排卵障礙性不孕患者促排卵周期應(yīng)用滋腎育胎丸聯(lián)合地屈孕酮的臨床研究
發(fā)布時(shí)間：2018-08-02 21:12
【摘要】：目的：克羅米芬作為排卵障礙性不孕癥促排卵治療的一線用藥被廣泛應(yīng)用于臨床,然而有很多研究表明在克羅米芬促排卵周期中,藥物的作用使得COS周期的內(nèi)分泌環(huán)境發(fā)生改變,影響黃體功能、子宮內(nèi)膜容受性及妊娠率。本研究通過觀察排卵障礙性不孕患者COS周期(克羅米芬+HMG)中滋腎育胎丸結(jié)合地屈孕酮對(duì)周期結(jié)局的影響,為滋腎育胎丸改善黃體功能及子宮內(nèi)膜內(nèi)環(huán)境、增加子宮內(nèi)膜容受性、提高妊娠率提供循證醫(yī)學(xué)證據(jù)。 方法：將符和納入標(biāo)準(zhǔn)與排除標(biāo)準(zhǔn)的排卵障礙性不孕癥患者隨機(jī)分為治療組(地屈孕酮+滋腎育胎丸組)、對(duì)照組(地屈孕酮組)兩組。均予CC/HMG/HCG促排卵治療,治療組于注射HCG日起予滋腎育胎丸,兩組均在HCG注射后48小時(shí)經(jīng)陰道B超檢測卵泡排出后(如發(fā)生LUFS,則予以剔除)予地屈孕酮。治療組共30例73周期,對(duì)照組共30例77周,期。比較排卵期BBT上升幅度；比較黃體中期血清E2、P水平及P/E2比值,以間接比較兩組黃體功能及子宮內(nèi)膜容受性；妊娠者比較臨床妊娠率、流產(chǎn)率及先兆流產(chǎn)癥狀積分。 結(jié)果：1.研究結(jié)果顯示,關(guān)于兩組排卵期BBT上升幅度,兩組第一個(gè)刺激周期比較并無顯著性差異(F0.05),第二、三刺激周期差異顯著,具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.對(duì)兩組黃體中期血清E2水平進(jìn)行比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療組黃體中期血清P、P/E2水平均高于對(duì)照組。兩組第二、三刺激周期比較P及P/E2有明顯差異(P0.05)。4.治療組總臨床妊娠率60%,早期流產(chǎn)率5.5%；對(duì)照組總臨床妊娠率46.6%,早期流產(chǎn)率14.2%,兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。5.對(duì)兩組先兆流產(chǎn)癥狀積分進(jìn)行比較,比較有統(tǒng)計(jì)學(xué)差別(P0.05)。 結(jié)論：地屈孕酮聯(lián)合滋腎育胎丸可以促進(jìn)黃體形成并分泌更多孕激素,改善黃體功能及子宮內(nèi)膜容受性,有利于胚胎著床；能夠有效改善先兆流產(chǎn)癥狀,提高臨床妊娠率,降低早期流產(chǎn)率。
[Abstract]:Objective: clomiphene is widely used in clinical practice as a first-line therapy for ovulation promotion in ovulatory infertility. However, many studies have shown that clomiphene promotes ovulation in the ovulation cycle. The effect of drugs on the endocrine environment of COS cycle, affecting luteal function, endometrial receptivity and pregnancy rate. In order to improve the luteal function and endometrial environment, the effect of Zishen Yu-Feiwan combined with Diproprogesterone on the outcome of COS cycle (clomiphene HMG) in infertile patients with ovulatory disorder was observed in this study. Increased endometrial receptivity and increased pregnancy rate provide evidence-based medical evidence. Methods: the infertile patients with ovulatory disorder were randomly divided into two groups: treatment group (diflexione group) and control group (diproprogesterone group). Both groups were treated with CC/HMG/HCG to promote ovulation. The treatment group was treated with Zishen Yuet Pill from the day of HCG injection. Both groups were given diproprogesterone 48 hours after HCG injection by vaginal B-ultrasound examination after follicle excretion (if LUFS was removed). There were 73 cycles in 30 cases in treatment group and 77 weeks in control group. The serum E2P level and P/E2 ratio in the middle luteal phase were compared to compare the luteal function and endometrial receptivity between the two groups, and the clinical pregnancy rate, abortion rate and symptom score of threatened abortion were compared between the pregnant women and the pregnant women. The result is 1: 1. The results showed that there was no significant difference in the first stimulation cycle between the two groups (F0. 05), but there was significant difference in the second and third stimulation cycles between the two groups (P0.05). There was no significant difference in serum E 2 levels between the two groups in the middle luteal phase (P0.05). 3. The serum levels of P P / E 2 in the middle luteal phase in the treatment group were higher than those in the control group. P and P/E2 were significantly different between the two groups in the second and third stimulation cycles (P0.05). 4. Treatment group total clinical pregnancy rate 60, early abortion rate 5.5; control group total clinical pregnancy rate 46. 6, early abortion rate 14. 2, there was no significant difference between the two groups (P0.05). 5. The symptoms of threatened abortion were compared between the two groups, the difference was statistically significant (P0.05). Conclusion: Diproprogesterone combined with Zishen Yuet pill can promote luteal formation and secretion of progesterone, improve luteal function and endometrial receptivity, facilitate embryo implantation, improve symptoms of threatened abortion and increase clinical pregnancy rate. Reduce early abortion rate.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.6
本文編號(hào)：2160741
[Abstract]:Objective: clomiphene is widely used in clinical practice as a first-line therapy for ovulation promotion in ovulatory infertility. However, many studies have shown that clomiphene promotes ovulation in the ovulation cycle. The effect of drugs on the endocrine environment of COS cycle, affecting luteal function, endometrial receptivity and pregnancy rate. In order to improve the luteal function and endometrial environment, the effect of Zishen Yu-Feiwan combined with Diproprogesterone on the outcome of COS cycle (clomiphene HMG) in infertile patients with ovulatory disorder was observed in this study. Increased endometrial receptivity and increased pregnancy rate provide evidence-based medical evidence. Methods: the infertile patients with ovulatory disorder were randomly divided into two groups: treatment group (diflexione group) and control group (diproprogesterone group). Both groups were treated with CC/HMG/HCG to promote ovulation. The treatment group was treated with Zishen Yuet Pill from the day of HCG injection. Both groups were given diproprogesterone 48 hours after HCG injection by vaginal B-ultrasound examination after follicle excretion (if LUFS was removed). There were 73 cycles in 30 cases in treatment group and 77 weeks in control group. The serum E2P level and P/E2 ratio in the middle luteal phase were compared to compare the luteal function and endometrial receptivity between the two groups, and the clinical pregnancy rate, abortion rate and symptom score of threatened abortion were compared between the pregnant women and the pregnant women. The result is 1: 1. The results showed that there was no significant difference in the first stimulation cycle between the two groups (F0. 05), but there was significant difference in the second and third stimulation cycles between the two groups (P0.05). There was no significant difference in serum E 2 levels between the two groups in the middle luteal phase (P0.05). 3. The serum levels of P P / E 2 in the middle luteal phase in the treatment group were higher than those in the control group. P and P/E2 were significantly different between the two groups in the second and third stimulation cycles (P0.05). 4. Treatment group total clinical pregnancy rate 60, early abortion rate 5.5; control group total clinical pregnancy rate 46. 6, early abortion rate 14. 2, there was no significant difference between the two groups (P0.05). 5. The symptoms of threatened abortion were compared between the two groups, the difference was statistically significant (P0.05). Conclusion: Diproprogesterone combined with Zishen Yuet pill can promote luteal formation and secretion of progesterone, improve luteal function and endometrial receptivity, facilitate embryo implantation, improve symptoms of threatened abortion and increase clinical pregnancy rate. Reduce early abortion rate.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.6
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