归肾丸加减联合芬吗通治疗卵巢储备功能低下性不孕患者临床效果及对性激素水平影响
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摘要
目的观察归肾丸加减联合芬吗通治疗卵巢储备功能低下(decreasing ovarian reserve, DOR)性不孕患者临床效果及对性激素水平的影响。方法选取符合纳入及排除标准的DOR性不孕96例,根据治疗方法不同将其分为观察组和对照组两组各48例,观察组给予归肾丸加减联合芬吗通治疗,对照组给予芬吗通治疗。观察比较两组治疗后临床效果、治疗后排卵情况、治疗前后血清性激素水平及治疗过程中不良反应发生情况。结果治疗后,观察组总有效率为91.67%明显高于对照组总有效率75.00%,差异有统计学意义(P<0.05)。治疗后,两组排卵率、妊娠率、卵泡成熟个数及卵泡成熟时间比较差异无统计学意义(P>0.05)。治疗前,两组血清卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E_2)水平比较差异无统计学意义(P>0.05);治疗后,血清FSH、LH和E_2水平观察组和对照组均低于治疗前,且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗过程中,观察组不良反应总发生率10.42%,对照组不良反应总发生率8.33%,两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 DOR性不孕患者应用归肾丸加减联合芬吗通治疗可显著提高临床效果,改善卵巢储备功能,促进卵泡排卵,且不增加不良反应。
Objective To observe the clinical effect of Guishen pills combined with femoston in treating patients with infertility due to diminished ovarian reserve(DOR) and their effect on sex hormone level. Methods A total of 96 cases with infertility due to DOR meeting inclusion and exclusion criteria were selected. They were divided into the observation group and the control group according to different treatment methods, with 48 cases in each group. The observation group was given Guishen pills combined with femoston, while the control group was given femoston. The clinical effects after treatment, the ovulation after treatment, serum sex hormone levels before and after treatment and the incidence of adverse reactions during treatment in both groups were observed and compared. Results After treatment, total effective rate of the observation group was significantly higher than that of the control group(91.67% vs 75.00%; P<0.05). After treatment, there was no statistic significance in the ovulation rate, pregnancy rate, the number of mature follicles, and time of follicle maturity between the two groups(P>0.05). Before treatment, there was no significant difference in serum follicle stimulating hormone(FSH), luteinising hormone(LH) and estradiol(E_2) levels between the two groups(P>0.05). As compared with those before treatment, serum FSH, LH and E_2 levels were lower in the observation group and the control group after treatment, which were lower in the observation group than in the control group, suggesting significant difference(P<0.05). During the treatment, the total incidence of adverse reactions was 10.42% in the observation group and 8.33% in the control group, and there was no significant difference between the two groups(P>0.05). Conclusion Guishen pill combined with femoston in the treatment of patients with infertility due to DOR can improve the clinical effect and function of ovarian reserve, promote ovulation, and does not increase the adverse reactions.
Objective To observe the clinical effect of Guishen pills combined with femoston in treating patients with infertility due to diminished ovarian reserve(DOR) and their effect on sex hormone level. Methods A total of 96 cases with infertility due to DOR meeting inclusion and exclusion criteria were selected. They were divided into the observation group and the control group according to different treatment methods, with 48 cases in each group. The observation group was given Guishen pills combined with femoston, while the control group was given femoston. The clinical effects after treatment, the ovulation after treatment, serum sex hormone levels before and after treatment and the incidence of adverse reactions during treatment in both groups were observed and compared. Results After treatment, total effective rate of the observation group was significantly higher than that of the control group(91.67% vs 75.00%; P<0.05). After treatment, there was no statistic significance in the ovulation rate, pregnancy rate, the number of mature follicles, and time of follicle maturity between the two groups(P>0.05). Before treatment, there was no significant difference in serum follicle stimulating hormone(FSH), luteinising hormone(LH) and estradiol(E_2) levels between the two groups(P>0.05). As compared with those before treatment, serum FSH, LH and E_2 levels were lower in the observation group and the control group after treatment, which were lower in the observation group than in the control group, suggesting significant difference(P<0.05). During the treatment, the total incidence of adverse reactions was 10.42% in the observation group and 8.33% in the control group, and there was no significant difference between the two groups(P>0.05). Conclusion Guishen pill combined with femoston in the treatment of patients with infertility due to DOR can improve the clinical effect and function of ovarian reserve, promote ovulation, and does not increase the adverse reactions.
引文
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[12] 黄小琼,黄威,朱颖欣,等.归肾丸对免疫性卵巢早衰小鼠白细胞介素-17和白细胞介素-1β水平的影响[J].实验动物与比较医学,2016,36(5):387-390.
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[14] 刘玉兰,高慧,夏天,等.坤泰胶囊对卵巢储备功能降低所致不孕症临床症状的疗效分析[J].天津中医药大学学报,2017,36(4):263-266.
[15] 岳瑶函,赵嘉晶.中西医结合治疗卵巢储备功能下降综合征致月经稀发的疗效分析及性激素水平相关性研究[J].山西医药杂志,2016,45(12):1382-1384.
[16] 赵少华,李玲,冯会敬,等.坤泰胶囊联合促性腺激素治疗卵巢储备功能低下患者的疗效观察[J].医学临床研究,2017,34(6):1198-1200.
[17] 连方,李冉.补肾中药联合避孕药预治疗肾虚型卵巢低反应临床观察[J].中国中西医结合杂志,2017,37(12):1435-1438.
[18] 杨帆.复方左归胶囊对卵巢储备功能低下患者卵巢动脉血流及性激素水平的影响[J].现代中西医结合杂志,2017,26(11):1229-1231,1251.
[19] 应敏丽,徐旭群,王佳曦.中药调周法对卵巢储备功能下降患者性激素和卵巢动脉血流的影响[J].上海中医药杂志,2016,50(5):58-60.
[20] 姜朵生,张迎春,吴晓兰,等.八髎穴隔姜灸配合补肾活血方治疗卵巢储备功能下降疗效观察[J].中国针灸,2017,37(10):1057-1060.
[21] 汤海霞.左归丸加味联合激素替代治疗卵巢储备功能下降30例临床观察[J].江苏中医药,2017,49(12):43-45.
[2] 陈钢,何红霞.腹腔镜全子宫并双侧输卵管切除对绝经后妇女卵巢功能的影响[J].空军医学杂志,2016,32(3):185-188,215.
[3] 崔娜,姜蕾,杨爱敏,等.坤泰胶囊治疗卵巢储备功能低下不孕症患者33例临床观察[J].中医杂志,2018,59(2):132-136.
[4] 马景,张亚宁,万怡婷,等.齐聪治疗卵巢储备功能低下性不孕症经验[J].山东中医杂志,2017,36(8):690-693.
[5] 柴海兰,陈守龙,高仁美,等.归肾丸为主治疗PCOS致排卵障碍性不孕症及对血清TGF-β1、CTGF水平的影响[J].陕西中医,2017,38(8):1065-1067.
[6] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:239-243.
[7] Li J,Mao Q,He J,et al.Human umbilical cord mesenchymal stem cells improve the reserve function of perimenopausal ovary via a paracrine mechanism[J].Stem Cell Res Ther,2017,8(1):55.
[8] 郭畅,樊桂玲,郭剑,等.多囊卵巢综合征和卵巢储备功能低下患者行IVF-ET的临床分析[J].河北医药,2013,35(9):1333-1334.
[9] 徐海冰,徐银静,黄海燕,等.中医综合治疗排卵障碍性不孕症中促排卵效应的临床疗效研究[J].成都中医药大学学报,2016,39(1):65-66,76.
[10] 王艳.两种中西结合方案治疗肾虚血瘀型排卵障碍性不孕症的临床疗效与安全性对比[J].中国妇幼保健,2017,32(15):3594-3597.
[11] 丘维钰,郜洁,高飞霞,等.“肾-天癸-冲任-胞宫”生殖轴的研究进展[J].广州中医药大学学报,2017,34(6):945-947.
[12] 黄小琼,黄威,朱颖欣,等.归肾丸对免疫性卵巢早衰小鼠白细胞介素-17和白细胞介素-1β水平的影响[J].实验动物与比较医学,2016,36(5):387-390.
[13] 张会仙,马堃,佟雅婧.补肾活血中药治疗卵巢储备功能低下的系统评价[J].中国中药杂志,2017,42(23):4464-4473.
[14] 刘玉兰,高慧,夏天,等.坤泰胶囊对卵巢储备功能降低所致不孕症临床症状的疗效分析[J].天津中医药大学学报,2017,36(4):263-266.
[15] 岳瑶函,赵嘉晶.中西医结合治疗卵巢储备功能下降综合征致月经稀发的疗效分析及性激素水平相关性研究[J].山西医药杂志,2016,45(12):1382-1384.
[16] 赵少华,李玲,冯会敬,等.坤泰胶囊联合促性腺激素治疗卵巢储备功能低下患者的疗效观察[J].医学临床研究,2017,34(6):1198-1200.
[17] 连方,李冉.补肾中药联合避孕药预治疗肾虚型卵巢低反应临床观察[J].中国中西医结合杂志,2017,37(12):1435-1438.
[18] 杨帆.复方左归胶囊对卵巢储备功能低下患者卵巢动脉血流及性激素水平的影响[J].现代中西医结合杂志,2017,26(11):1229-1231,1251.
[19] 应敏丽,徐旭群,王佳曦.中药调周法对卵巢储备功能下降患者性激素和卵巢动脉血流的影响[J].上海中医药杂志,2016,50(5):58-60.
[20] 姜朵生,张迎春,吴晓兰,等.八髎穴隔姜灸配合补肾活血方治疗卵巢储备功能下降疗效观察[J].中国针灸,2017,37(10):1057-1060.
[21] 汤海霞.左归丸加味联合激素替代治疗卵巢储备功能下降30例临床观察[J].江苏中医药,2017,49(12):43-45.
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