本文選題：歸芍地 + 黃湯�。� 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：近年來,隨著環(huán)境的改變以及社會壓力的日益增加,不孕的發(fā)生率越來越高,其已成為生殖醫(yī)學(xué)亟待解決的問題。臨床上發(fā)現(xiàn)卵泡發(fā)育不良性不孕的發(fā)生率逐年升高,但目前對于該疾病尚無明確的治療方法,因此卵泡發(fā)育不良的診治對不孕癥的臨床研究有著根本而重大的意義。本文通過臨床研究,觀察歸芍地黃湯對FM性不孕患者卵泡發(fā)育、排卵結(jié)局及生殖軸的影響,探討其作用機理及療效上的獨特優(yōu)勢,從而進一步完善中醫(yī)藥治療排卵障礙性不孕的方案。方法：臨床上將因FM導(dǎo)致不孕的患者40例,隨機分為兩組,每組20例,試驗組即中西藥結(jié)合組(歸芍地黃湯加減聯(lián)合CC),對照組即西藥組(CC),連續(xù)觀察三個周期,進行治療前后對照及組間對照,通過觀察患者治療前后及兩組間臨床癥狀的改善,基礎(chǔ)體溫,排卵當(dāng)日卵泡最大平均直徑與子宮內(nèi)膜厚度、卵泡早期及排卵期激素水平(FSH、LH、 E2),以及黃體期激素水平(E、P)的變化,排卵率與妊娠結(jié)局,評價歸芍地黃湯對FM性不孕癥的臨床療效。結(jié)果：試驗組與對照組雖然總療效均為90%,但試驗組治愈率為60%,妊娠率為30%,明顯高于對照組。兩組均能促進卵泡生長,提高成熟卵泡直徑(P0.05),但試驗組增長更明顯。試驗組可以明顯增加子宮內(nèi)膜厚度(P0.05),對照組在子宮內(nèi)膜增長上療效不顯(P0.05),兩組有顯著性差異。試驗組藥物能顯著降低患者中醫(yī)癥候積分,提高基礎(chǔ)狀態(tài)下E2水平,改善患者卵巢功能。結(jié)論：歸芍地黃湯加減能有效促進卵泡發(fā)育、增加排卵日卵泡的直徑、子宮內(nèi)膜的厚度,提高卵子質(zhì)量及妊娠率,改善患者癥狀,從而治療FM性不孕癥。與西藥組相比,在提高卵泡直徑方面差異不明顯,但在提高子宮內(nèi)膜厚度、改善患者癥狀、提高妊娠率方面,中西醫(yī)結(jié)合組更具優(yōu)勢。
[Abstract]:Objective: in recent years, with the change of environment and the increasing of social pressure, the incidence of infertility is increasing, which has become an urgent problem in reproductive medicine.It is found that the incidence of follicular dysplasia is increasing year by year, but there is no definite treatment for this disease. Therefore, the diagnosis and treatment of follicular dysplasia is of fundamental and great significance to the clinical study of infertility.The effects of Guishao Dihuang decoction on follicle development, ovulation outcome and reproductive axis of FM infertile patients were observed through clinical study.So as to further improve the treatment of Chinese medicine ovulatory infertility program.Methods: clinically, 40 patients with infertility caused by FM were randomly divided into two groups (20 cases in each group). The experimental group was divided into two groups: the experimental group was treated with traditional Chinese medicine combined with western medicine (Guishao Dihuang decoction combined with CCG), the control group was the western medicine group, and the control group was treated with CCG for three consecutive periods.The improvement of clinical symptoms, basal body temperature, maximum mean follicle diameter and endometrial thickness were observed before and after treatment.The changes of hormone levels in early follicle and ovulation stage (FSHLH, E2P, and luteal hormone level), ovulation rate and pregnancy outcome, and the clinical efficacy of Guishaihuang decoction in the treatment of FM infertility were evaluated.Results: although the total curative effect of the test group and the control group was 90, the cure rate and pregnancy rate of the test group were 60 and 30 respectively, which were significantly higher than those of the control group.Both groups could promote follicular growth and increase the diameter of mature follicles (P 0.05), but the growth of the test group was more obvious.The experimental group could significantly increase the endometrial thickness (P 0.05), while the control group had no effect on endometrial growth (P 0.05), and there was a significant difference between the two groups.In the test group, the scores of TCM symptoms were significantly decreased, E2 level was increased and ovarian function was improved in the trial group.Conclusion: Guishaodihuang decoction can effectively promote follicle development, increase follicle diameter, endometrial thickness, improve egg quality and pregnancy rate, and improve the symptoms of patients with FM infertility.Compared with western medicine group, there was no significant difference in increasing follicle diameter, but the combination of traditional Chinese and western medicine had more advantages in increasing endometrial thickness, improving patients' symptoms and increasing pregnancy rate.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R271.14

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