CAJ | 학술논문

目的：观察中药促排卵颗粒联合克罗米芬治疗排卵障碍性不孕症的临床疗效。方法：将171例排卵障碍患者分为中药组42例，克罗米芬（CC）组53例，中药＋CC组76例。超声观察患者子宫内膜、卵泡发育和子宫动脉搏动指数（PI），测定用药前后E2、LH、P值，并随访患者妊娠情况。结果：中药＋CC组和CC组的排卵率高于中药组（P＜0．05）；中药＋CC组妊娠率高于中药组和CC组（P＜0．05）。中药＋CC组和中药组的子宫内膜厚度及A型内膜率高于CC组（P＜0．05）。治疗后HCG日3组PI值比较，中药＋CC组和中药组低于CC组（P＜0．05）。3组的E2值治疗后明显高于治疗前，中药＋CC组及CC组的E2、LH治疗前后的差值明显高于中药组（P＜0．05）；排卵后7 d中药＋CC组和中药组的P值治疗前后的差值高于CC组（P＜0．05）。结论：中药与克罗米芬联用可以促进卵泡的发育，改善 CC 的抗雌激素作用，调节子宫内膜血流及内分泌，提高排卵率，降低流产率，治疗排卵障碍性不孕优于单独使用CC和中药治疗。
목적：관찰중약촉배란과립연합극라미분치료배란장애성불잉증적림상료효。방법：장171례배란장애환자분위중약조42례，극라미분（CC）조53례，중약＋CC조76례。초성관찰환자자궁내막、란포발육화자궁동맥박동지수（PI），측정용약전후E2、LH、P치，병수방환자임신정황。결과：중약＋CC조화CC조적배란솔고우중약조（P＜0．05）；중약＋CC조임신솔고우중약조화CC조（P＜0．05）。중약＋CC조화중약조적자궁내막후도급A형내막솔고우CC조（P＜0．05）。치료후HCG일3조PI치비교，중약＋CC조화중약조저우CC조（P＜0．05）。3조적E2치치료후명현고우치료전，중약＋CC조급CC조적E2、LH치료전후적차치명현고우중약조（P＜0．05）；배란후7 d중약＋CC조화중약조적P치치료전후적차치고우CC조（P＜0．05）。결론：중약여극라미분련용가이촉진란포적발육，개선 CC 적항자격소작용，조절자궁내막혈류급내분비，제고배란솔，강저유산솔，치료배란장애성불잉우우단독사용CC화중약치료。
Objective To observe the clinical curative effect of patients with ovulation obstructive infertility by combined treatmentofstimulating ovulation particles and clmiphene citrateclinical. Methods 171 patients were randomly divided into Traditional Chinese medicine (TCM) group (42 cases), clmiphene citrateclinical (CC) group (53 cases) andcombined treatment of TCM and CC group (76 cases). Ultrasound examinations were used to monitor the development of endometrium, follicular development and value of Plusatility Index (PI). The levels of E2,LH and P were measured before and after medication. And pregnancy of patients was followed up. Results Ovulation rates of combined treatment of TCM and CC group and the CC group were both higher than TCM group (P<0.05). Pregnancy rate of combined treatment of TCM and CC group was higher than TCM group and CC group (P<0.05). Endometrial thickness and type A lining rate of combined treatment of TCM and CC groupandTCM group were both higher than CC group (P < 0.05). The values of PI of combined treatment of TCM and CC groupand TCMgroup were both lower than CC group on HCG day after treatment (P<0.05). E2 values ofpost-treatment of three groups were all significantly higher than that before treatment.Difference in values of E2 and LH between pretherapy and post-treatment of combined treatment of TCM and CCwere obviously higher than that of TCM group (P<0.05).Difference in values of P between pretherapy and post-treatment of tcombined treatment of TCM and CC and TCM group were higher than CC group on the seventh day after ovulation (P < 0.05). Conclusions Combination of traditional Chinese medicine and CCcouldnot only promote follicle growth , but also improve anti-estrogen role of CC , endometrial blood flow and endocrine regulation , enhance ovulation rate and decrease the rate of abortion. Ovulation obstructive infertility treatment was better than that of CC and TCM treatment.