【摘要】 目的 通过循证医学的方法为1例子宫内膜容受性（ER）低下的不孕患者制定治疗方案。方法 根据循证医学的PICO原则，提出问题，检索证据，对所获证据进行质量评价，并结合患者具体情况制定治疗方案。结果 共检索出与不同问题相关的随机对照试验245篇，系统评价或Meta分析86篇。共纳入中、英文文献83篇，22篇随机对照试验，12篇Meta分析。证据结果表明：中药针灸在改善ER方面有效果好、无痛苦或痛苦小、无副作用等特点；西药抗凝剂（阿司匹林）临床应用效果较确切；雌孕激素的适当补充对提高ER有一定作用；子宫内膜机械刺激疗效未证实，对患者有一定伤害；其他宫腔内干预措施是否确定有效要进一步证实。结论 采用循证治疗的方法能够为子宫内膜容受性低下的不孕患者制定合理的治疗方案，可提高患者的妊娠率。更多还原

【Abstract】 Objective To develop a treatment plan for an infertile patient with low endometrial receptivity(ER) in one case by evidence-based medicine. Methods According to the PICO principle of evidence-based medicine, questions were asked,evidence was retrieved, the quality of the evidence obtained was evaluated, and the treatment plan was formulated according to the specific situation of the patient. Results A total of 245 randomised controlled trials and 34 systematic reviews or meta-analyses were found to be associated with different problems. A total of 83 Chinese and English literature, 22 randomized controlled trials, and 2 meta-analyses were included. The evidence showed that Chinese medicine acupuncture had good effect on improving ER, no pain or little pain, and no side effects. The clinical application effect of Western medicine anticoagulants(aspirin) was exact;Appropriate supplementation of estrogen-progesterone had certain effect on raising ER; The curative effect of mechanical stimulation of the endometrium had not been proven, and there was a certain harm to the patient.The validity of other intrauterine interventions was further confirmed. Conclusion The use of evidence-based treatment methods to formulate a reasonable treatment plan for infertile patients with low endometrial receptivity can improve the pregnancy rate of patients.更多还原