| 张冬梅,杨伟伟,阎慧娟.补肾调轴方治疗体外受精 -胚胎移植反复胚胎着床失败伴慢性子宫内膜炎症的临床研究[J].安徽医药,2025,29(1):178-183. |
| 补肾调轴方治疗体外受精 -胚胎移植反复胚胎着床失败伴慢性子宫内膜炎症的临床研究 |
| Clinical study of Bushen Tiaozhou prescription on repeated implantation failure of IVF-ET with chronic endometritis |
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| DOI：10.3969/j.issn.1009-6469.2025.01.037 |
| 中文关键词: 不育，女(雌)性 体外受精 -胚胎移植 胚胎植入 补肾调轴方 慢性子宫内膜炎症 子宫免疫微环境 子宫内膜容受性 妊娠结局 |
| 英文关键词: Infertility, female In vitro fertilization-Embryo transfer Embryo implantation Bushen Tiaozhou prescription Chronic endometrial inflammation Uterine immune microenvironment Endometrial receptivity Pregnancy outcome |
| 基金项目:河南省医学科技攻关计划项目( LHGJ20191098) |
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| 中文摘要: |
| 目的观察补肾调轴方对体外受精 -胚胎移植( IVF-ET)反复胚胎着床失败并且合并慢性子宫内膜炎症病人内膜容受性、胚胎种植率、子宫免疫微环境和妊娠结局的影响。方法选择于黄河三门峡医院生殖医学中心治疗的 150例 IVF-ET反复胚胎着床失败并且合并慢性子宫内膜炎症病例，治疗时间为 2018年 2月至 2021年 2月，采用随机数字表法分组。 75例对症组，于 IVF-ET失败后第 1个月经周期行抗感染治疗，经期停药，经净后继续服药，共服用 14 d，75例病人为补肾调轴方组，给予自拟中药补肾调轴方治疗，连续服用 30 d。治疗前、后检测两组病人肿瘤坏死因子 α(TNF-α)、谷胱甘肽过氧化物酶( GSH-Px)、白细胞介素 4(IL-4)、超氧化物歧化酶( SOD)、白细胞介素 -1β(IL-1β)、抗超氧阴离子自由基(抗 O2.)活力水平及 CD138阳性率，检测病人 CD56+表达情况，检测子宫内膜厚度、子宫动脉的血流指数、搏动指数、阻力指数，治疗前、后给予病人 Salle及中医证候评分，记录对症组、补肾调轴方组临床妊娠率、移植胚胎数、早期流产率、胚胎种植率及活产率。结果补肾调轴方组病人 TNF-α、IL-1β、CD56+含量、 CD138阳性率较对症组明显低( P<0.05)补肾调轴方组病人 IL-4含量较对症组明显高( P<0.05)，补肾调轴方组病人 SOD、抗 O2.活力、 GSH-Px含量较对症组明显高( P<0.，05)；补肾调轴方组病人子宫内膜厚度、子宫动脉的血流指数较对症组高( P<0.05)补肾调轴方组病人子宫动脉的搏动指数、阻力指数较对症组低( P<0.05)，补肾调轴方组中医证候评分较对症组明显低( P<0.05)，补肾调轴方组 Salle评分较对症组明显高( P<0.05)，补肾调轴方组胚胎种植率、临床妊娠率、活产率较对症组高( 33.33%、42.67%、4，1.33%)比( 22.36%、26.67%、22.67%)(P<0.05)两组早期流产率比较差异无统计学意义( P> 0.05)，结论补肾调轴方治疗 IVF-ET反复胚胎着床失败伴慢性子宫内膜炎症可抑制机体炎症，调节子宫免疫微环境，减少氧化应激损伤，改善子宫内膜容受性，缓解病人临床症状，改善病人妊娠结局。病人 |
| 英文摘要: |
| Objective To observe the effects of Bushen Tiaozhou prescription on endometrial receptivity, embryo implantation rate,uterine immune microenvironment and pregnancy outcome in patients with repeated implantation failure in vitro fertilization-embryo transfer (IVF-ET) complicated with chronic endometrial inflammation.Methods A total of 150 IVF-ET cases with repeated embryoimplantation failure and chronic endometrial inflammation were selected from Reproductive Medicine Center of Sanmenxia Hospital ofthe Yellow River from February 2018 to February 2021, and were divided by random number table method. The 75 patients in thesymptomatic group received anti-infection treatment in the first menstrual cycle after IVF-ET failure, stopped taking the drug duringmenstrual period, and continued taking the drug after purification for a total of 14 days, and 75 patients in the Bushen Tiaozhou pre-scription group were treated with Bushen Tiaozhou prescription for 30 consecutive days. The activity levels of tumor necrosis factor-α (TNF-α), glutathione peroxidase (GSH-Px), interleukin4 (IL-4), superoxide dismutase (SOD), interleukin-1β (IL-1β), anti-superoxide anion radical (anti-O2.) and the positive rate of CD138 in the two groups were detected before and after treatment. CD56+ expressionwas detected, endometrial thickness, uterine artery blood flow index, pulse index and resistance index were detected, Salle and TCMsyndrome scores were given to patients before and after treatment, and clinical pregnancy rate, number of transplanted embryos, earlyabortion rate, embryo implantation rate and live birth rate were recorded in the treatment group and Bushen Tiaozhou prescription group.Results The contents of TNF-α, IL-1β, CD56+ and the positive rate of CD138 in Bushen Tiaozhou prescription were lower than those of the Symptomatic group (P<0.05); the content of IL-4 in Bushen Tiaozhou prescription was higher than Symptomatic group (P< 0.05). The contents of SOD, anti-O2. activity and GSH-Px in Bushen Tiaozhou prescription were higher than those of the Symptomatic group (P<0.05). The endometrial thickness and blood flow index of uterine artery in Bushen Tiaozhou prescription were higher than those of the Symptomatic group (P<0.05); the uterine artery pulsation index and resistance index in Bushen Tiaozhou prescription were lower than those of the Symptomatic group (P<0.05). The TCM syndrome score of Bushen Tiaozhou prescription was lower than that of the Symptomatic group (P<0.05); the Salle score of Bushen Tiaozhou prescription was higher than that of the Symptomatic group (P< 0.05). The embryo implantation rate, clinical pregnancy rate and live birth rate in Bushen Tiaozhou prescription were higher than those of the Symptomatic group (33.33%, 42.67%, 41.33%) vs. (22.36%, 26.67%, 22.67%), and the difference was statistically significant (P< 0.05), while there was no statistically significant difference in early abortion rate between the two groups (P>0.05).Conclusions In the treatment of patients with repeated embryo implantation failure of IVF-ET and chronic endometrial inflammation, Bushen Tiaozhou pre-scription can inhibit body inflammation, regulate uterine immune microenvironment, reduce oxidative stress damage, improve endome-trial receptivity, alleviate clinical symptoms and improve pregnancy outcomes. |
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