优化中西医结合方案治疗不孕症118例临床观察

目的：探讨监测排卵法对优化中西医结合方案干预不孕症的临床指导意义。方法：对118例不孕症患者根据监测排卵多项指标（内分泌激素测定、宫颈黏液评分、尿促黄体生成素测定、系列B超监测、基础体温测量），并按临床表现中医辨证分为肾阴虚火旺、肾阳虚痰湿、肾阳虚瘀血、肝郁4组，分别采用补肾、化痰、活血、疏肝法治疗，同时适时选择性加用雌二醇（E2）、孕酮（P）、人工周期（E2＋P）、克罗米酚（CC）、尿促性腺激素（HMG）、绒毛膜促性腺激素（HCG）、溴隐亭（BCT）、达因-35、通等治疗。结果：全部患者均获得临床妊娠，其中单纯用中药治疗者25例，占21．19％；中药分别加用E2P、CC、HCG、HMG、BCT、达因-35、安体舒通治疗者93例，占78．81％。经中西药干预后，排卵各项指标均达到受孕水平。结论：监测排卵对及时制定出优化的中西医结合治疗方案具有确切的临床意义，中西医结合冶疗不孕症具有优越性。

Clinical Observation on 118 Cases of Infertility Treated with Optimized Program of Integrated Chinese and Western Medicine

Objective:To study on the clinical significance of ovulation-monitoring method for optimized program of integrated Chinese and western medicine in treatment of female infertility.Methods:Hormones,score of cervical mucus,urinary luteinizing hormone(LH),serial B-ultrasonography,and BBT were monitored in 118 cases of female infertility.According to clinical manifestations,they were divided into 4 types,i.e.Yin-deficiency and fire-excess of the kidney,kidney Yang-deficiency and phlegm-dampness,kidney Yang-deficiency and blood stasis,and stagnation of the liver-qi,and were treated respectively with tonifying the kidney,resolving phlegm,activating blood circulation,and soothing the liver,meanwhile,estradiol(E2),progesterone(P),artificial cycle(E2 P),clomiphene(CC),urinary gonadotropin(HMG),chorionic gonadotropin(HCG),bromocriptinum(BCT),dyne-35,antisterone were selectively added.Results:All cases achieved clinical pregnancy.Among them,25 cases(21.19%) were treated with simple Chinese drugs,and 93 cases(78.81%) were treated with Chinese drugs with E2,P,CC,HCG,HMG,dyne-35,antisterone selectively.After treatment,all indexes for monitoring ovulation reached to the level of pregnancy.Conclusion:The ovulation-monitoring method is of a definite clinical significance for the optimized program of integrated Chinese and western medicine,which has superiority for treatment of female infertility.