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目的:观察归肾丸合逍遥散联合克罗米芬治疗多囊卵巢综合征(PCOS)排卵障碍性不孕的临床疗效。方法:将90例PCOS排卵障碍性不孕患者随机分为对照组和观察组各45例,2组均予枸橼酸氯米芬胶囊口服治疗,观察组在此基础上应用中药周期疗法,服用归肾丸合逍遥散加减,总疗程均为3个月经周期。治疗前后检测性激素水平,并在治疗过程中观察患者排卵、妊娠、并发卵巢过度刺激症(OHSS)情况;疗程结束后当月进行宫颈黏液评分,比较2组的临床疗效。结果:观察组总有效率为88.89%,对照组总有效率为66.67%,2组相比,差异有统计学意义(P<0.01)。疗程结束后,2组黄体生成激素(LH)、睾酮(T)及雌二醇(E2)均较治疗下降,促卵泡激素(FSH)较治疗前上升,差异均有统计学意义(P<0.05,P<0.01);观察组LH及T水平均较对照组下调(P<0.05),FSH及E2水平虽较对照组有所改善,但差异均无统计学意义(P>0.05)。2组排卵率接近(P>0.05)。观察组妊娠率达24.44%,高于对照组的11.11%,差异有统计学意义(P<0.01)。对照组有3例并发OHSS,观察组仅1例并发OHSS。观察组宫颈黏液评分高于对照组(P<0.01)。结论:归肾丸合逍遥散联合克罗米芬治疗PCOS排卵障碍性不孕能有效改善患者的激素水平,提高排卵率及妊娠率,缓解临床症状,减少并发症,临床疗效满意。
Objective: To observe the curative effect of Guishen pill combined Xiaoru powder combined with clomiphene in the treatment of polycystic ovary syndrome (PCOS) ovulation disorder infertility. Methods: Ninety patients with infertility with PCOS were randomly divided into control group and observation group (n = 45). The two groups were orally treated with clomiphene citrate capsules. The observation group was treated with traditional Chinese medicine cycle therapy Guishen pill combined Xiaoyaosan addition and subtraction, the total course of treatment is 3 menstrual cycle. The levels of sex hormones were measured before and after treatment. Ovulation, pregnancy and ovarian hyperstimulation (OHSS) were observed in the course of treatment. Cervical mucus score was measured in the same month after the treatment, and the clinical efficacy was compared between the two groups. Results: The total effective rate was 88.89% in the observation group and 66.67% in the control group. There was significant difference between the two groups (P <0.01). After the course of treatment, the LH, T and E2 levels in the two groups were significantly lower than those before treatment, and FSH was higher than before treatment (P <0.05 , P <0.01). The levels of LH and T in the observation group were significantly lower than those in the control group (P <0.05). The levels of FSH and E2 in the observation group were improved compared with those in the control group, but the differences were not statistically significant (P> 0.05). The ovulation rate in the two groups was close (P> 0.05). The pregnancy rate of observation group was 24.44%, which was higher than that of control group (11.11%), the difference was statistically significant (P <0.01). There were 3 cases of OHSS complicated with OHSS in the control group and only 1 case of OHSS in the observation group. Cervical mucus score in observation group was higher than that in control group (P <0.01). Conclusion: Guishen pill combined Xiaoru powder combined with clomiphene in ovulation disorder infertility PCOS can effectively improve the patient’s hormone levels, improve ovulation and pregnancy rates, relieve clinical symptoms and reduce complications, the clinical efficacy is satisfactory.