何金群 刘凤萍 黄亚玲 邓丽娟 黄莉华

摘要 目的：探討五子衍宗丸加减联合西药对排卵障碍性不孕患者的促孕效果。方法：选取2018年6月至2020年6月清远市中医院收治的排卵障碍性不孕患者90例作为研究对象，按照随机数字表法分为西药组、中药组和联合组，每组30例。西药组给予枸橼酸氯米芬胶囊治疗，中药组给予五子衍宗丸加减治疗，联合组给予以上2种方法联合治疗，比较3组有效率、子宫内膜以及排卵率等指标。结果：治疗后，联合组、中药组、西药组的总有效率分别为93.33%、66.67%、73.33%，3组有效率差异有统计学意义（P<0.05）。联合组和中药组治疗后子宫内膜明显增厚（P<0.05）。联合组、中药组、西药组的周期排卵率分别为74.05%、49.65%、62.16%，3组排卵率差异有统计学意义（P<0.05）。治疗后联合组的基础体温（BBT）分布双相患者例数增加、妊娠率升高、宫颈黏液评分（CMS）提高，且优于中药组和西药组，差异有统计学意义（P<0.05）。结论：五子衍宗丸加减联合西药枸橼酸氯米芬胶囊可以改善排卵障碍性不孕患者的排卵率、妊娠率、子宫内膜厚度、BBT分布以及CMS，并且评分疗效较单独使用中药或者单独使用西药好。

关键词 五子衍宗丸;枸橼酸氯米芬胶囊;排卵障碍性不孕;促孕效果;子宫内膜;排卵率;体温;妊娠

Study on the Effects of Modified Wuzi Yanzong Pills Combined with Western Medicine in the Treatment of Patients with Anovulatory Infertility

HE Jinqun1，LIU Fengping1，HUANG Yaling1，DENG Lijuan2，HUANG Lihua3

（1 Department of Obstetrics and Gynecology，Qingyuan Traditional Chinese Medicine Hospital of Guangdong Province，Qingyuan 511500，China; 2 Department of Obstetrics and Gynecology，Heyuan Traditional Chinese Medicine Hospital of Guangdong Province，Heyuan 517000，China; 3 Qingcheng District People′s Hospital of Guangdong Province，Qingyuan 511500，China）

Abstract Objective：To study the effect of Wuzi Yanzong Pills combined with Western medicine in the treatment of patients with anovulatory infertility.Methods：A total of 90 patients with anovulatory infertility admitted to Qingyuan Traditional Chinese Medicine Hospital from January 2019 to January 2020 were selected as the research objects and were randomly divided into a Western medicine group，a traditional Chinese medicine group and a combined group，with 30 cases in each group.Patients in the Western medicine group were treated with clomiphene citrate capsule，and patients in the traditional Chinese medicine group were treated with Wuzi Yanzong Pills，and patients in the combined group were treated with both methods above.The efficiency，endometrium and ovulation rate were compared among in the 3 groups.Results：After treatment，the total effective rates of combined group，traditional Chinese medicine group and Western medicine group were 93.33%，66.67% and 73.33% respectively.There was significant difference among 3 groups（P<0.05）.The endometrium in the combined group and the traditional Chinese medicine group was obviously thickened（P<0.05）.The periodic ovulation rates of combined group，Chinese medicine group and Western medicine group were 74.05%，49.65% and 62.16% respectively.There was a statistically significant difference in ovulation rate among the 3 groups（P<0.05）.After treatment，BBT scores of biphasic patients in the combined group increased，pregnancy rate increased，CMS scores increased.Those were better than those in the traditional Chinese medicine group and Western medicine group，and the difference was statistically significant（P<0.05）.Conclusion：Wuzi Yanzong Pills combined with clomiphene citrate capsule can significantly improve ovulation rate，pregnancy rate，endometrial thickness，BBT distribution and CMS of anovulatory infertility patients，and the distribution is better than that of traditional Chinese medicine only or Western medicine only.

Keywords Wuzi Yanzong Pills; Clomiphene citrate capsules; Anovulatory infertility; Effect of promoting pregnancy; Endometrium; Ovulation rate; Body temperature; Pregnancy

中图分类号：R289.5;R711.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.09.021

当女性机体中枢神经系统-下丘脑-垂体-卵巢轴功能以及内分泌调节正常时，成熟卵子会从卵泡逸出，一旦患者长期处于各种压力中，女性正常的内分泌节律紊乱，就会导致排卵功能障碍不孕症[1]。目前，不孕人群中有20%～38%的患者為排卵障碍性不孕，严重影响患者夫妻双方的身心健康以及家庭幸福。目前西医常采用克罗米芬等对患者进行治疗，从而诱发患者排卵。中医主要的治疗方式是调节内分泌失调，常用药物有五子衍宗丸等。中西医治疗该病各有所长，但西药治疗排卵功能障碍不孕症存在一系列不良反应，如排卵率高、妊娠率低等，无法根治该病。中药治疗显效慢，对于大龄妇女来说，妊娠风险增高，而中西医结合治疗能够很好地克服以上不足[2-4]。……