【作者】 刘建国；

【导师】 马健； 金保方；

【作者基本信息】 南京中医药大学 ， 中医临床基础， 2010， 博士

【摘要】 目的：研究补肾调周法对拟行辅助生殖技术周期患者治疗的可行性和有效性。通过研究补肾调周法对于拟行体外受精-胚胎移植(IVF-ET)或单精子卵泡浆注射(ICSI)与冻胚移植(FET)患者干预的疗效分析,评价补肾调周法对于拟行IVF/ICSI-ET或FET的患者临床干预的价值。探讨补肾调周法在辅助生殖各个环节的作用机理,并研究中药保胎的可能机制。从中医角度为拟行IVF/ICSI-ET或FET患者提供可行性建议,增加IVF/ICSI-ET或FET的成功率,给本病的诊治提供新的方法,为临床治疗本病提供帮助。方法：将拟行辅助生殖技术的患者,根据其选择辅助生殖技术的方式分为两个大组,一大组为拟行鲜胚移植周期的患者,另一大组为拟行冻胚移植周期的患者。鲜胚移植周期组：将160例拟行IVF/ICSI-ET的患者随机分为干预组(80例)和对照组(80例),对照组采用江苏省人民医院生殖中心常规的进IVF/ICSI-ET周期方案,干预组在对照组的治疗基础上运用补肾调周法对其进行中药治疗,观察两组患者子宫内膜厚度、计算取卵数、观察受精率、计算优质胚胎率、生化妊娠率和临床妊娠率。冻胚移植周期组：将160例拟行冻胚移植周期(FET)的患者随机分为干预组(80例)和对照组(80例),对照组采用江苏省人民医院生殖中心常规进FET周期方案,干预组在对照组的治疗基础上运用补肾调周法对其进行中药治疗,观察两组患者子宫内膜厚度,统计生化妊娠率和临床妊娠率。结果：干预组患者在子宫内膜厚度、取卵数、受精率、优质胚胎率、生化妊娠率和临床妊娠率均有显著性统计学差异,其中鲜胚移植周期组：干预组可以极显著提高患者子宫内膜的厚度(P<0.01)；而且在提高取卵数、受精率、优质胚胎率及最终提高临床妊娠率方面均优于对照组(P<0.05)。冻胚移植周期组：治疗组可以极显著提高患者子宫内膜的厚度(P<0.01)；而且在提高患者生化妊娠率及最终提高临床妊娠率方面均优于对照组(P<0.05)。结论：补肾调周法可以促进患者排卵数、增加子宫内膜内膜厚度、提高受精率及优质胚胎率、辅助胚胎着床,进行安胎,提高其临床妊娠率。因此补肾调周法配合辅助生殖技术进周期方案,可明显提高患者的辅助生殖妊娠率,具有良好的经济和社会价值。更多还原

【Abstract】 Objective:To observe the curative effect of kidney-reinforcing and menstrual cycle-regulating therapy with in assisted reproductive techniques (ART). Research the feasibility and effectiveness of the patients with kidney-reinforcing and menstrual cycle-regulating therapy with in ART. Through the study kidney-reinforcing and menstrual cycle-regulating therapy with in vitro fertilization-embryonic or single sperm injection (IVF /ICSI-ET) and frozen embryos transplantation (FET) patients, evaluation of value of kidney-reinforcing and menstrual cycle-regulating therapy with in ART. Discusses in kidney-reinforcing and menstrual cycle-regulating therapy with in ART each link mechanism, clinical treatment for help.Methods:ET group:The 160cases receiving IVF/ICSI-ET were randomly divided into two groups:the treatment group (n=80) treated with the routine schedule of hospital of JianSu province people combined with kidney-reinforcing and menstrual cycle-regulating therapy in different periods of IVF-ET, and the control group (n=80) with the routine schedule of hospital of JianSu province pepole alone. The, endometrium thickness, follicular oocyte number, fertilization rate, high-quality embryo rate and pregnancy rate of both groups were observedFET group:The 160cases receiving FET were randomly divided into two groups:the treatment group (n=80) treated with the routine schedule of hospital of JianSu province people combined with kidney-reinforcing and menstrual cycle-regulating therapy in different periods of IVF-ET, and the control group (n=80) with the routine schedule of hospital of JianSu province pepole alone. The, endometrium thickness,and pregnancy rate of both groups were observedResults:ET group:In the treatment group, endometrium thickness and ertilization rate increased (P＜0.01), and the effect on increasing high-quality embryorate, biochemical pregnancy rate and clinical pregnancy rate was better than that in the control group (P＜0.05)FET group:In the treatment group, endometrium thickness increased (P＜0.01), and the effect on increasing biochemical pregnancy rate and clinical pregnancy rate was better than that in the control group (P<0.05)Conclusions:The therapy of kidney-reinforcing and menstrual cycle-regulating is effective in promoting ovulation, increasing endometrium thickness, and helping embryo implantation. In combination with assisted reproductive techniques, it increases the pregnancy rate, serving as an effective treatment for infertile women.更多还原