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目的:观察中西医结合治疗脾肾阳虚型黄体功能不全(LPD)不孕症的临床疗效。方法:将66例脾肾阳虚型LPD不孕患者随机分成西药组、中药组和联合组,每组22例。临床研究过程中,西药组脱落5例,中药组脱落1例。西药组给予地屈孕酮片治疗,中药组给予补阳方合寿胎丸治疗,联合组给予地屈孕酮片、补阳方合寿胎丸治疗。观察3组治疗前后中医症状、基础体温(BBT)及血孕酮(P)值的变化,比较3组妊娠率。结果:治疗后,3组中医证候积分均较治疗前降低(P<0.05,P<0.01);中药组和联合组的中医证候积分均低于西药组(P<0.05,P<0.01);中药组的中医证候积分与联合组比较,差异无统计学意义(P>0.05)。西药组总有效率64.7%,中药组总有效率85.7%,联合组总有效率100%,联合组总有效率高于对照组(P<0.01)。治疗后,中药组与联合组的血P值均较治疗前升高(P<0.01),且均高于西药组(P<0.01)。结论:在使用地屈孕酮片的基础上加用补阳方合寿胎丸治疗脾肾阳虚型LPD不孕症患者,可有效改善症状、BBT及血P值,提高妊娠率。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of infertility with luteal insufficiency (spleen deficiency and kidney deficiency syndrome). Methods: Sixty-six cases of LPD infertility with spleen and kidney yang deficiency were randomly divided into western medicine group, traditional Chinese medicine group and combination group, with 22 cases in each group. In the clinical research process, the western medicine group shed 5 cases, the traditional Chinese medicine group shed 1 case. Western medicine group to give progesterone tablets treatment, Chinese medicine group given Buyang Fangshou tire pill treatment, the combination group given to bend progesterone tablets, Buyang Fangshou tire pill treatment. The changes of TCM symptoms, basal body temperature (BBT) and blood progesterone (P) before and after treatment were observed in 3 groups. The pregnancy rates of 3 groups were compared. Results: After treatment, the scores of TCM syndromes in three groups were significantly lower than those before treatment (P <0.05, P <0.01); the scores of TCM syndromes in TCM group and combined group were lower than those in western medicine group (P <0.05, P <0.01) ; Chinese medicine group TCM syndrome score and the combined group, the difference was not statistically significant (P> 0.05). The total effective rate was 64.7% in the western medicine group, 85.7% in the traditional Chinese medicine group, and 100% in the combined group. The total effective rate in the combined group was higher than that in the control group (P <0.01). After treatment, the blood P values of both the traditional Chinese medicine group and the combination group were significantly higher than those before treatment (P <0.01), and were higher than those of the western medicine group (P <0.01). Conclusion: It is effective in treating LPD infertility patients with deficiency of spleen and kidney-yang type by using BuYangHong ShouTai Wan on the basis of using DVP tablets, which can effectively improve symptoms, BBT and blood P values and improve pregnancy rate.