中药补肾序贯疗法有效提高卵巢储备功能下降女性的生殖潜能及生活质量：一项随机对照研究
Sequential therapy for kidney-tonifying via traditional Chinese medicine effectively improves the reproductive potential and quality of life of women with decreased ovarian reserve: a randomized controlled study.
作者信息
Duan Wenxu, Cheng Yueyi
机构信息
Department of Gynecology, Tianjin Nankai Hospital Tianjin City, China.
Department of Surgery, Tianjin Public Security Hospital Tianjin City, China.
出版信息
Am J Transl Res. 2021 Apr 15;13(4):3165-3173. eCollection 2021.
OBJECTIVE
To investigate the effect of sequential therapy for kidney-tonifying via traditional Chinese medicine (TCM) on improving the fecundity and quality of life (QOL) of women with decreased ovarian reserve (DOR).
METHODS
A prospective and randomized controlled study was conducted, in which 80 infertile patients with DOR were selected in our hospital and randomly divided into the test group (n=40) and the control group (n=40). The control group was given sequential therapy of artificial menstrual cycle via administration of estrogen and progesterone, and the test group received sequential therapy for kidney-tonifying via TCM. Then, Kupperman indices, hormone levels, ovarian reserve functions, menopause specific quality of life questionnaire (MENQOL) scores, as well as the pregnancy rates within one year before and after treatment were compared between the two groups.
RESULTS
Compared with the control group, the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and resistance index (RI) of ovarian stroma were significantly decreased in the test group (all P<0.001), while the levels of estradiol (E2), anti-Mullerian hormone (AMH), mid-luteal phase E2, progesterone, antral follicular count (AFC), and ovarian diameter (OVD) of patients were notably increased in the test group (all P<0.001). After treatment, the Kupperman indices and MENQOL scores of the test group were considerably lower than those of the control group (P<0.001). No adverse effects were observed in the test group, whereas the incidence of adverse effects in the control group was 12.50%, although without significant difference between the two groups (P>0.05). The pregnancy rate within one year in the test group was significantly higher than that of the control group (47.50% vs. 25.00%) (P<0.05).
CONCLUSION
Sequential therapy for kidney-tonifying via TCM could effectively improve the clinical symptoms, hormone levels, and ovarian function, increase ovulation quality and pregnancy rate, and improve the QOL of DOR patients.
目的
探讨中医补肾序贯疗法对改善卵巢储备功能下降（DOR）女性生育力及生活质量（QOL）的影响。
方法
进行一项前瞻性随机对照研究，选取我院80例DOR不孕患者，随机分为试验组（n = 40）和对照组（n = 40）。对照组采用雌激素和孕激素进行人工月经周期序贯治疗，试验组采用中医补肾序贯疗法。然后，比较两组治疗前后的库珀曼指数、激素水平、卵巢储备功能、绝经特异性生活质量问卷（MENQOL）评分以及一年内的妊娠率。
结果
与对照组相比，试验组促卵泡生成素（FSH）、促黄体生成素（LH）及卵巢基质阻力指数（RI）水平显著降低（均P < 0.001），而患者的雌二醇（E2）、抗苗勒管激素（AMH）、黄体中期E2、孕酮、窦卵泡计数（AFC）及卵巢直径（OVD）水平显著升高（均P < 0.001）。治疗后，试验组的库珀曼指数和MENQOL评分显著低于对照组（P < 0.001）。试验组未观察到不良反应，而对照组不良反应发生率为12.50%，两组间虽无显著差异（P > 0.05）。试验组一年内的妊娠率显著高于对照组（47.50%对25.00%）（P < 0.05）。
结论
中医补肾序贯疗法可有效改善DOR患者的临床症状、激素水平及卵巢功能，提高排卵质量和妊娠率，改善生活质量。
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