滋陰補陽序貫治療聯(lián)合促排卵對PCOS不孕癥患者子宮內(nèi)膜HOXA10的調(diào)控
發(fā)布時間：2018-12-06 07:26
【摘要】：目的研究滋陰補陽序貫治療對多囊卵巢綜合征(PCOS)不孕癥患者的子宮內(nèi)膜容受性影響的臨床療效及對其子宮內(nèi)膜組織同源框基因(HOXA10)的調(diào)控。方法選取前來江蘇省中醫(yī)院生殖醫(yī)學(xué)科就診的PCOS不孕癥患者共80例,按照隨機(jī)數(shù)字表法分為治療組和對照組。對照組給予克羅米芬(clomiphene,CC)+人絕經(jīng)期促性腺激素(human menopausal gonadotropin,HMG)+人絨毛膜促性腺激素(human chorionic gonadotropin,HCG)治療,治療組給予CC+HMG+HCG+滋陰補陽序貫治療。療程均為3個周期,觀察2組患者以下指標(biāo):測量子宮內(nèi)膜增生中晚期及分泌中期子宮內(nèi)膜厚度(Em);檢測黃體中期子宮內(nèi)膜螺旋動脈搏動指數(shù)(PI)、阻力指數(shù)(RI);檢測黃體中期患者血清中雌二醇(E2)、孕酮(P)的水平;檢測黃體中期2組患者子宮內(nèi)膜組織中的HOXA10 mRNA表達(dá)情況;比較2組的臨床妊娠率、流產(chǎn)率。結(jié)果治療組與對照組比較,治療組卵泡中晚期及黃體中期Em均增加,卵泡中晚期Em 2組比較有統(tǒng)計學(xué)差異(P0.05),黃體中期Em 2組比較無統(tǒng)計學(xué)意義(P0.05);治療組與對照組比較,治療組E2及P數(shù)值均升高,有統(tǒng)計學(xué)意義(P0.05);與對照組比較,治療組PI和RI均降低,有統(tǒng)計學(xué)意義(P0.05);治療組HOXA10 mRNA表達(dá)升高,有統(tǒng)計學(xué)意義(P0.01);與對照組比較,治療組妊娠率升高,有統(tǒng)計學(xué)差異(P0.05),流產(chǎn)率降低,無統(tǒng)計學(xué)意義(P0.05)。結(jié)論滋陰補陽序貫治療可提高PCOS患者的妊娠率,降低其流產(chǎn)率,其機(jī)制可能與增加PCOS患者的HOXA10 mRNA的表達(dá),降低PCOS患者的子宮螺旋動脈PI、RI,健全黃體功能治療有關(guān),從而改善子宮內(nèi)膜容受性,值得在臨床上進(jìn)一步推廣運用。
[Abstract]:Objective to study the effect of sequential therapy of nourishing yin and nourishing yang on endometrial receptivity in (PCOS) infertility patients with polycystic ovary syndrome (PCOS) and the regulation of homobox gene (HOXA10) in endometrium. Methods A total of 80 patients with PCOS infertility were selected and divided into treatment group and control group according to the method of random digital table. The control group was treated with clomiphene (clomiphene,CC), human menopausal gonadotropin (human menopausal gonadotropin,HMG), human chorionic gonadotropin (human chorionic gonadotropin,HCG), and the treatment group was treated with CC HMG HCG. The course of treatment was 3 cycles. The following indexes were observed: (Em); was used to measure the endometrial thickness in the middle and late stage of endometrial hyperplasia and the middle phase of endometrial secretion to detect (PI), resistance index (RI);) of endometrial spiral artery pulsatility index in middle luteal phase. The levels of estradiol (E2) and progesterone (P) in serum of patients with middle luteal phase were detected. The expression of HOXA10 mRNA in endometrium of patients with middle luteal phase was detected. The clinical pregnancy rate and abortion rate were compared between the two groups. Results compared with the control group, the Em of the treatment group was increased in the late follicle and middle luteal phase, the difference between the two groups was statistically significant (P0.05), but there was no significant difference in the Em 2 group in the middle luteal phase (P0.05). Compared with the control group, the value of E2 and P in the treatment group increased significantly (P0.05); compared with the control group, the PI and RI in the treatment group decreased significantly (P0.05). Compared with the control group, the pregnancy rate of the treatment group increased, there was statistical difference (P0.05), the abortion rate decreased, there was no statistical significance (P0.05). Conclusion the sequential therapy of nourishing yin and tonifying yang can increase the pregnancy rate and decrease the abortion rate of PCOS patients. The mechanism may be related to increasing the expression of HOXA10 mRNA in PCOS patients and decreasing the luteal function of PI,RI, of uterine spiral artery in PCOS patients. In order to improve endometrial receptivity, it is worthy of further clinical application.
【作者單位】： 江蘇省中醫(yī)院;南京中醫(yī)藥大學(xué);
【基金】：江蘇省科技廳臨床醫(yī)學(xué)科技專項(SBL201320056) 江蘇省中醫(yī)院2014年院級課題(Y14036)
【分類號】：R711.75
本文編號：2365657
[Abstract]:Objective to study the effect of sequential therapy of nourishing yin and nourishing yang on endometrial receptivity in (PCOS) infertility patients with polycystic ovary syndrome (PCOS) and the regulation of homobox gene (HOXA10) in endometrium. Methods A total of 80 patients with PCOS infertility were selected and divided into treatment group and control group according to the method of random digital table. The control group was treated with clomiphene (clomiphene,CC), human menopausal gonadotropin (human menopausal gonadotropin,HMG), human chorionic gonadotropin (human chorionic gonadotropin,HCG), and the treatment group was treated with CC HMG HCG. The course of treatment was 3 cycles. The following indexes were observed: (Em); was used to measure the endometrial thickness in the middle and late stage of endometrial hyperplasia and the middle phase of endometrial secretion to detect (PI), resistance index (RI);) of endometrial spiral artery pulsatility index in middle luteal phase. The levels of estradiol (E2) and progesterone (P) in serum of patients with middle luteal phase were detected. The expression of HOXA10 mRNA in endometrium of patients with middle luteal phase was detected. The clinical pregnancy rate and abortion rate were compared between the two groups. Results compared with the control group, the Em of the treatment group was increased in the late follicle and middle luteal phase, the difference between the two groups was statistically significant (P0.05), but there was no significant difference in the Em 2 group in the middle luteal phase (P0.05). Compared with the control group, the value of E2 and P in the treatment group increased significantly (P0.05); compared with the control group, the PI and RI in the treatment group decreased significantly (P0.05). Compared with the control group, the pregnancy rate of the treatment group increased, there was statistical difference (P0.05), the abortion rate decreased, there was no statistical significance (P0.05). Conclusion the sequential therapy of nourishing yin and tonifying yang can increase the pregnancy rate and decrease the abortion rate of PCOS patients. The mechanism may be related to increasing the expression of HOXA10 mRNA in PCOS patients and decreasing the luteal function of PI,RI, of uterine spiral artery in PCOS patients. In order to improve endometrial receptivity, it is worthy of further clinical application.
【作者單位】： 江蘇省中醫(yī)院;南京中醫(yī)藥大學(xué);
【基金】：江蘇省科技廳臨床醫(yī)學(xué)科技專項(SBL201320056) 江蘇省中醫(yī)院2014年院級課題(Y14036)
【分類號】：R711.75
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