本文選題：滋腎疏肝湯 + 子宮腺肌病��； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討滋腎疏肝湯對腎虛肝郁型子宮腺肌病伴不孕患者IVF-ET早期妊娠的影響。方法:將2015年6月至2016年2月就診于河南中醫(yī)藥大學(xué)第一附屬醫(yī)院生殖醫(yī)學(xué)科門診的100例腎虛肝郁型子宮腺肌病伴不孕欲于超長方案促排卵后行自然周期凍融胚胎移植的患者,隨機(jī)分為治療組與對照組,每組各50例。治療組采用滋腎疏肝湯治療,對照組不予任何處理。觀察兩組研究對象在凍融胚胎移植日子宮內(nèi)膜厚度、形態(tài);兩組移植后14天的-HCG水平、移植后28天的臨床妊娠率及胚胎種植率;兩組治療后臨床癥狀的改變情況。結(jié)果:(1)治療組與對照組移植后14天-HCG水平分別是576.38±275.33m IU/ml、410.16±307.47m IU/ml,兩組移植后14天的-HCG水平比較,差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。兩組移植后28天臨床妊娠率、胚胎種植率分別為治療組57.14%,35.55%,對照組36.00%,21.97%,兩組移植后28天的臨床妊娠率和胚胎種植率相比較,差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。(2)治療后治療組的臨床療效有效率是67.35%,對照組的臨床療效有效率是50.00%,治療組療效優(yōu)于對照組,且差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。(3)移植前子宮內(nèi)膜厚度比較,治療組為9.63±1.38mm,對照組為9.02±1.42mm,治療組子宮內(nèi)膜厚度較對照組厚,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。移植前子宮內(nèi)膜形態(tài)比較,治療組較對照組A型子宮內(nèi)膜多,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)治療組治療后中醫(yī)證候積分為9.22±1.57,有效率為93.88%,對照組治療后中醫(yī)證候積分為17.60±3.93,有效率為14.00%,兩組治療后證候療效比較,差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。結(jié)論:(1)滋腎疏肝湯可以明顯提高腎虛肝郁型子宮腺肌病伴不孕患者行IVF-ET患者移植后14天的 HCG水平、臨床妊娠率、胚胎種植率,且療效優(yōu)于對照組。(2)滋腎疏肝湯可以明顯改善腎虛肝郁型子宮腺肌病伴不孕行IVF-ET患者移植前子宮內(nèi)膜厚度、形態(tài)。(3)滋腎疏肝湯能明顯改善腎虛肝郁型子宮腺肌病伴不孕患者的臨床癥狀。
[Abstract]:Objective: to investigate the effect of Zishen Shugan decoction on early pregnancy with IVF-ET in patients with uterine adenomyosis with kidney deficiency and liver depression. Methods: from June 2015 to February 2016, 100 patients with kidney deficiency and liver depression type uterine adenomyosis and infertility who were undergoing natural cycle frozen-thawing embryo transfer after ovulation promotion by super long plan were selected from the Department of Reproductive Medicine, first affiliated Hospital of Henan University of traditional Chinese Medicine, who were admitted to the clinic of Department of Reproductive Medicine, Henan University of traditional Chinese Medicine, from June 2015 to February 2016. They were randomly divided into treatment group and control group with 50 cases in each group. The treatment group was treated with Zishen Shugan decoction, while the control group was not treated. The thickness and morphology of endometrium on the day of frozen thawed embryo transfer, the level of -HCG on the 14th day after transplantation, the clinical pregnancy rate and embryo implantation rate at 28 days after transplantation, and the changes of clinical symptoms in the two groups were observed. Results the levels of -HCG in treatment group and control group were 576.38 鹵275.33m / ml 410.16 鹵307.47m / ml 14 days after transplantation respectively, and the difference was statistically significant (P 0.05). The clinical pregnancy rate and embryo implantation rate in the two groups were 57.14 and 35.55, respectively. The clinical pregnancy rate and embryo implantation rate in the control group were 36.00 and 21.97, respectively. The clinical pregnancy rate and embryo implantation rate in the two groups were compared 28 days after transplantation. The difference was statistically significant (P < 0.05).) the effective rate of the treatment group was 67.35 and that of the control group was 50.00.The curative effect of the treatment group was better than that of the control group, and the difference was statistically significant. The thickness of endometrium in the treatment group was 9.63 鹵1.38 mm and that in the control group was 9.02 鹵1.42 mm. The thickness of endometrium in the treatment group was thicker than that in the control group (P 0.05). The number of type A endometrium in the treatment group was higher than that in the control group. The difference was statistically significant (P 0.05). The score of TCM syndromes was 9.22 鹵1.57 and the effective rate was 93.88 in the treatment group, and 17.60 鹵3.93 and 14.00 respectively in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion (1) Zishen Shugan decoction can significantly increase the level of HCG, clinical pregnancy rate and embryo implantation rate 14 days after transplantation in patients with adenomyosis with infertility due to kidney deficiency and liver depression. And the curative effect was better than that of control group. (2) Zishen Shugan decoction could obviously improve the endometrial thickness before transplantation in patients with kidney deficiency and liver depression type of uterine adenomyosis and infertility. Zishen Shugan decoction can obviously improve the clinical symptoms of patients with uterine adenomyosis complicated with infertility due to kidney deficiency and liver depression.
【學(xué)位授予單位】：河南中醫(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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