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

卷:

35

期数:

2018年4

页码:

336-339

栏目:

临床研究

出版日期:

2018-04-05

文章信息/Info

Title:

Effect of Kuntai capsule combined with chloramiphene in the treatment of anovulatory infertility

作者:

时建荣; 张瑞琪; 穆艳丽

（济源市中医院妇科，河南　济源　459000）

Author(s):

SHI Jian-rong; ZHANG Rui-qi; MU Yan-li

（Department of Gynaecology，Jiyuan Traditional Chinese Medicine Hospital，Jiyuan 459000，Henan Province，China）

关键词:

排卵障碍性不孕症; 坤泰胶囊; 克罗米芬; 白血病抑制因子; 表皮生长因子; 胰岛素样生长因子-1

Keywords:

anovulatory infertility; Kuntai capsule; chloramiphene; leukemia inhibitory factor; epidermal growth factor; insulin-like growth factor-1

分类号:

R711.6

DOI:

10.7683/xxyxyxb.2018.04.021

文献标志码:

A

摘要:

目的　探讨坤泰胶囊联合克罗米芬治疗排卵障碍性不孕症的临床效果及作用机制。方法　选择2016年5月至2017年5月济源市中医院收治的排卵障碍性不孕症患者100例作为研究对象，根据治疗方法分为观察组和对照组，每组50例。对照组患者给予克罗米芬治疗，观察组患者在克罗米芬治疗基础上加用坤泰胶囊。分别于治疗前3 d及药物治疗第10天使用超声测定卵泡大小和数量、子宫内膜厚度和类型，并采集子宫内膜组织，采用免疫组织化学法检测子宫内膜组织中白血病抑制因子（LIF）、表皮生长因子（EGF）和胰岛素样生长因子-1（IGF-1）蛋白表达。结果　治疗前2组患者成熟卵泡数及子宫内膜厚度比较差异均无统计学意义（t=0.345、0.287，P>0.05）；与治疗前比较，治疗后2组患者成熟卵泡数和子宫内膜厚度显著增加（t=3.564、4.006，P<0.05）；治疗后观察组患者成熟卵泡数和子宫内膜厚度显著大于对照组（t=4.352、4.576，P<0.05）。治疗前2组子宫内膜类型比较差异无统计学意义（χ²=1.212，P>0.05）；治疗后2组患者子宫内膜类型显著优于治疗前（χ²=6.643、7.221，P<0.05），且观察组患者子宫内膜类型显著优于对照组（χ²=5.763，P<0.05）。治疗前对照组和观察组患者排卵率分别为30.0%（15/50）、28.0%（14/50），治疗后分别为44.0%（22/50）、76.0%（38/50）；治疗前2组患者排卵率比较差异无统计学意义（χ²=0.225，P>0.05）；治疗后2组患者排卵率显著高于治疗前（χ²=17.231、14.456，P<0.05），且观察组患者治疗后排卵率显著高于对照组（χ²=8.125，P<0.05）。治疗前2组患者子宫内膜组织中LIF、EGF及IGF-1蛋白表达比较差异均无统计学意义（t=0.023、0.978、0.053，P>0.05）；治疗后2组患者子宫内膜组织中LIF、EGF及IGF-1蛋白表达显著高于治疗前（t=3.784、4.675、4.273，P<0.05），且观察组患者子宫内膜组织中LIF、EGF及IGF-1蛋白表达显著高于对照组（t=4.009、4.287、5.009，P<0.05）。结论　坤泰胶囊联合克罗米芬能够促进排卵障碍性不孕症患者卵子发育，改善子宫内膜容受性。

Abstract:

Objective　To investigate the clinical effect and mechanism of Kuntai capsule combined with chloramiphene in the treatment of anovulatory infertility.Methods　A total of 100 patients with anovulatory infertility in Jiyuan Traditional Chinese Medicine Hospital from May 2016 to May 2017 were selected as the subjects，and the patients were divided into observation group and control group according to the treatment，50 cases in each group.The patients in the control group were treated with chloramiphene，and the patients in the observation group were treated with chloramiphene and Kuntai capsule.At three days before treatment and the tenth day after drug treatment，the size and quantity of ovarian follicle and the thickness and type of endometrium were measured by ultrasound；the endometrial tissues were collected，and the expression of leukemia inhibitory factor （LIF），epidermal growth factor （EGF） and insulin-like growth factor-1 （IGF-1） protein in endometrial tissue were detected by immunohistochemistry.Results　There was no significant difference in the number of mature follicles and the thickness of endometrium between the two groups before treatment （t=0.345，0.287；P>0.05）.The number of mature follicles and the thickness of endometrium after treatment were significantly greater than those before treatment in the two groups（t=3.564，4.006；P<0.05）.The number of mature follicles and the thickness of endometrium in the observation group were significantly greater than those in the control group after treatment，（t=4.352，4.576；P<0.05）.There was no significant difference in the type of endometrium between the two groups before treatment （χ²=1.212，P>0.05）.The type of endometrium after treatment was significantly better than that before treatment in the two groups （χ²=6.643，7.221；P<0.05）.The type of endometrium in the observation group was significantly better than that in the control group after treatment （χ²=5.763，P<0.05）.The ovulation rate in the control group and the observation group was 30.0% （15/50） and 28.0% （14/50） before treatment，and it was 44.0% （22/50） and 76.0% （38/50） after treatment respectively.There was no significant difference in ovulation rate between the two groups before treatment （χ²=0.225，P>0.05），but the ovulation rate after treatment was significantly higher than that before treatment in the two groups （χ²=17.231，14.456；P<0.05），and the ovulation rate in the observation group was significantly higher than that in the control group after treatment （χ²=8.125，P<0.05）.There was no significant difference in the expression of LIF，EGF and IGF-1 protein in the endometrium tissues between the two groups before treatment （t=0.023，0.978，0.053；P>0.05）.The expression of LIF，EGF and IGF-1 protein in the endometrium tissues after treatment was significantly higher than that before treatment in the two groups （t=3.784，4.675，4.273；P<0.05）；and the expression of LIF，EGF and IGF-1 protein in the endometrium tissues in the observation group was significantly higher than that in the control group after treatment （t=4.009，4.287，5.009；P<0.05）.Conclusion　Kuntai capsule combined with chloramiphene can promote the development of ovum and improve endometrial receptivity in patients with anovulatory infertility.

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更新日期/Last Update: 2018-04-05