本文選題：中醫(yī)藥干預　切入點：IVF-ET　出處：《山東中醫(yī)藥大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：分析中醫(yī)藥干預體外受精-胚胎移植（In Vitro Fertilization and EmbryoTransfer，IVF-ET）成功分娩母親妊娠期及分娩和產后并發(fā)癥的發(fā)生率，并與我國自然妊娠流行病學數據比較，為中醫(yī)藥干預IVF-ET安全性提供臨床參考。 方法：隨機抽取2003年1月-2006年1月，2009年6月-2014年1月就診于山東中醫(yī)藥大學附屬醫(yī)院中西醫(yī)結合生殖與遺傳中心，行中醫(yī)藥干預IVF-ET并成功分娩的不孕癥患者為研究對象，共190例。分別建立《中醫(yī)藥干預IVF-ET母親健康檢查表》，登記不孕患者的聯系方式、一般情況（包括病歷號、年齡、IVF-ET指征、胚胎移植日期等相關信息）及服用中藥情況。主要通過電話對成功分娩的患者隨訪調查，登記兩大類信息：1、母親妊娠期并發(fā)癥，如：卵巢過度刺激綜合征（OvarianHyperstimulation Syndrome，OHSS）、妊娠期貧血、異位妊娠（Ectopic Pregnancy，EP）、妊娠期高血壓疾�。≒regnaney Induced Hypertension Syndrome，PIH）、妊娠期糖尿�。℅estational diabetes mellitus，GDM）、妊娠期肝內膽汁淤積癥、前置胎盤、胎盤早剝、胎膜早破、羊水過少、羊水過多、臍帶繞頸、恥骨聯合分離等并發(fā)癥；2、分娩及產后并發(fā)癥：分娩方式、分娩孕周、產后出血、產后月經改變等情況。對收集到的數據進行統計學處理，并與我國自然妊娠流行病學數據進行比較分析。 結果： 1.一般情況：單胎146例（76.84%），雙胎44例（23.15%），雙胎妊娠率符合IVF-ET的雙胎出生率（20%-30%），但高于根據自然妊娠Hellin多胎妊娠計算公式（多胎發(fā)生率為1：80n-1）所計算的結果（雙胎率1.25%）。 2.母親妊娠期并發(fā)癥：中醫(yī)藥干預IVF-ET母親宮內合并宮外妊娠的發(fā)生率為0.53%，低于IVF-ET的流行病學數據（2.1%-8.6%），但高于自然妊娠的流行病學數據（1:3889-1:30000）。中醫(yī)藥干預IVF-ET母親妊娠期合并OHSS、PIH的發(fā)病率低于流行病學數據，其中單胎與雙胎之間PIH發(fā)病率的差異無統計學意義（P0.05）。中醫(yī)藥干預IVF-ET母親與自然妊娠母親之間的妊娠期貧血、胎膜早破、臍帶繞頸發(fā)病率的差異有統計學意義（P0.05）。 3.分娩及產后并發(fā)癥：分娩方式中剖宮產171例（90%），早產30例（15.78%）。其中不同胎數之間剖宮產率的差異無統計學意義（P0.05）。不同胎數之間早產率的差異有統計學意義（P0.05），雙胎妊娠的早產率要高于單胎（0R0.107，95%CI0.046-0.252）。 結論： 1.中醫(yī)藥干預IVF-ET助孕患者成功分娩的子代雙胎率符合IVF-ET雙胎出生率的流行病學數據，但高于我國自然妊娠流行病學數據。 2.中醫(yī)藥干預IVF-ET母親宮內合并宮外妊娠的發(fā)生率低于IVF-ET的流行病學數據資料但高于自然妊娠流行病學資料。其中中醫(yī)藥干預IVF-ET母親妊娠期合并OHSS、PIH、妊娠期貧血、胎膜早破、臍帶繞頸的發(fā)病率低于自然妊娠流行病學數據。 3.中醫(yī)藥干預IVF-ET母親分娩的剖宮產率、早產率明顯高于我國自然妊娠流行病學數據，，其中早產率升高與雙胎妊娠率較高有相關性。
[Abstract]:Objective: to analyze the incidence of pregnancy, delivery and postpartum complications in Vitro Fertilization and Embryo transfer (IVF-ETT) intervention of traditional Chinese medicine (TCM), and compare with the epidemiological data of natural pregnancy in China. To provide clinical reference for Chinese medicine to interfere with the safety of IVF-ET. Methods: from January 2003 to January 2006, from June 2009 to June 2009, we randomly selected the infertile patients who were treated with traditional Chinese medicine (TCM) intervention in IVF-ET and delivered successfully at the Center for Reproductive and genetic Integration of traditional Chinese Medicine and Western Medicine, affiliated Hospital of Shandong University of traditional Chinese Medicine (Shandong University of traditional Chinese Medicine). A total of 190 cases were selected to establish the "Maternal Health examination form of intervention of traditional Chinese Medicine (TCM)", to register the contact information of infertile patients, general information (including medical record number, age and IVF-ET indication), Follow up the successful delivery patients by telephone, register two kinds of information: 1, pregnancy complications, such as ovarian hyperstimulation syndrome, ovarian hyperstimulation Syndrome OHSS, gestational anemia, Ectopic Pregnancy#en0#, Pregnaney Induced Hypertension SyndromeP, gestational diabetes mellitus Gestational diabetes mellitusus GDMN, intrahepatic cholestasis of pregnancy, placenta previa, placental abruption, premature rupture of membranes, oligohydramnios, amniotic fluid, amniotic fluid, umbilical cord around neck, Complications such as symphysis pubis separation, parturition and postpartum complications: mode of delivery, gestational weeks of delivery, postpartum hemorrhage, changes in postpartum menstruation, etc. And compared with the epidemiological data of natural pregnancy in China. Results:. 1. General situation: one hundred and forty-six cases with single pregnancy and 44 cases with twin pregnancy were 23.150.The twin pregnancy rate was in line with the twin birth rate of IVF-ET, but it was higher than that calculated according to the formula of Hellin multiple pregnancy of natural pregnancy (1: 80n-1) (the twin pregnancy rate was 1.25%). 2. Complications of pregnancy: the incidence of intrauterine and extrauterine pregnancy in IVF-ET mothers with TCM intervention was 0.53, which was lower than that of IVF-ET epidemiology data (2.1-8.6), but higher than that of natural pregnancy (1.3889-1: 300000.Chinese medicine interfered with pregnancy complicating IVF-ET mothers' pregnancy). The incidence of OHSS PIH was lower than that of epidemiology. There was no significant difference in the incidence of PIH between single and twin children. There was a significant difference in the incidence of pregnancy anemia, premature rupture of membranes and umbilical cord around neck between IVF-ET mothers and natural pregnant mothers by traditional Chinese medicine (TCM). 3. Delivery and postpartum complications: 171 cases of cesarean section and 30 cases of premature delivery were involved in the mode of delivery. There was no significant difference in cesarean section rate among different number of births (P 0.05). The preterm rate of pregnancy was higher than that of single pregnancy. Conclusion:. 1. The rate of twin twins in the successful delivery of IVF-ET assisted pregnancy patients with traditional Chinese medicine was in line with the epidemiological data of the birth rate of IVF-ET twins, but higher than that of natural pregnancy in China. 2. The incidence of intrauterine pregnancy associated with ectopic pregnancy in IVF-ET mothers was lower than that of IVF-ET, but higher than that of natural pregnancy. Among them, Chinese medicine intervention in IVF-ET mother pregnancy with OHSS PIH, gestational anemia, premature rupture of membranes. The incidence of umbilical cord around neck was lower than that of natural pregnancy. 3. The rate of preterm delivery of IVF-ET mothers was significantly higher than that of natural pregnancy in China, and there was a correlation between the increase of preterm delivery rate and the rate of twin pregnancy.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.8

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