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坤泰胶囊对排卵障碍性不孕症患者卵泡发育、子

2015-07-24 09:31 来源:学术参考网 作者:未知

 【摘要】 目的 探讨中成药坤泰胶囊对排卵障碍性不孕症患者卵泡发育、子宫内膜及排卵的影响。方法 选取排卵障碍性不孕症患者210例, 随机分成A、B、C三组, 各70例。A组口服坤泰胶囊, B组口服克罗米芬, C组口服坤泰胶囊+克罗米芬, 观察三组患者的卵泡大小、数目、子宫内膜厚度及类型。出现成熟卵泡再重新分组, Ⅰ组口服坤泰胶囊, 直至排卵, Ⅱ组肌内注射人绒毛膜促性腺激素(HCG), 观察两组患者排卵及卵泡黄  [;0.05)。结论 坤泰胶囊对卵子发育成熟、改善子宫内膜容受性、卵子排出具有明显效果。
  【关键词】 不孕症;排卵障碍;坤泰胶囊;克罗米芬;人绒毛膜促性腺激素;疗效
  DOI:10.14163/j.cnki.11-5547/r.2015.18.005
  Influence by Kuntai capsule on follicular development, endometrium and ovulation in ovulation failure infertility patients WU Cui-jie. Department of Obstetrics and Gynecology, Anyang City Hospital of Traditional Chinese Medicine, Anyang 455000, China
  【Abstract】 Objective To investigate the influence of Chinese patent medicine Kuntai capsule on follicular development, endometrium and ovulation in ovulation failure infertility patients. Methods A total of 210 ovulation failure infertility patients were randomly divided into groups A, B and C, with 70 cases in each group. Group A received Kuntai capsule through oral administration, group B received clomiphene through oral administration, and group C received Kuntai capsule+clomiphene through oral administration. Size, number of follicular, thickness and type of endometrium were observed in the three groups. Patients with mature follicle were divided into new groups. Group Ⅰ received Kuntai capsule through oral administration till ovulation, and group Ⅱ received human chorionic gonadotropin (HCG) through intramuscular injection. Ovulation and follicle luteinization were observed in the two groups. Results Groups B and C had higher mature follicle number and ovulation rate group A, and their difference had statistical significance (P<0.01), while the difference between group B and group C had no statistical significance (P>0.05). Groups A and C had better thickness and type of endometrium, and the difference had statistical significance (P<0.01), while the difference between group A and group C had no statistical significance (P>0.05). The difference of cases with serum estradiol (E2)≥3000 pg/ml and ovulation rate between groupⅠ and groupⅡ had no statistical significance (P>0.05). GroupⅠ had much lower follicle luteinization rate than groupⅡ, and their difference had statistical significance (P<0.05). Conclusion Kuntai capsule provides obvious effects for ovum development, improving receptivity of endometrium and ovulation.  【Key words】 Infertility; Ovulation failure; Kuntai capsule; Clomiphene; Human chorionic gonadotropin; Curative effect
  排卵障碍包括两个方面:一是卵子发育成熟障碍, 二是卵子排出障碍, 是引起女性不孕的主要原因之一, 约占40%。主要治疗方法是药物诱发排卵。理想的促排卵方案不仅要保证必要的优势卵泡数和卵子排出, 同时应避免并发症。坤泰胶囊为纯中药制剂, 药理研究能改善卵巢功能, 内源性调节促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)等激素群水平。本院采用坤泰胶囊治疗排卵障碍性不孕, 疗效满意, 现报告如下。
  1 资料与方法
  1. 1 一般资料 选取2012年7月~2013年6月本院妇科门诊收治的排卵障碍性不孕患者210例, 年龄23~43岁, 平均年龄(30.8±4.6)岁, 不孕时间2~14年, 平均时间(3.5±3.6)年。所有患者符合《不孕与不育》排卵障碍的临床诊断标准[1], 属于世界卫生组织无排卵分类中的WHOⅠ型和WHOⅡ型, 均排除男方因素、免疫因素和输卵管等生殖系统器质性病变所致不孕。随机分成A、B、C三组, 各70例。三组患者年龄、不孕时间比较, 差异无统计学意义(P>0.05), 具有可比性。
  三组患者经治疗, 当阴道B超监测出现至少1个卵泡成熟(≥18 mm)、子宫内膜厚度达8 mm左右时, 按先后顺序依次编号, 重新分组, 单号为Ⅰ组, 双号Ⅱ组。
  1. 2 治疗方法 A组患者口服坤泰胶囊(国药准字Z20000083, 贵阳新天药业股份有限公司生产), 3次/d, 4粒/次, 直至成熟卵泡出现;B组患者均从月经第5天口服克罗米芬(国药准字H31021107, 上海衡山药业有限公司生产), 50 mg/次, 1次/d, 连服5 d;C组患者口服坤泰胶囊+克罗米芬, 用法同前。
  Ⅰ组患者口服坤泰胶囊, 3次/d, 8粒/次, 直至排卵, 排卵后仍改为3次/d, 4粒/次, 直至化验为阳性;Ⅱ组患者肌内注射HCG 10000 U(前提是血清E2<3000 pg/ml)。
  1. 3 观察指标 A、B、C三组:从月经第10天始阴道B超检查卵泡大小、数目、子宫内膜厚度及类型(A或B型)。
  Ⅰ、Ⅱ两组:观察两组血清E2≥3000 pg/ml的例数、排卵情况和卵泡黄素化情况。超声图像显示卵泡消失或最大卵泡直径缩小>5 mm, 并见囊壁皱缩, 形态不规则, 认为已排卵。
  1. 4 统计学方法 采用

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