摘要
目的 加味五子衍宗丸联合地屈孕酮片在黄体功能不全(LPD)不孕症患者中的应用效果.方法 选取2021 年11 月—2022 年12 月180 例LPD不孕症,随机数字表法分为对照组和观察组,每组90 例,对照组采取地屈孕酮片治疗,于此基础上观察组联合加味五子衍宗丸治疗.观察2 组疗效、不良反应、妊娠率,比较治疗前后中医证候积分、高温相评分(HPS)、性激素[孕酮(P)、雌二醇(E2)]、子宫动脉血流阻力指数(RI)、搏动指数(PI)、子宫内膜厚度、Th1/Th2 细胞因子[白细胞介素-4(IL-4)、白细胞介素-13(IL-13)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]及子宫内膜容受性相关 miRNA 表达.结果 观察组总有效率 86.67%(78/90)高于对照组 65.56%(59/90)(P＜0.05).治疗后观察组各中医证候积分、RI、PI、TNF-α、IFN-γ水平低于对照组,基础体温HPS、子宫内膜厚度、P、E2、IL-4、IL-13 水平高于对照组(P＜0.05).治疗后观察组miR-494-5p、miR-544b表达量低于对照组,miR-4427 表达量高于对照组(P＜0.05).观察组不良反应总发生率10.00%与对照组6.67%比较,无显著差异(P＞0.05);观察组妊娠率高于对照组(P＜0.05).结论 在LPD不孕症患者治疗中,加味五子衍宗丸联合地屈孕酮片可增强疗效,改善子宫内膜容受性,促进胚胎植入,提高妊娠率,这可能与Th1/Th2 免疫应答、miRNA调控有关.
Abstract
Objective To explore the application effect of modified Wuzi Yanzong pills combined with Dydrogester-one tablets in infertility patients with luteal phase defect(LPD).Methods A total of 180 cases of infertility caused by LPD from November 2021 to December 2022 were selected and divided into control group and observation group by random number table method,with 90 cases in each group.The control group was treated with Dydrogesterone tablets,and the observation group was supplemented with Wuzi Yanzong pill on this basis.The efficacy,adverse reactions and pregnancy rate of the two groups were observed.TCM syndrome score,high temperature phase score(HPS),sex hormone[progesterone(P),estradi-ol(E2)],uterine artery flow resistance index(RI),pulse index(PI),endometrial thickness,Th1/Th2 cytokines[interleu-kin-4(IL-4),interleukin-13(IL-13),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)]and miRNA expression re-lated to endometrial receptivity were compared before and after treatment.Results The total effective rate of the observation group was86.67%(78/90),which was higher than that of the control group[65.56%(59/90)](P＜0.05).After treat-ment,the TCM syndrome scores,RI,PI,TNF-α and IFN-γ levels in observation group were lower than those in control group,while the basal body temperature HPS score,endometrial thickness,P,E2,IL-4 and IL-13 levels in observation group were higher than those in control group(P＜0.05).After treatment,the expression levels of miR-494-5p and miR-544b in the observation group were lower than those in the control group,and the expression levels of miR-4427 were higher than those in the control group(P＜0.05).The total incidence of adverse reactions in the observation group was 10.00%compared with 6.67%in the control group(P＞0.05).The pregnancy rate of observation group was higher than that of control group(P＜0.05).Conclusion In the treatment of infertility patients caused by LPD,the combination of modified Wuzi Yanzong pills and Didrogesterone tablet can enhance the curative effect,improve endometrial tolerance,promote embryo implantation,and increase the pregnancy rate,which may be related to Thl/Th2 immune response and miRNA regulation.
维普
万方数据