【作者】 杨东霞；

【导师】 侯丽辉；

【作者基本信息】 黑龙江中医药大学 ， 中医妇科学， 2004， 硕士

【摘要】 无排卵性不孕是妇女常见的不孕症之一，其主要原因是下丘脑—垂体—卵巢轴功能失调引起卵巢排卵障碍，该病在临床上可按不同情况诊断为多囊卵巢综合症、高泌乳素血症、无排卵性月经失调、卵泡黄素化综合症、卵巢早衰等疾病。本病的主要治疗方法是促排卵。本文通过应用中药周期疗法联合克罗米芬／溴隐亭治疗无排卵性不孕，观察中西医结合治疗本病的临床疗效，探讨了本病的病因病机以及中药周期疗法联合克罗米芬／溴隐亭治疗本病的作用机制。 本研究将来自临床的52例无排卵性不孕患者，随机分为两组：西药治疗组、中西药结合治疗组。共治疗两个疗程(6个月)。用药后记录以下指标：宫颈评分、基础体温(BBT)、B超监测排卵情况、优势卵泡直径、血清孕酮(P)及排卵期子宫内膜厚度。 结果表明：中西药结合组的总有效率和治愈率明显高于单纯西药组，排卵率和妊娠成功率也较高，且无明显不良反应出现；中西药结合组排卵期子宫内膜厚度较厚、宫颈评分较高，卵泡发育好，月经周期第21～23天血清P值较高。 本研究提示无排卵性不孕的病因病机主要为肾虚，临床以肾阳虚夹痰湿、肾阴虚兼肝郁多见，故温肾祛痰、滋肾疏肝是治疗无排卵性不孕症的有效方法；中药周期疗法联合克罗米芬／溴隐亭能显著提高排卵率，中西药结合组排卵期的宫颈评分及子宫内膜厚度均优于西药组，这可能是中西药结合治疗无排卵性不孕妊娠率较高的原因。更多还原

【Abstract】 Objective: To observe the effect of the periodical therapy of Chinese medicine combined with clomiphene /bromocriptine on patients with anovulatory infertility and to explore the mechanism of this treatment from the view of Chinese traditional medicine.Method: 52 cases of anovulatory infertility were divided into two treatment groups:GroupA,(n=25) treated by clomiphene/ bromocriptine. GroupB, (n=27) by Tiaoj ingzhuyun decoction and clomiphene/bromocriptine, respectively. After treatment, the serum level of progesterone was measured in the 21- 23th day of menstrual cycle. With transvaginal sonography the follicular development and periovulatory endometrial thickness were monitored. The effects of treatment were evaluated by pregent rate, ovulatory rate , periovulatory endometrial thickness,the cervical mucus scores, basal body temperature and the serum level of P.Results: serum level of P in group B was higher than that in group A. The other indices in group B is better than those in group A. The efficiency of group B is superior to group A.Conclusion: The periodic therapy of Chinese medcine combined with clomifene/bromocriptine is an effective recipe in ovulation induction. The effect may be achieve by this treatment through regulating the function of hypothalamus -pituitary - ovary axis and the endocrinal enviroment in the patients with anovulatory infertility.更多还原