温肾养血颗粒联合枸橼酸氯米芬对卵泡发育不良性不孕患者INH-ACT-FS系统的调控作用

[Regulation and control of wenshen yangxue granule combined with clomifene citrate on INH-ACT-FS system in patients with follicular maldevelopment infertility].

作者信息

Ming-wei Xin, Xin-yun Liang, Jun-qin He

机构信息

Department of Traditional Chinese Medicine, Beijing Hospital of Obstetrics and Gynecology, Capital Medical University, Beijing.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Dec;31(12):1596-600.

PMID:22384541

Abstract

OBJECTIVE

To observe the clinical curative effect of Wenshen Yangxue Granule (WSYXG) combined with clomifene citrate (CC) in treating follicular maldevelopment (FM) infertility, and to explore its possible action channels.

METHODS

Ninety patients with FM of Shen-deficiency blood stasis syndrome were randomly assigned to 3 groups, i.e., the Chinese medicine group (CMG, treated with WXYXG), the Western medicine group (WMG, treated with CC), and the combination group of Chinese medicine and Western medicine (CG, treated with both WSYXG and CC), 30 cases in each group. Three menstrual cycles were totally observed. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2 ), inhibin B (INHB), activin A (ACTA), and follistatin (FS) were tested before and after treatment, and the ovulation was monitored and their basic body temperature measured.

RESULTS

There was no statistical difference in clinical efficacy among the three groups (P> 0.05). Better effects on the Chinese medicine syndrome efficacy, the ovulation rate, and the endometrium thickness on the ovulation day were shown in CMG and CG than in WMG, showing statistical difference (P < 0.05). The E2 level increased on the third day of the first menstrual cycle in CG when compared with before treatment. On the 10th day of the 1st menstrual cycle, the INHB and FS increased and the ACTA decreased, showing statistical difference (P < 0.05). On the 10th day of the 3rd menstrual cycle the serum LH level decreased more obviously in CG than in WMG, showing statistical difference (P < 0.05). On the 3rd day of the 3rd menstrual cycle in CG, the INHB was negatively correlated with FSH (r = -0.492,P < 0.01), and INHB on the 10th day was positively correlated with E2 and FS (r = 0.682, 0.772, P < 0.01), and negatively correlated with ACTA on the 10th day (r = -0.635, P < 0.01).

CONCLUSION

WSYXG combined with CC could improve Chinese medicine syndrome, regulate the expressions of FM patients' ovary local factors INHB, ACTA and FS, improve the condition of ovary functions, and control the follicle development.

摘要

目的

观察温肾养血颗粒（WSYXG）联合枸橼酸氯米芬（CC）治疗卵泡发育不良（FM）性不孕的临床疗效，并探讨其可能的作用途径。

方法

将90例肾虚血瘀型FM患者随机分为3组，即中药组（CMG，采用温肾养血颗粒治疗）、西药组（WMG，采用CC治疗）和中西医结合组（CG，采用WSYXG和CC联合治疗），每组30例。共观察3个月经周期。治疗前后检测血清促黄体生成素（LH）、促卵泡生成素（FSH）、雌二醇（E2）、抑制素B（INHB）、激活素A（ACTA）和卵泡抑素（FS）水平，监测排卵情况并测量基础体温。

结果

三组临床疗效无统计学差异（P>0.05）。CMG和CG在中医证候疗效、排卵率及排卵日子宫内膜厚度方面的效果优于WMG，差异有统计学意义（P<0.05）。CG在第1个月经周期第3天时E2水平较治疗前升高。在第1个月经周期第10天时，CG的INHB和FS升高，ACTA降低，差异有统计学意义（P<0.05）。在第3个月经周期第10天时，CG血清LH水平较WMG下降更明显，差异有统计学意义（P<0.05）。在第3个月经周期第3天时，CG的INHB与FSH呈负相关（r=-0.492，P<0.01），第10天时INHB与E2和FS呈正相关（r=0.682、0.772, P<‍0.01），与第10天时的ACTA呈负相关（r=-0.635, P<0.01）。