本文關(guān)鍵詞： 體外受精-胚胎移植 宮腔積液 清熱化瘀　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:體外受精-胚胎移植等輔助生育技術(shù)不斷發(fā)展,我們認(rèn)識(shí)到移植周期中的宮腔積液會(huì)使子宮內(nèi)膜的微環(huán)境發(fā)生改變,影響子宮內(nèi)膜對胚胎的容受性,降低輔助生育技術(shù)的胚胎種植率。因此,處理宮腔積液成為亟待解決的問題,在眾多處理方式中,治療效果不甚滿意等問題困擾著我們,中醫(yī)藥可發(fā)揮其優(yōu)勢,對宮腔積液的消除有一定效果。本研究應(yīng)用中醫(yī)藥清熱化瘀法輔助治療體外受精-胚胎移植過程中移植周期的宮腔積液,提高子宮內(nèi)膜容受性,進(jìn)而降低移植周期取消率、提高臨床妊娠率。方法:本研究的研究對象為行體外受精-胚胎移植助孕的患者,就診時(shí)間段為2015年3月至2016年12月,年齡在22歲～42歲之間,凍融胚胎移植周期中陰道B超診斷為宮腔積液的患者,共60例,隨機(jī)分為兩組:中藥聯(lián)合抽吸治療組、單純抽吸對照組,每組各30例。中藥聯(lián)合抽吸治療組:月經(jīng)周期第10～12天或激素替代治療的第10～12天,陰道B超發(fā)現(xiàn)宮腔積液,隨即在陰道B超監(jiān)視下行宮腔抽吸術(shù),術(shù)后內(nèi)服清熱化瘀中藥方至移植日停藥。單純抽吸對照組:月經(jīng)周期第10～12天或激素替代治療的第10～12天,陰道B超發(fā)現(xiàn)宮腔積液,隨即在陰道B超監(jiān)視下行宮腔抽吸術(shù)。移植胚胎日移植前復(fù)查陰道B超,觀察宮腔積液是否消失。復(fù)查陰道B超時(shí)宮腔積液消失者進(jìn)行胚胎移植,觀察兩組的移植取消率、臨床妊娠率。結(jié)果:1.治療后宮腔積液發(fā)生率的比較,治療組與對照組進(jìn)行比較有顯著性差異(P0.05)。2.兩組的移植取消率比較有顯著性差異(P0.05),臨床妊娠率比較無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.清熱化瘀療法可明顯減少宮腔積液發(fā)生率。2.清熱化瘀療法在不影響臨床妊娠率的基礎(chǔ)上,可減少移植取消率。
[Abstract]:Objective: assisted fertility techniques such as in vitro fertilization and embryo transfer have been developed. We recognize that the uterine cavity effusion in the transfer cycle will change the microenvironment of the endometrium and affect the endometrial receptivity to the embryo. Therefore, the treatment of uterine cavity effusion has become a problem to be solved urgently. Among the many ways of treatment, the treatment effect is not satisfactory and so on. Chinese medicine can play its advantage. This study used traditional Chinese medicine to clear heat and remove blood stasis in the treatment of in vitro fertilization and embryo transfer period of uterine effusion in order to improve endometrial receptivity. In order to reduce the cancellation rate of transplantation cycle and improve the clinical pregnancy rate. Methods: the study object of this study was the patients who were assisted by IVF and embryo transfer. From March 2015 to December 2016, 60 patients, aged from 22 years to 42 years old, were diagnosed as intrauterine effusion by B-ultrasound in the frozen and thawed embryo transfer cycle. They were randomly divided into two groups: the Chinese medicine combined with aspiration treatment group and the simple aspiration control group with 30 cases in each group. The Chinese medicine combined aspiration therapy group: the menstrual cycle 1012 days or the 10th day of hormone replacement therapy. Vaginal B ultrasound found intrauterine effusion, and then vaginal B-ultrasound monitoring of uterine cavity aspiration. Simple aspiration control group: menstrual cycle 10 days 12 days or hormone replacement therapy 10 days 12 days, vaginal B ultrasound found intrauterine effusion. Then the uterine cavity aspiration was performed under the monitoring of vaginal B-ultrasound. Before the embryo transfer day the vaginal B-mode ultrasound was reexamined to observe whether the uterine cavity effusion disappeared or not. The embryo transfer was carried out when the uterine cavity effusion disappeared during the re-examination of vaginal B-mode ultrasound. The transplant cancellation rate and clinical pregnancy rate of the two groups were observed. Results: 1. The incidence of intrauterine effusion was compared after treatment. There was a significant difference between the treatment group and the control group (P 0.05). 2. There was a significant difference between the two groups in the cancellation rate of transplantation (P0.05). There was no statistical difference in clinical pregnancy rate (P 0.05). Conclusion 1. The incidence of uterine effusion can be significantly reduced by removing heat and removing blood stasis. 2. The treatment of clearing heat and removing blood stasis can not affect the clinical pregnancy rate. The transplant cancellation rate can be reduced.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714.8

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