滋肾育胎丸在体外受精-胚胎移植中效果的研究

柏海燕 王婷 刘晓娟

摘要 目的：探讨滋肾育胎丸对体外受精-胚胎移植（IVF-ET）结局的影响。方法：选取2016年1月23日至2016年9月11日西北妇女儿童医院生殖中心接受IVF-ET助孕的女性随机双盲分为滋肾育胎丸药物组及安慰剂组，均采用长方案，降调日起服药，至移植后35 d停药，比较2组超排卵的治疗过程及结局;结果：共入组205例，药物组（103例）和安慰剂组（102例）基础数据没有差异，2组促排卵时间、促排卵药物总量、HCG日子宫内膜厚度、优胚率亦没有统计学意义。药物组HCG日每成熟卵泡对应E2值、新鲜移植胚胎种植率及临床妊娠率均高于安慰剂组，差异有统计学意义（P<0.05）;结论：IVF-ET过程中配合应用滋肾育胎丸能够改善卵细胞质量，促进胚胎种植，最终可提高IVF-ET助孕效率。

关键词 滋肾育胎丸;不孕症;体外受精-胚胎移植;妊娠结局

Study on Effects of Zishen Yutai Pill on Pregnancy Outcome of Women

Undergoing in vitro Fertilization-embryo Transfer

Bai Haiyan， Wang Ting， Liu Xiaojuan

（Center for Assisted Reproduction， Northwest Women and Children′s Hospital， Xi′an 710003， China）

Abstract Objective：To observe the effects of Zishen Yutai Pill （ZYP） on pregnancy outcomes of women undergoing in vitro fertilization-embryo transfer. Methods：Infertile women underwent long protocol IVF cycle in our center from January 23， 2016 to September 11， 2015 were divided into drug group and placebo group randomly. ZYP or placebo was added from the day of down-regulation until 35 days after embryo transfer. Results：A total of 205 patients were included in this study. There was no difference in general between the drug group （103 cases） and placebo group （102 cases）. During the process of COH， there was no significant difference in the time of stimulation （9.92 vs. 10.06）， the dosage of Gn， the endometrial thickness， the number of oocyte retrieval and the rate of top quality embryo between two groups. The E2 value per mature follicle， rates of implantation， rates of clinical pregnancy in drug group were higher in drug group than those in the placebo group under fresh ET （P<0.05）. Conclusion：The application of ZYP could improve the quality of oocytes， promote embryo implantation and ultimately could improve the efficiency of IVF-ET.

Key Words Zishen Yutai Pill; Infertility; IVF-ET; Pregnancy outcome

中圖分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.028

不孕不育是当今社会高发病，约占育龄夫妇的10%～15%，相当比例不孕只能采用体外受精-胚胎移植（IVF-ET）方法助孕。目前IVF-ET的妊娠率仅有30%～50%[1]，成功妊娠后患者阴道出血、绒毛膜下血肿等先兆流产症状常见，最终有17.79%发展为自然流产[2]。如何提高IVF成功率、降低流产率，最终提高IVF抱婴回家率一直是生殖领域研究热点。在中医体系中，“肾主生殖”，若肾气不足、冲任不能相资、气血失调，则难以受孕;肾气虚、冲任不固、胎失所系，可导致先兆流产和复发性流产的发生。既然不孕不育及自然流产均与肾气不足密切相关，那么在IVF-ET助孕过程中配合使用滋肾中药是否可提高IVF成功率、降低流产率呢？本研究采用前瞻性双盲随机病例对照设计，观察滋肾育胎丸对IVF-ET助孕结局的影响，为临床提高IVF-ET助孕效率寻找新路径。……