| 刘宇新,祁冰.不同降调节方案联合温肾活血汤在肾虚血瘀证多囊卵巢综合征不孕病人辅助生殖中的应用效果[J].安徽医药,2026,30(6):1248-1253. |
| 不同降调节方案联合温肾活血汤在肾虚血瘀证多囊卵巢综合征不孕病人辅助生殖中的应用效果 |
| Application effect of different down-regulation protocols combined with Wenshen Huoxue decoction in assisted reproduction of infertile patients with polycystic ovary syndrome of kidney deficiency and blood stasis syndrome |
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| DOI：10.3969/j.issn.1009-6469.2026.06.037 |
| 中文关键词: 多囊卵巢综合征 温补肾阳 活血化瘀 超长降调节方案 长降调节方案 不孕 体外受精 /卵胞质内单精子注射技术 |
| 英文关键词: Polycystic ovary syndrome Warmly invigorating kidney yang Promoting blood circulation for removing blood stasis Ultra-long down conditioning program Long down conditioning program Infertility In vitro fertilization/intracytoplasmic sperm injection technology |
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| 中文摘要: |
| 目的分析在肾虚血瘀证多囊卵巢综合征( PCOS)不孕病人体外受精 /卵胞质内单精子注射( IVF/ICSI)技术辅助生殖中应用不同的降调节方案联合温肾活血汤的临床效果。方法前瞻性纳入 2021年 2月至 2022年 2月北京同仁堂中医医院收治的 66例肾虚血瘀证 PCOS不孕病人作为研究对象，采用随机数字表法分为对照 1组( n=16)、对照 2组( n=16)、观察 1组( n=17)和观察 2组( n=17)。对照 1组采用超长降调节方案，对照 2组采用长降调节方案，观察 1组采用超长降调节方案 +温肾活血汤，观察 2组采用长降调节方案 +温肾活血汤，比较四组治疗前后的性激素水平、卵巢体积、窦卵泡数目，并统计四组促排卵相关指标、胚胎着床率、临床妊娠率及卵巢过度刺激综合征发生率。结果治疗后，观察 1组和观察 2组的雌二醇和卵泡刺激素指标水平高于对照 1组和对照 2组( P<0.05)；观察 1组和观察 2组的血清睾酮和黄体生成素指标水平低于对照 1组和对照 2组( P<0.05)；观察1组和观察 2组的卵巢体积小于对照 1组和对照 2组(P<0.05)；观察 1组和观察 2组的窦卵泡数目少于对照 1组和对照 2组( P<0.05)；观察 1组和观察 2组的促性腺激素使用的时间短于对照 1组和对照 2组( P<0.05)；观察 1组和观察 2组的促性腺激素使用的剂量少于对照 1组和对照 2组( P<0.05)；观察 1组和观察 2组的胚胎着床率［ 94.12%(16/17)比 50.00%(8/16)、 100.00%(17/17)比 50.00%(8/16)］和临床妊娠率［ 94.12%(16/17)比 43.75%(7/16)、 94.12%(16/17)比 50.00%(8/16)］高于对照 1组和对照 2组( P<0.05)；观察 1组和观察 2组的卵巢过度刺激综合征发生率低于对照 1组和对照 2组( P<0.05)。治疗前，四组的中医证候积分比较差异无统计学意义( P>0.05)；治疗后，观察 1组和观察 2组的中医证候积分均低于对照组 1组和对照组 2组( P<0.05)。观察 1组和观察 2组的总有效率高于对照 1组和对照 2组［ 94.12%(16/17)比 62.50%(10/16)、 94.12%(16/17)比 56.25%(9/16)，P<0.05］。观察 1组和观察 2组治疗后以上指标均差异无统计学意义( P>0.05)。结论超长降调节方案和长降调节方案在 PCOS不孕病人 IVF/ICSI技术辅助生殖中效果无明显差别，两种降调节方案联合温肾活血汤均可有效提升胚胎着床率和临床妊娠率，改善病人的性激素水平及其卵巢体积和卵泡数目异常增大和增多情况，并减少促性腺激素使用时间、剂量及卵巢过度刺激综合征的发生风险，提高 IVF/ICSI技术辅助生殖过程中的安全性。 |
| 英文摘要: |
| Objective To analyze the clinical efficacy of different down-regulation protocols combined with Wenshen Huoxue decoc. tion in infertile patients with polycystic ovary syndrome (PCOS) of kidney deficiency and blood stasis syndrome undergoing assisted re.production with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).Methods A prospective study was conducted on 66infertile PCOS patients with kidney deficiency and blood stasis syndrome admitted to Beijing Tongrentang Hospital of Traditional Chi.nese Medicine from February 2021 to February 2022. They were randomly divided into control group 1 (n=16), control group 2 (n=16), observation group 1 (n=17), and observation group 2 (n=17). Control group 1 received the ultra-long down-regulation protocol; control group 2 received the long down-regulation protocol; observation group 1 received the ultra-long down-regulation protocol plus Wenshen Huoxue decoction; observation group 2 received the long down-regulation protocol plus Wenshen Huoxue decoction. Sex hormone levels, ovarian volume, and antral follicle count were compared among the four groups before and after treatment. Ovulation induction-related indicators, embryo implantation rate, clinical pregnancy rate, and incidence of ovarian hyperstimulation syndrome (OHSS) were also re.corded.Results After treatment, the levels of estradiol and follicle-stimulating hormone in observation group 1 and observation group2 were higher than those in control group 1 and control group 2, and the differences were statistically significant (P<0.05). The levels ofserum testosterone and luteinizing hormone in observation group 1 and observation group 2 were lower than those in control group 1 andcontrol group 2, and the differences were statistically significant (P<0.05). The ovarian volume in observation group 1 and observationgroup 2 was smaller than that in control group 1 and control group 2, and the differences were statistically significant (P<0.05). Thenumber of antral follicles in observation group 1 and observation group 2 was less than that in control group 1 and control group 2, andthe differences were statistically significant (P<0.05). The number of days of gonadotropin use in observation group 1 and observationgroup 2 was shorter than that in control group 1 and control group 2, and the differences were statistically significant (P<0.05). The dos.age of gonadotropin used in observation group 1 and observation group 2 was less than that in control group 1 and control group 2, andthe differences were statistically significant (P<0.05). The embryo implantation rates [94.12% (16/17) vs. 50.00% (8/16), 100.00% (17/ 17) vs. 50.00% (8/16)] and clinical pregnancy rates [94.12% (16/17) vs. 43.75% (7/16), 94.12% (16/17) vs. 50.00% (8/16)] in observa.tion group 1 and observation group 2 were higher than those in control group 1 and control group 2, and the differences were statistical.ly significant (P<0.05). The incidence of ovarian hyperstimulation syndrome in observation group 1 and observation group 2 was lowerthan that in control group 1 and control group 2, and the differences were statistically significant (P<0.05). Before treatment, there was no statistically significant difference in TCM syndrome scores among the four groups (P>0.05). After treatment, the TCM syndromescores in observation group 1 and observation group 2 were lower than those in control group 1 and control group 2, and the differenceswere statistically significant (P<0.05). The total effective rate in observation group 1 and observation group 2 was higher than that incontrol group 1 and control group 2, and the differences were statistically significant [94.12% (16/17) vs. 62.50% (10/16), 94.12% (16/ 17) vs. 56.25% (9/16), P<0.05]. After treatment, there were no statistically significant differences in the above indicators between obser.vation group 1 and observation group 2 (P>0.05).Conclusions There is no significant difference in the effects between the ultra-long down-regulation protocol and the long down-regulation protocol in the assisted reproduction of IVF/ICSI technology in infertile patients with PCOS. Both down-regulation protocols combined with Wenshen Huoxue decoction can effectively improve the embryo implantationrate and clinical pregnancy rate, improve the patients' sex hormone levels and the abnormal enlargement and increase of ovarian vol.ume and follicle number, reduce the number of days and dosage of gonadotropin use and the risk of ovarian hyperstimulation syndrome,and improve the safety during the assisted reproduction process of IVF/ICSI technology. |
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