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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年8

页码:

727-730

栏目:

临床研究

出版日期:

2017-08-05

文章信息/Info

Title:

Effect of clomifene citrate combined with Wuziyanzong pill in the treatment of follicular maldevelopment infertility

作者:

石　玲; 张　月

（辽宁中医药大学附属第二医院妇科，辽宁　沈阳　110034）

Author(s):

SHI Ling; ZHANG Yue

（Department of Gynecology，the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine，Shenyang 110034，Liaoning Province，China）

关键词:

卵泡发育不全; 不孕; 五子衍宗丸加减; 氯米芬; 性激素

Keywords:

follicular maldevelopment; infertility; Wuziyanzong pill; clomiphene; sex hormone

分类号:

R714

DOI:

10.7683/xxyxyxb.2017.08.017

文献标志码:

A

摘要:

目的　探讨枸橼酸氯米芬联合五子衍宗丸加减治疗卵泡发育不全性不孕的临床效果，并分析其对患者血清性激素水平的影响。方法　选取2014年4月至2016年7月辽宁中医药大学附属第二医院收治的卵泡发育不全性不孕患者92例，根据治疗方法分为对照组和观察组，每组46例。对照组患者给予枸橼酸氯米芬片治疗，观察组患者给予枸橼酸氯米芬片联合五子衍宗丸加减治疗。观察2组患者血清性激素水平、肌肉注射绒毛膜促性腺激素（HCG）当日子宫内膜厚度及类型；治疗后随访1 a，观察2组患者排卵情况、妊娠结局及临床疗效。结果　对照组和观察组患者治疗总有效率分别为76.09%（35/46）、91.30%（42/46），观察组患者治疗总有效率显著高于对照组（χ²=7.072，P<0.05）。肌肉注射HCG当日，观察组和对照组患者子宫内膜厚度分别为（10.27±1.55）、（9.23±1.63）mm，观察组患者子宫内膜厚度显著大于对照组（t=11.027，P<0.05）。肌肉注射HCG当日，观察组患者A、B、C型子宫内膜分别为25、18、3例，对照组患者A、B、C型子宫内膜分别为19、17、10例，2组比较差异有统计学意义（χ²=7.097，P<0.05）。月经周期第5天，2组患者血清卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）及雌二醇（E₂）水平比较差异均无统计学意义（P>0.05）；肌肉注射HCG当日，2组患者血清FSH、LH、T及E₂水平均显著高于月经周期第5天时（P<0.01），且观察组患者血清FSH、LH、T及E₂水平显著高于对照组（P<0.05）。治疗后1 a内，对照组患者排卵率、妊娠率、双胎妊娠率、生化妊娠率、早期流产率分别为67.39%（31/46）、30.43%（14/46）、17.39%（8/46）、2.17%（1/46）、6.52%（3/46），观察组患者排卵率、妊娠率、双胎妊娠率、生化妊娠率、早期流产率分别为67.39%（31/46）、65.22%（30/46）、4.35%（2/46）、2.17%（1/46）、0.00%（0/46），观察组患者妊娠率显著高于对照组（χ²=9.271，P<0.05），早期流产率显著低于对照组（χ²=4.281，P<0.05），2组患者排卵率、双胎妊娠率及生化妊娠率比较差异均无统计学意义（χ²=1.082、1.002、1.000，P>0.05）。结论　枸橼酸氯米芬联合五子衍宗丸加减治疗可以显著改善卵泡发育不全性不孕患者的子宫腔内环境，提高排卵率和妊娠率，降低早期流产率。

Abstract:

Objective　To investigate the clinical effect of clomifene citrate combined with Wuziyanzong pill in the treatment of follicular maldevelopment infertility，and analyze the influence of them on the serum sex hormone levels.Methods　A total of 92 patients with follicular maldevelopment infertility were selected from April 2014 to July 2016 in the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.The patients were divided into control group and observation group according to the treatment methods，46 cases in each group.The patients in the control group were treated with clomifene citrate tablet，and the patients in the observation group were treated with clomifene citrate tablet combined with Wuziyanzong pill.The serum sex hormone level and the thickness and type of endometrium on the day of intramuscular injection of chorionic gonadotrophin（HCG） were observed in the two groups.The patients in the two groups were followed-up for one year after treatment，the ovulation，pregnancy outcome and clinical effect were observed.Results　The total effective rate in the control group and the observation group was 76.09%（35/46） and 91.30%（42/46） respectively，the total effective rate in the observation group was significantly higher than that in the control group （χ²=7.072，P<0.05）.On the day of intramuscular injection of HCG，endometrial thickness in the observation group and control group was （10.27±1.55），（9.23±1.63）mm respectively，the endometrial thickness in the observation group was significantly greater than that in the control group （t=11.027，P<0.05）.On the day of intramuscular injection of HCG，there were 25，18 and 3 cases of type A，B and C endometrium respectively in the observation group；and there were 19，17 and 10 cases of type A，B and C endometrium respectively in the control group；there was no significant difference in the type of endometrium between the two groups （χ²=7.097，P<0.05）.There was no significant difference in serum follicle-stimulating hormone（FSH），luteinizing hormone（LH），testosterone（T） and estradiol（E₂） levels between the two groups on the fifth day of menstrual cycle （P>0.05）.The levels of serum FSH，LH，T and E₂ on the day of intramuscular injection of HCG were significantly higher than those on the fifth day of menstrual cycle in the two groups （P<0.01）.The levels of serum FSH，LH，T and E₂ in the observation group were significantly higher than those in the control group on the day of intramuscular injection of HCG （P<0.05）.The ovulation rate，pregnancy rate，twin pregnancy rate，biochemical pregnancy rate and early abortion rate in the control group were 67.39%（31/46），30.43%（14/46），17.39%（8/46），2.17%（1/46） and 6.52%（3/46） respectively within one year after treatment；and they were 67.39%（31/46），65.22%（30/46），4.35%（2/46），2.17%（1/46） and 0.00%（0/46） respectively；the pregnancy rate in the observation group was significantly higher than that in the control group （χ²=9.271，P<0.05），and the early abortion rate was significantly lower than that in the control group （χ²=4.281，P<0.05），but there was no significant difference in ovulation rate，twin pregnancy rate and biochemical pregnancy rate between the two groups （χ²=1.082，1.002，1.000；P>0.05）.Conclusion　Clomiphene citrate combined with Wuziyanzong pill in the treatment of follicular maldevelopment infertility can significantly improve uterine cavity environment，improve the ovulation rate and pregnancy rate，decrease the early abortion rate.

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更新日期/Last Update: 2017-08-05