补肾调周法改善卵巢储备功能在辅助生殖技术中运用的临床研究

补肾调周法改善卵巢储备功能在辅助生殖技术中运用的临床研究

李 东郭 佳

李 东,女,硕士,副主任医师(北京大学第三医院中医科 北京100083)

摘要:目的 观察补肾调周法在辅助生殖技术中改善卵巢储备功能的临床疗效。方法 将体外受精 胚胎移植(I V F ET)过程中因卵巢功能不良被建议放弃促排卵周期的患者按随机表随机分为中药组(30例)和西药去氧孕烯炔雌醇(30例),观察两组治疗前后月经周期第2~3天血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)的基础值(bFSH、bL H、bE2)水平,并观察治疗前后窦卵泡变化情况。结果中药组治疗后血清基础bFSH、bLH水平及FS H/LH比值较治疗前降低(P<0.

05),而且在降低bFS H水平及增加高龄妇女窦卵泡数方面优于西药对照组(P<0.05)。结论 中药可以改善不孕妇女的卵巢储备,为辅助生殖技术提供新思路和方法。

关键词:补肾调周;卵巢储备功能;辅助生殖技术

中图分类号:R271.14

Appli cati on of ki dney rei nforci ng and m enstrual cycle regul ati ng therapy i n assisted reproductive techniques for i m proving ovarian reserve

LI Dong,GUO Jia

(Depart m ent of Ch i n ese M edicine,Th ird H osp ita,l Peking University,Be ijing 100083)

Abst ract:Objec tive To obser ve the cura ti v e effect of kidney-re i n fo rcing and m enstr ual cycle regu l a ti n g t h erapy for i m prov i n g ovarian reserve i n assisted reproducti v e techniques(ART).M et hod The pati e nts,w ho w ere suggested to abandon the pro m oti n g ovulati o n duri n g in v itro fertilizati o n e m br yo transp lant(I V F ET)period because their ovarian reserves were poor,w ere rando m ly div i d ed into the treat m ent group(treated w ith Ch i n ese m edicines,n=30)and t h e contro l group(treated w it h Desogestre l and E th i n ylestrad i o lTab lets,n=30)accord i n g to the rando m tab le.The serum leve ls of basal fo llicle sti m u lating hor m one(bFSH),basa l lute i n izing hor m one(bL H)and basal estradio l(bE2),as w ell as the changes o f antral fo llicles,were observed on2nd to3r d day of a m enstr ua l cycle in t w o g r oups before and after t h e treat m en.t R esult The serum leve ls of bFS H,bL H and ratio of FS H to LH i n the treat m en t group w ere decreased after t h e treat m ent(P<0.05).The resu lts o f the treat m ent group i n the decrease o f bFSH and i n crease o f an tra l fo llicle nu m ber i n aged wo m en w ere better than those o f the contro l group(P <0.05).Conclusion Chinese m ed icines can pro m ote the ovarian reserve i n sterility w o m en,w hich open a ne w trai n of th i n k i n g and prov i d e ne w m ethods for ART.

K ey words:k i d ney re i n forci n g and m enstrua l cyc le regulati n g;ovarian reser ve;assisted repr oducti v e techniques

随着人们思想观念的更新,婚龄及育龄的拖延,感染类疾患发病率的上升,以致不孕不育的发生率呈上升趋势。近十几年,我国广泛开展了辅助生殖技术(A ssisted Reproducti v e Techniques,ART),尤其人工受精-胚胎移植技术(I V F ET)已广泛用于治疗不孕症。体外受精成功的关键在于通过超促排卵获得数量适中的优质卵子,但部分患者尤其大龄不孕者因卵巢反应低下,不能募集足够数量的卵子,甚

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第31卷第2期2008年2月V o.l31N o.2F eb.2008 北京中医药大学学报

Journal o f Be iji ng U n i versity o f T rad iti ona l Chinese M ed i c i ne