补肾疏肝方联合克罗米芬治疗黄体功能不全不孕(肝郁肾虚)随机平行对照研究
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摘要
[目的]观察补肾疏肝方联合克罗米芬治疗黄体功能不全不孕(肝郁肾虚)疗效。[方法]使用随机平行对照方法,将80例门诊患者按随机数字表法随机分为两组。对照组40例克罗米芬,50mg/次,1次/d,月经第5d开始服用,持续5d。治疗组40例补肾疏肝方(柴胡、枸杞子、地黄熟各12g,淫羊藿、菟丝子各15g,白芍、当归、车前子、泽泻、茯苓、牡丹皮、山萸肉、牛膝各10g,甘草炙6g),水煎400mL,2次/d;克罗米芬治疗同对照组。连续治疗3个月为1疗程。观测临床表现、催乳激素、尿促卵泡素、促黄体生成素、睾酮、孕酮、雌二醇、不良反应。治疗1疗程(4周),判定疗效。随访1年,观测妊娠率。[结果]治疗组显效23例,有效15例,无效3例,总有效率92.50%;对照组显效11例,有效12例,无效17例,总有效率57.50%;治疗组疗效优于对照组(P<0.05)。PRL、FSH、LH、T、P、E2两组均有改善(P<0.05,P<0.01),治疗组改善优于对照组(P<0.01)。随访1年,治疗组妊娠率77.50%优于对照组52.50%(P<0.05)。[结论]补肾疏肝方联合克罗米芬治疗黄体功能不全不孕(肝郁肾虚),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Bushen Shugan Decoction combined with clomiphene in the treatment of infertility due to luteal insufficiency(Ganyu Shenxu). [Method] 80 outpatients were randomly divided into two groups by random number table method. 40 patients in the control group received clomiphene 50 mg/time, once a day, starting on the 5 th day of menstruation, lasting for 5 days. In the treatment group, 40 cases of Bushen Shugan recipe(Chaihu, Gouqizi, Shudihuang each12 g, Yinyanghuo, Tusizi each 15 g,Baishao, Danggui, Cheqianzi, Zexie, Fuling, Mudanpi, Shanyurou, Niuxi each 10 g, Zhigancao 6 g) were decocted in water for 400 mL twice a day; western medicine treatment was the same as the control group. Continuous treatment for 3 months is a course of treatment. Clinical manifestations, prolactin, urinary follicle stimulating hormone, luteinizing hormone, testosterone, progesterone, estradiol and adverse reactions were observed. One course of treatment(4 weeks) was used to determine the curative effect. The pregnancy rate was observed after 1 year follow-up. [Result] In the treatment group, 23 cases were markedly effective, 15 cases were effective, 3 cases were ineffective, and the total effective rate was 92.50%. In the control group, 11 cases were markedly effective, 12 cases were effective and 17 cases were ineffective, the total effective rate was 57.50%. The curative effect of the treatment group was better than that of the control group(P<0.05). PRL, FSH, LH, T, P and E2 were improved in both groups(P<0.05, P<0.01), and the improvement in treatment group was better than that in control group(P<0.01). Following up for one year, the pregnancy rate of the treatment group was 77.50%better than that of the control group 52.50%(P<0.05). [Conclusion] Bushen Shugan decoction combined with clomiphene in the treatment of infertility due to luteal insufficiency(Ganyu Shenxu). The curative effect was satisfactory and there were no serious adverse reactions. It is worth promoting.
[Objective] To observe the curative effect of Bushen Shugan Decoction combined with clomiphene in the treatment of infertility due to luteal insufficiency(Ganyu Shenxu). [Method] 80 outpatients were randomly divided into two groups by random number table method. 40 patients in the control group received clomiphene 50 mg/time, once a day, starting on the 5 th day of menstruation, lasting for 5 days. In the treatment group, 40 cases of Bushen Shugan recipe(Chaihu, Gouqizi, Shudihuang each12 g, Yinyanghuo, Tusizi each 15 g,Baishao, Danggui, Cheqianzi, Zexie, Fuling, Mudanpi, Shanyurou, Niuxi each 10 g, Zhigancao 6 g) were decocted in water for 400 mL twice a day; western medicine treatment was the same as the control group. Continuous treatment for 3 months is a course of treatment. Clinical manifestations, prolactin, urinary follicle stimulating hormone, luteinizing hormone, testosterone, progesterone, estradiol and adverse reactions were observed. One course of treatment(4 weeks) was used to determine the curative effect. The pregnancy rate was observed after 1 year follow-up. [Result] In the treatment group, 23 cases were markedly effective, 15 cases were effective, 3 cases were ineffective, and the total effective rate was 92.50%. In the control group, 11 cases were markedly effective, 12 cases were effective and 17 cases were ineffective, the total effective rate was 57.50%. The curative effect of the treatment group was better than that of the control group(P<0.05). PRL, FSH, LH, T, P and E2 were improved in both groups(P<0.05, P<0.01), and the improvement in treatment group was better than that in control group(P<0.01). Following up for one year, the pregnancy rate of the treatment group was 77.50%better than that of the control group 52.50%(P<0.05). [Conclusion] Bushen Shugan decoction combined with clomiphene in the treatment of infertility due to luteal insufficiency(Ganyu Shenxu). The curative effect was satisfactory and there were no serious adverse reactions. It is worth promoting.
引文
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[12]赵海专,陈进,苏汉桥,等.162例不孕症患者血清性激素水平的检测及分析[J].武汉大学学报(医学版),2004,25(5):602-603.
[13]王东蕾.性激素六项在原发和继发性不孕症中的临床应用价值[J].临床检验杂志(电子版),2014,3(1):534-535.
[14]高学敏.中药学[M].北京:中国中医药出版社,2007.
[15]王浴铭,杨云.山茱萸临床应用与药理作用[J].河南中医药学刊,1999,14(1):61-62.
[16]刘秀英,孙世成,王英淑,等.枸杞子的临床应用[J].邯郸医学高等专科学校学报,2004,17(6):518-519.
[17]周永莉.柴胡临床应用浅析[J].临床合理用药杂志,2016,9(13):110-112.
[18]刘燕平,黄岑汉.当归对药的临床应用[J].辽宁中医杂志,2010,37(2):325.
[19]段好磊.牛膝古今配伍应用规律研究[D].济南:山东中医药大学,2012.
[20]黄伟震,潘莉莉.炙甘草在经方“六剂”中作用辨析[J].辽宁中医药大学学报,2006,8(5):28-29.
[2]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2016-05-01].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[3]乐杰.妇产科学[M].北京人民卫生出版社,2008:361.
[4]张玉珍.中医妇科学[M].北京:中国中医药出版社,2004:323-324.
[5]常瑞萍,赵可宁.黄体功能不健的不孕症中医临床研究[J].辽宁中医药大学学报,2009,11(4):84-86.
[6]廖更新,潘耀平,成敏锐,等.黄体功能不全与不孕及反复早期自然流产的关系[J].济宁医学院学报,2007,30(2):141-142.
[7]陈银华.女性不孕不育症相关因素与病因探讨[J].深圳中西医结合杂志,2017,27(7):81-82.
[8]倪涵,季桂兰.克罗米芬在不孕症中的应用[J].南京医科大学学报,1998,18(4):357-358.
[9]张雪峰.泌乳素与女性不孕症的关系[J].标记免疫分析与临床,2003,10(4):256.
[10]谭玉彬,刘奇志,陈碧辉,等.两种促卵泡素治疗不孕症的临床疗效比较[J].实用医学杂志,2011,27(13):1802-1803.
[11]何冰,成俊萍,黄莉,等.促黄体生成素在卵泡发育及辅助生殖促排卵中的作用[J].中国临床新医学,2012,5(7):656-659.
[12]赵海专,陈进,苏汉桥,等.162例不孕症患者血清性激素水平的检测及分析[J].武汉大学学报(医学版),2004,25(5):602-603.
[13]王东蕾.性激素六项在原发和继发性不孕症中的临床应用价值[J].临床检验杂志(电子版),2014,3(1):534-535.
[14]高学敏.中药学[M].北京:中国中医药出版社,2007.
[15]王浴铭,杨云.山茱萸临床应用与药理作用[J].河南中医药学刊,1999,14(1):61-62.
[16]刘秀英,孙世成,王英淑,等.枸杞子的临床应用[J].邯郸医学高等专科学校学报,2004,17(6):518-519.
[17]周永莉.柴胡临床应用浅析[J].临床合理用药杂志,2016,9(13):110-112.
[18]刘燕平,黄岑汉.当归对药的临床应用[J].辽宁中医杂志,2010,37(2):325.
[19]段好磊.牛膝古今配伍应用规律研究[D].济南:山东中医药大学,2012.
[20]黄伟震,潘莉莉.炙甘草在经方“六剂”中作用辨析[J].辽宁中医药大学学报,2006,8(5):28-29.