摘要
【目的】观察垂体降调节超促排卵周期加用益气血补肝肾中药对体外受精(IVF)周期性激素水平及临床结局指标的影响。【方法】将207例行周期标准长方案垂体降调节体外受精—胚胎移植(IVF-ET)治疗的患者随机分为中药组(101例)和对照组(106例),中药组于应用促性腺激素释放激素激动剂(GnRH-a,曲普瑞林)降调节时加用促黄体颗粒1周,于应用促性腺激素(Gn)促排卵时加用经后增殖颗粒至绒毛膜促性腺激素(HCG)注射日;取卵后继续给予促黄体颗粒1周。对照组采用标准方案治疗不加用中药。主要观察2组一般资料、HCG日血清性激素水平及临床结局等指标的变化。【结果】2组患者的不孕因素构成比例、平均年龄、不孕年限、获卵数、受精方式、受精率、平均移植胚胎数、黄体酮用量等指标比较,差异均无显著性意义(P>0.05)。但中药组平均Gn天数和Gn用量显著低于对照组(P<0.01或P<0.001),HCG日促黄体生成素(LH)水平中药组和对照组分别为(1.2±0.47)U/L和(1.06±0.53)U/L,2组比较,差异有显著性意义(P<0.05)。中药组种植率和双胎率均高于对照组(P<0.05);2组的妊娠率及流产率比较,差异无显著性意义(P>0.05)。【结论】益气血补肝肾中药能适当提高垂体降调节后HCG日的LH水平,减少Gn用量和使用天数,增加胚胎种植率。
Objective To observe the effect of therapy of strengthening Qi and blood, and tonifying liver and kidney on sexual hormone levels and clinical outcome in in-vitro fertilization patients. Methods Two hundred and seven patients receiving in-vitro fertilization and embryo transfer （IVF-ET） were randomized into herbal medicine group （ N = 101 ） and control group （ N = 106 ）. The herbal medicine group was treated with gonadotrophinreleasing hormone agonist （GnRH-a） for down-regulation and ovarian stimulation and with herbal medicine of Cu Huangti Granules for one week, and then with gonadotrophin （Gn） combined with Jinghou Zengzhi Granules till human chorionic gonadotrophin （HCG） days, finally with Cu Huangti Granules for one more week after ovulation. The control group received the same IVF-ET regimen but without medication of herbal medicine. A retrospective analysis was carried out for serum sexual hormones levels and clinical outcome during HCG days in the two groups.Results The differences of the constituent ratio of infertility factors, mean age, infertility time, ovulation frequency, fertility route, fertility rate, averaged transferred embryos, and progesterone dosage were insignificant in the two groups （P 〉 0. 05 ）. In herbal medicine group, the days for usage of Gn were shorter and Gn dosage was less than those in the control group. Serum luteinizing hormone （LH） level during HCG days was 1.2 ±0. 47 U/L in herbal medicine and 1.06 ± 0. 53 U/L in the control group （P = 0. 048 ）. Implantation rate and bigeminal rate were higher in herbal medicine group than those in the control group （ P 〈 0.05 ） , but the differences of pregnancyrate and abortion rate were insignificant in the two groups （ P 〉 0. 05 ）. Conclusion Herbal medicine with the actions of strengthening Qi and blood, and tonifying liver and kidney can increase serum LH level during HCG days, reduce Gn dosage and medication time, and increase embryo implantation rate for infertility patients after treatment with GnRH-a.
出处
《广州中医药大学学报》
CAS
2010年第5期457-460,共4页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局科研基金课题(编号:2009437)
关键词
经后增殖颗粒/治疗应用
促黄体颗粒/治疗应用
益气血补肝肾法
体外受精—胚胎移植
促黄体生成素
JINGHOU ZENGZHI GRANULES/therapeutic use
CU HUANGTI GRANULES/therapeutic use
THERAPY OF STRENGTHENING QI AND BLOOD, AND TONIFYING LIVER AND KIDNEY
IN-VITRO FERTILIZATION-EMBRYO TRANSFER
LUTEINIZING HORMONE
