目的 研究中药调经助孕方联合来曲唑对多囊卵巢综合征(PCOS)不孕患者卵泡发育及抗苗勒氏管激素(AMH)的影响,探讨其作用机制.方法 将60例PCOS不孕患者随机分为3组,每组20例.中药组服用调经助孕方,西药组服用来曲唑,中西药组采用调经助孕方联合来曲唑治疗.比较3组患者治疗2个疗程后月经改善情况、基础体温(BBT)变化、排卵恢复情况、血清性激素及AMH水平.结果 治疗后中药组排卵率为45％(9例),西药组为60％(12例),中西药组为85％(17例),中西药组高于中药组及西药组(P＜0.05)；中药组受孕率为40％(8例),西药组为45％(9例),中西药组为80％(16例),中西药组高于中药组及西药组(P＜0.05).治疗后较治疗前各组血清性激素雌二醇、孕酮水平均升高,黄体生成素、睾酮、AMH水平均降低(P＜0.05).结论 调经助孕方联合来曲唑对PCOS不孕患者有较好的促排卵作用,并可提高受孕率,其作用机制可能与调节AMH水平有关.%Objective To investigate the influences of Tiaojing Zhuyun Fang (TJZYF) combined with letrozole on the situation of follicular development and anti-Mullerian hormone (AMH) level in infertility patients with polycystic ovary syndrome (PCOS), and explore its mechanism. Methods Sixty infertility patients with PCOS were divided into three groups randomly with 20 cases in each group. The Chinese medicine group was treated by TJZYF, the western medicine group was treated by letrozole, and the integrative medicine group was given both of them. The menstruation improvement, the change of the basal body temperature (BBT), spontaneous ovulation recovery, serum sexual hormones and AMH of the three groups after 2 courses of treatment were compared. Results After the treatment, the ovulation rate in the Chinese medicine group was 45% (9 cases), western medicine group was 60% (12 cases), while the integrative medicine group was 85% (17 cases). The ovulation rate in the integrative medicine group was higher than that both in Chinese medicine group and western medicine group (P<0.05). The pregnancy rate of Chinese medicine group, western medicine group and integrative medicine group was 40% (8 cases), 45% (9 cases) and 80% (16 cases) respectively. The pregnancy rate in the integrative medicine group was higher than that in the other groups after treatment (P<0.05). Compared with before treatment, the levels of serum E2 and P were increased, serum LH, T and AMH were decreased in each group after the treatment (P<0.05). Conclusion TJZYF combined with letrozole is effective in improving the ovulation rate and pregnancy rate of infertility patients with PCOS. The mechanism is related with regulating AMH level of the patients.
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