经阴道超声在中西医结合治疗多囊卵巢综合征不孕中的临床价值研究

目的 探讨经阴道超声在中西医结合（针灸配合西药）治疗多囊卵巢综合征（polycystic ovarian syndrome，PCOS）不孕的临床价值。方法 选取2022年1–11月在赣州市中医院治疗的PCOS不孕患者100例，采用随机法分为对照组和观察组，每组50例。对照组采用单纯来曲唑治疗，观察组采用针灸联合来曲唑治疗。比较两组患者的排卵率及受孕率等。结果 观察组患者子宫内膜厚度、卵巢最大卵泡直径较对照组均明显增大，卵巢体积小于对照组，平均卵泡个数少于对照组（P<0.05）；观察组患者卵巢间质动脉的收缩期峰值流速（peak systolic velocity，PSV）低于对照组，搏动指数（pulsatility index，PI）、阻力指数（resistance index，RI）均高于对照组（P<0.05）；观察组促卵泡激素（follicle-stimulating hormone，FSH）、雌二醇（estradiol，E2）、黄体生成素（luteinizing hormone，LH）/FSH比值均较对照组明显增高，LH、睾酮水平均较对照组明显减低（P<0.05）；观察组最大卵泡直径（13.65±2.35）cm]、排卵率（88%）、受孕率（56%）均明显高于对照组分别为（6.24±2.14）cm、70%、36%]，差异有统计学意义（P<0.05）。结论 与单纯口服来曲唑相比，针灸联合来曲唑治疗PCOS不孕患者可提高患者的排卵率、受孕率，临床效果显著，具有良好的应用前景和推广价值。

Clinical value of integrated traditional Chinese and western medicine in the treatment of infertility with polycystic ovarian syndrome by transvaginal ultrasound

Objective To explore the clinical value of integrated traditional Chinese and western medicine in the treatment of infertility with polycystic ovarian syndrome (PCOS) by transvaginal ultrasound. Methods Totally 100 cases of infertility with PCOS treated in Ganzhou Hospital of Traditional Chinese Medicine from January to November 2022 were randomly divided into control group and observation group, with 50 cases in each group. Compare the ovulation and conception rates of two groups of patients. Results The thickness of endometrium and the diameter of the largest ovarian follicle in observation group were significantly higher than those in control group. The peak systolic velocity (PSV) of ovarian interstitial artery in observation group was lower than that in control group, while the pulsatility index (PI) and resistance index (RI) were higher than those in control group (P<0.05). The levels of follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH)/FSH ratio in observation group were higher than those in control group, while the levels of LH and testosterone were lower than those in the control group (P<0.05). The maximum follicle diameter (13.65±2.35) cm], ovulation rate (88%) and pregnancy rate (56%) in observation group were higher than those in control group (6.24±2.14) cm, 70%, 36%, respectively], and the differences were statistically significant (P<0.05). Conclusion In the treatment of infertility patients with PCOS, compared with oral letrozole alone, acupuncture combined with letrozole in the treatment of infertility patients with PCOS can better guide the timing of sexual intercourse, improve the follicular maturation rate, ovulation rate, pregnancy rate of patients. The clinical effect is significant, with good application prospects and promotion value.