examined by transvaginal three-dimensional power Doppler ultrasonography. The ovarian volume and the number of ovaries were recorded. Analysis and comparison of the differences between the two groups of parameters. On the basis of previous study, 27 cases of PCOS patients were treated with Zishen Yuet pill for 6 menstrual cycles, and the changes of indexes before and after treatment were observed by using three dimensional energy Doppler ultrasound. To evaluate the curative effect. The result is 1: 1. Analysis of the results before treatment in PCOS group and normal group 1.1Ovarian volume and follicle number were significantly higher and the maximum follicle diameter was smaller in the ratio of two dimensional ultrasound than that in the normal control group, but the diameter of the largest follicle was smaller than that in the normal group. There was significant difference in blood flow parameters of three dimensional power Doppler ultrasound in the interstitial artery of ovary (P 0.01). 1.2. The blood flow parameters of VIVFI in the PCOS group were significantly higher than those in the normal group. There was no significant difference in fi between the two groups (P < 0.05), and the serum LHH PRLT level and the LH/FSH ratio in the two groups were significantly higher than those in the normal group (P < 0.0001, P < 0.002, P < 0.002) and the ratio of LH/FSH was significantly higher than that in the normal control group (P < 0.0001, P < 0.002, P < 0.002) and the ratio of LH/FSH was significantly higher than that in the normal group (P < 0.05). 涓ょ粍琛，

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