第一章 观察温肾养血颗粒联合枸橼酸氯米芬对卵泡发育不良性不孕症.docVIP

观察温肾养血颗粒联合枸橼酸氯米芬对卵泡发育不良性不孕症（Follicular Maldevelopment, FM）患者基础体温(BBT)、血清性激素水平及抑制素B(INHB)、激活素A（ACTA）、卵泡抑素（FS）水平的影响，探讨其可能的作用途径。 方法 选取90例FM患者随机分为中药组、西药组和中西药联合组，每组各30例。中药组服用温肾养血颗粒，西药组服用枸橼酸氯米芬，中西药联合组同时服用温肾养血颗粒和枸橼酸氯米芬。测定三组患者治疗前后血清黄体生成素（LH）、卵泡刺激素（FSH）、雌激素（E2）、INHB、ACTA、FS水平；月经第10天开始监测排卵直至卵泡排出。各组患者治疗期间均自测基础体温。 结果 温肾养血颗粒联合枸橼酸氯米芬在排卵率和排卵日子宫内膜厚度方面明显优于西药组和中药组；中西医组与西药组相比对血中FSH、INHB、ACTA、FS也有相似调节作用，中西医组在调节LH，防止LH峰提早出现方面作用更有优势；中西医组第三周期d3INHB与d3FSH呈显著负相关，d10INHB与d10E2, d10FS成显著正相关性，与d10ACTA呈显著负相关。 结论 温肾养血颗粒联合枸橼酸氯米芬可以调节FM患者卵巢局部因子INHB、ACTA、FS的表达，反映卵巢功能状态，调控卵泡发育。 The effect of granules of warming-kidney and nourishing-blood (GWN) combined with clomifene citrate (CC) on basic body temperature (BBT) of follicular maldevelopment(FM) infertility patients, as well as the level of serum sex hormones, inhibin B (INHB), activin A (ACTA) and follistatin (FS) was observed. Simultaneously, the possible action channels were also explored. Methods: 90 patients with FM were selected and divided into 3 groups stochastically: Chinese medicine group (CMG) treated with GWN, western medicine group(WMG) treated by CC and combination group of Chinese medicine and western medicine given by GWN and CC, 30 cases in each group. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), INHB, ACTA, and FS among the three groups were determined before and after treatment and the ovulation were monitored from the tenth day of menstruation until follicular releasing. Every patient measured the basic body temperature by their selves during treatment. Results: Ovulation rate and the thickness of endometrium on the menstruation dates of combination group of Chinese medicine and western medicine was superior to those in Chinese medicine group and western medicine group. Compared with western medicine group, the combination group had a similar adjustment effect to the serum FSH, INHB, ACTA, FS and a better function to adjust LH to prevent the advance of LH peak. In the 3rd period of