子宫内膜异位症相关不孕症患者子宫内膜容受性及中药治疗的疗效评价

目的对子宫内膜异位症(EMs)相关不孕症患者子宫内膜容受性进行评价,并观察中药对子宫内膜容受性及体外受精-胚胎移植术(IVF-ET)妊娠结局的影响。方法将EMs不孕患者50例随机分为2组。治疗组30例,于IVF-ET胚胎移植前连续服用中药3个月;对照组20例,不予药物治疗。并以30例健康者为正常对照。于窗口期利用经阴道彩色多普勒超声检测子宫内膜厚度、子宫内膜及内膜下血流分布类型、子宫动脉血流参数并进行比较。结果 EMs不孕患者的子宫内膜厚度与正常对照组差异无统计学意义,且中药治疗前后子宫内膜厚度亦无明显变化(均P0.05);EMs不孕患者子宫动脉血流搏动指数(RI)、阻力指数(PI)均明显升高,与正常组比较差异有统计学意义(P0.05);治疗组Ⅰ型血流分布约23.33%(7/30),对照组Ⅰ型血流分布占25.00%(5/20),正常组为66.67%(20/30),明显高于EMs不孕患者,差异有统计学意义(P0.01);治疗组治疗后子宫动脉血流参数RI、PI较治疗前均明显下降,内膜及内膜下血流Ⅰ型分布提高至60.00%(18/30)。治疗组正常妊娠率约46.67%(14/30),对照组正常妊娠率为30.00%(6/20)。结论 EMs可能影响子宫动脉的血流动力学状态,影响子宫内膜的容受性;中药治疗可提高EMs不孕患者子宫内膜容受性,提高IVF-ET成功率。

Evaluation of Endometrium Receptivity and Traditional Chinese Medicine Treatment in ;Endometriosis Infertile Patients

Objective To evaluate the endometrium receptivity of endometriosis （EMs） infertile patients, and observe the influence of TCM treatment to endometrium receptivity and IVF-ET pregnancy outcome. Methods Fifty EMs infertile patients were randomly divided into two groups. The reatment group （30 cases） kept taking TCM for 3 month continuously before IVF-ET embryo transplantation, and the control group （20 cases） received no treatment, with 30 healthy women as normal control. Using transvaginal color doppler ultrasound to detect and compare the endometrial thickness, endometrium and endometrial blood flow distribution types, and uterine artery blood flow parameters in window transvaginal stage. Results There was no difference in endometrial thickness between the EMs infertility patients and the normal group, and the endometrial thickness also had no obvious changes before and after treatment （P〉0.05）. RI and PI of EMs infertility patients were significantly increased, compared the with normal control group （P〈0.05）. In treatment group, the persentage of type Ⅰ blood distribution was 23.33%（7/30）, in control group was 25.00%（5/20）, and 66.67%（20/30） in the normal group, significantly higher than that of the EMs infertility patients （P〈0.01）. Uterine artery blood flow parameters RI, PI value were significantly decreased after treatment in treatment group, endometrium and endometrial blood flow type Ⅰ distribution increased to 60.00%（18/30）. The rate of normal pregnancy was 46.67% （14/30） in treatment group, and control group was 30.00% （6/20）. Conclusion EMs may affect uterine artery hemodynamic status and endometrium receptivity. TCM treatment can improve the endometrium receptivity of EMs infertile patients and improve the success rate of IVF-ET.