【摘要】 目的:研究薄型子宫内膜患者黄体中期超声参数特征,观察补胞汤联合针刺对薄型子宫内膜患者的干预作用及对后续冻融胚胎移植(FET)妊娠结局的影响。方法:利用阴道彩超检测85例薄型子宫内膜患者(薄型子宫内膜组)和30例正常育龄妇女(对照组)的黄体中期子宫内膜厚度、子宫血流参数及salle评分。将薄型子宫内膜组随机分为阿司匹林组43例,中药联合治疗组42例。观察治疗前后各组对薄型子宫内膜患者的干预作用及对后续FET周期妊娠结局的影响。结果:薄型子宫内膜组在黄体中期的内膜厚度、Salle评分显著低于对照组(P<0.01);内膜血流阻力指数(RI)、收缩期峰值流速/舒张末期流速(S/D)、子宫动脉血流平均搏动指数(mPI)显著高于对照组(P<0.01,P<0.05)。治疗2个月后,两个治疗组子宫内膜厚度、Salle评分显著增加,子宫血流阻力均显著下降(P<0.05)。中药联合治疗组较阿司匹林组内膜厚度及Salle评分显著增加,内膜RI、S/D显著下降(P<0.05)。中药联合治疗组FET周期胚胎移植日的内膜厚度及生化妊娠率、临床妊娠率与阿司匹林组比较均显著增加(P<0.05)。结论:薄型子宫内膜患者黄体中期子宫血流阻力较正常育龄妇女显著增加,内膜厚度及Salle评分显著下降。以补肾填精为主要功效的补胞汤联合针刺能改善子宫内膜厚度,增加子宫血流灌注,提高Salle评分,有利于FET周期妊娠结局的改善。更多还原

【Abstract】 Objective: To study the ultrasonographic characteristics at midluteal phase in patients with thin endometrium and the intervention effect of Bubao Decoction combined with acupuncture as well as the pregnancy outcome of subsequent frozen-thawed embryo transfer(FET). Methods: Transvaginal color Doppler ultrasonography was used to measure the endometrial thickness, parameters of uterine blood flow and Salle score at midluteal phase of 85 patients with thin endometrium(thin endometrium group) and 30 normal women(control group). Then thin endometrium group were randomly divided into the aspirin group(43 patients) and TCM combined treatment group(42 patients) to observe the intervention effect of each group on thin endometrium patients before and after treatment and the effect on subsequent FET cycle pregnancy outcome. Results: At midluteal phase, the endometrial thickness and Salle score was significantly decreased in thin endometrium group than that in control group(P<0.01). Endometrial blood resistance index(RI), systolic/diastolic ratio value(S/D) and uterine blood Mean PI(mPI) were significantly higher in thin endometrium group in comparison to control group(P<0.01, P<0.05). After 2 months’ treatment,endometrial thickness and Salle score increased significantly and uterine blood flow resistance decreased significantly(P<0.05) in both treatment groups. The endometrial thickness and Salle score were significantly increased, and the endometrial blood RI, S/D were significantly lower in TCM combined treatment group than that in aspirin group(P<0.05). At the embryo transfer day during FET cycle, the endometrial thickness, biochemical pregnancy rate and clinical pregnancy rate were significantly increased in the TCM combined treatment group than that in aspirin group(P<0.05). Conclusion: In comparison with normal women, patients with thin endometrium have significantly higher resistance to uterine and endometrial blood flow, thinner endometrium and lower salle score. Bubao Decoction with the effects of invigorating kidney for consolidating semen, combined with acupuncture can improve endometrial thickness, increase uterine blood flow perfusion, and improve Salle score, which was conducive to the improvement of FET cycle pregnancy outcome.更多还原