本文關(guān)鍵詞： 五子養(yǎng)泡湯 隔姜灸 卵泡發(fā)育不良 不孕癥 臨床療效　出處：《廣西中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:觀察五子養(yǎng)泡湯加隔姜灸治療腎氣虛型卵泡發(fā)育不良不孕癥的療效,經(jīng)過統(tǒng)計分析,比較治療前后卵泡發(fā)育情況、子宮內(nèi)膜厚度、卵泡期結(jié)局、中醫(yī)證候療效,并觀察治療后臨床妊娠率等情況,探討其臨床療效及作用機制。方法:本課題選擇符合入選標準為卵泡發(fā)育不良不孕癥患者125例,中醫(yī)辨證為腎氣虛證,隨機分為治療組與對照組,治療組63例,對照組62例。治療過程中,因各種因素共有4例病例中途中止實驗,治療組2例,對照組2例,實際治療組完成61例研究病例,對照組完成60例研究病例。治療組給予五子養(yǎng)泡湯聯(lián)合隔姜灸治療,中藥每日1劑,分早、晚兩次服,月經(jīng)周期第5天開始,根據(jù)排卵監(jiān)測結(jié)果,若有排卵,服藥至排卵后3天,若未排卵,服藥至月經(jīng)周期第15天,連服3個周期,服藥同時加用隔姜灸神闕、關(guān)元穴,服藥止時停隔姜灸治療;對照組用克羅米芬治療,每日50mg,連用5天,月經(jīng)周期第5天開始服用,若排卵效果不佳,第2個周期,改為每日100mg。治療期間,于月經(jīng)周期第10天行開始用陰道B超監(jiān)測卵泡發(fā)育,監(jiān)測時間固定在每日上午,卵泡直徑10mm,每3天檢查1次,10~15mm時隔日檢查1次,15mm時每日檢查1次,直至排卵(卵泡消失或驟然縮小5mm以上),監(jiān)測3個月經(jīng)周期。治療后,觀察比較兩組病例的卵泡發(fā)育情況、子宮內(nèi)膜厚度、卵泡期結(jié)局、臨床妊娠率及中醫(yī)證候在治療前后的變化。用SPSS17.0分析所有數(shù)據(jù)。病例來源:廣西中醫(yī)藥大學附屬瑞康醫(yī)院(國家三級甲等醫(yī)院)婦科門診。結(jié)果:五子養(yǎng)泡湯聯(lián)合隔姜灸治療組總有效率達到76.67%,西藥對照組總有效率73.33%,兩組差異無統(tǒng)計學意義(P0.05)。兩組治療后最大卵泡平均直徑均大于治療前最大卵泡平均直徑,差異有統(tǒng)計學意義(P0.05);兩組間比較治療后最大卵泡平均直徑、血清FSH值的差異無統(tǒng)計學意義(P0.05)。圍排卵期的排卵率、尿LH陽性率兩組間比較,二者差異無統(tǒng)計學意義(P0.05)。圍排卵期子宮內(nèi)膜厚度比較,五子養(yǎng)泡湯聯(lián)合隔姜灸治療組平均內(nèi)膜厚度優(yōu)于西藥對照組平均內(nèi)膜厚,差異有統(tǒng)計學意義(P0.05)。五子養(yǎng)泡湯聯(lián)合隔姜灸治療組的血清E2值與西藥對照組的血清E2值比較,二者差異有統(tǒng)計學意義(P0.05)。五子養(yǎng)泡湯聯(lián)合隔姜灸治療組的排卵率與西藥對照組的排卵率比較,二者差異有統(tǒng)計學意義(P0.05)。五子養(yǎng)泡湯聯(lián)合隔姜灸治療組妊娠率與西藥對照組妊娠率比較,二者差異有統(tǒng)計學意義(P0.05)。結(jié)論:五子養(yǎng)泡湯加隔姜灸治療能改善腎氣虛型卵泡發(fā)育不良不孕癥患者的卵巢功能和卵泡質(zhì)量,促進卵泡生長發(fā)育,提高成熟卵泡排卵率,其療效等同于克羅米芬對照組,五子養(yǎng)泡湯加隔姜灸治療組的子宮內(nèi)膜厚度優(yōu)于克羅米芬對照組,避免克羅米芬在促排卵治療中卵泡生長發(fā)育與子宮內(nèi)膜生長不同步的缺點。隔姜灸操作簡單、取材方便,療效顯著,值得臨床推廣。
[Abstract]:Objective: to observe the curative effect of Wuzi Yangbao decoction plus ginger separated moxibustion on follicular dysplasia of kidney qi deficiency type. After statistical analysis, the development of follicle, the thickness of endometrium, the outcome of follicular phase and the curative effect of TCM syndrome were compared before and after treatment. The clinical pregnancy rate after treatment was observed and the clinical curative effect and mechanism were discussed. Methods: 125 cases of follicular dysplasia infertility were selected according to the selected criteria, and the syndrome differentiation of TCM was deficiency of kidney qi. There were 63 cases in treatment group and 62 cases in control group. In the course of treatment, there were 4 cases of halting experiment because of various factors, 2 cases in treatment group, 2 cases in control group, 61 cases in actual treatment group. In the control group, 60 cases were studied. The treatment group was treated with Wuzi Yangbao decoction combined with ginger-separated moxibustion. The treatment group was given 1 dose of traditional Chinese medicine once a day, taking it early and twice, starting from the 5th day of menstrual cycle, according to the results of ovulation monitoring, if there was ovulation, Take medicine until 3 days after ovulation, if not ovulation, take medicine until the 15th day of menstrual cycle, take 3 cycles, take medicine and add ginger moxibustion Shenque, Guan Yuan point, stop ginger moxibustion treatment when taking medicine, and control group with clomiphene treatment, 50 mg daily, continuous use for 5 days, the fifth day of menstrual cycle began to take, if the ovulation effect is not good, the second cycle, changed to 100 mg daily. During treatment, on the 10th day of menstrual cycle, using vaginal B ultrasound to monitor follicle development, The monitoring time is fixed in the morning, the follicle diameter is 10mm, every 3 days the follicle diameter is 1015mm, every 3 days, 1015mm, every other day, 15mm every other day, until ovulation (follicle disappear or suddenly shrink more than 5mm), monitor 3 menstrual cycles. After treatment, The follicular development, endometrial thickness and follicular outcome were observed and compared between the two groups. Clinical pregnancy rate and changes of TCM syndromes before and after treatment. All data were analyzed by SPSS17.0. Case source: gynecological outpatient department of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine (National Grade 3A Hospital). The total effective rate of the ginger-separated moxibustion group was 76.67 and that of the western medicine control group was 73.33. There was no significant difference between the two groups (P 0.05). The mean diameter of the largest follicle in the two groups was larger than that before the treatment. There was no significant difference in the mean diameter of the largest follicle and serum FSH between the two groups. The ovulation rate and urinary LH positive rate in the periovulation period were compared between the two groups. There was no significant difference between the two groups (P 0.05). The mean endometrial thickness of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was better than that of western medicine control group. The difference was statistically significant (P 0.05). The serum E _ 2 value of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. The difference was statistically significant (P 0.05). The ovulation rate of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. The pregnancy rate of Wuzi Yangbao decoction combined with ginger separated moxibustion treatment group was compared with that of western medicine control group. Conclusion: the combination of Wuzi Yangbao decoction and ginger moxibustion can improve the ovarian function and follicular quality, promote follicular growth and increase the ovulation rate of mature follicles in infertile patients with deficiency of kidney qi. The effect was equal to that of clomiphene control group, and the endometrial thickness of the treated group was better than that of the clomiphene control group. To avoid the disadvantage of not synchronizing follicle growth and endometrial growth in ovulation promotion therapy with clomiphene. Ginger-separated moxibustion is easy to operate, easy to take, and effective, which is worth popularizing clinically.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.14

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