Zuogui Pill Pretreatment On The Effect Of Poor Ovarian Response In Patients With Infertility Were Observed

Objective:The purpose of this paper is to observe the therapeutic effect by Zuogui Pill on ovarian response of patients with infertility, And to explore its possible mechanism。Clinical pretreatment for poor ovarian response to provide new ideas and methods.Methods:On60patients met the inclusion criteria were, According to the ratio of1:1were randomly divided into:①The treatment group (TCM+western medicine down regulation group):30patients, Zuogui pill+oral desogestrel and ethinyl estradiol tablets+Subcutaneous injection of gonadotropin releasing hormone agonist.②The control group(The pure western medicine down regulation group):30patients, oral desogestrel and ethinyl estradiol tablets+Subcutaneous injection of gonadotropin releasing hormone agonist. Observation and patients in the control group. after the kidney yin deficiency syndrome of treatment group, And compared. Record two groups of patients in general、the clinical and laboratory indexes、the outcome of pregnancy、untoward reaction, to evaluate the clinical effect of Zuogui Pill.The results:1. According to the diagnostic criteria, the final choice of the object of study of60cases, The treatment group and the control group with30cases in each, no statistical significance in two groups of patients in general, endocrine, ovarian reserve and down regulation of TCM symptoms integral differences (P>0.05), no comparison.2. Relevant clinical indexes:There were no significant differences between the two groups of patients with days of down regulation the use of gonadotropin releasing hormone agonist dose、Starting on the day of the measured estradiol、luteinizing hormone、progesterone levels,(P>0.05). That oral Zuogui pill pretreatment on the down-regulation process without too big impact. Two groups of gonadotropin use days and starting dose equivalent conditions, the treatment group total gonadotropin dose is less than that of the control group, there was significant difference,(P<0.05); injection of hCG on bilateral ovarian>14mm were no significant difference between the two groups (P>0.05), But the estradiol levels in treatment group than in the control group, there was significant difference (P<0.05), prompt Zuogui pill without any increase in gonadotropin case, can cooperate with gonadotrophins promote oocyte maturation and avoid gonadotropin-releasing hormone agonist on pituitary excessive suppression. Two groups of patients with injection of hCG on intimal thickness、luteinizing hormone and progesterone levels、Chorionic gonadotrophin dosage had no significant differences (P>0.05). it demonstrates that oral administration of Zuogui pill pretreatment did not affect the excretion of endometrial development process、luteinizatio、the formation of the preovulatory luteinizing hormone peak.3. Laboratory related indexes:In the treatment group increased the number of retrieved oocytes、fertilized oocytes、the number of cleavage、cleavage stage embryos、the number of embryos transferred effect is not obvious.,no significant difference compared with the control group(P>0.05), The oocyte retrieval rate、fertilization rate、the cleavage rate compared with the control group no significant difference (P>0.05).But the treatment group the number of mature eggs、the number of high quality embryos、frozen embryo number and the quality of embryos was significantly higher than the control group (P<0.05), that Zuogui pill pretreatment on the increase of oocytes rate had no significant effect, but may further promote oocyte cytoplasmic maturation、to improve the quality of oocyte、to improve the rate of high quality embryos.4. Pregnancy outcome:Implantation rate and pregnancy rate in the treatment group were higher than those in the control group, the difference was statistically significant (P<0.05) Twin pregnancy rate, abortion rate, ectopic pregnancy rate because of the number of cases is too small, can not be analyzed statistically, that poor ovarian response in patients with infertility by Zuogui pill pretreatment may get a good pregnancy outcome.5. TCM Syndrome:The patients in the treatment group after down regulation of kidney yin deficiency syndrome total score lower than the down regulation of, patients in the control group after down regulation of kidney yin deficiency syndrome total score higher than the down regulation of, there were significant differences(P<0.05). The patients in the treatment group after down regulation the color dark red light in the down regulation of, patients in the control group after down regulation the color dark red heavy degree in down regulation of, there were significant differences (P<0.05). Blood viscosity、hot flashes red cheeks、 dizziness、tinnitus、dry stool of patients in the treatment group showed no significant difference before and after down regulation (P>0.05). While the control group after down regulation of above symptoms significantly heavier than the down regulation of, there were significant differences (P<0.05). Two groups of patients before and after down regulation in five upset hot symptoms had no significant difference (P>0.05). Two groups of patients after down regulation in dry mouth and throat and waist-leg numbness symptoms significantly heavier than the down regulation of, there were significant differences (P<0.05). That Zuogui Pill in improving the color dark red、blood viscosity、hot flashes red cheeks、 dizziness、tinnitus、the size of anomaly effect, therefore Zuogui pill can obviously improve the appearance after down regulation of kidney yin deficiency syndrome.6. Safety analysis:The patients in the treatment group without the occurrence of urticaria、nausea、vomit、syncope and other allergic reactions and adverse reactions in the course of the study, blood before and after treatment, liver and renal function and the general project examination showed no abnormality, indicates that the clinical application of Zuogui pill is non-toxic side effects, safe and reliable.Conclusion:1. Nourishing kidney-yin method can reduce the side reaction of in vitro fertilization and embryo transfer after down regulation;2. Application of traditional Chinese medicine Zuogui pill pretreatment may be synergistic medicine promote oocyte cytoplasmic maturation、improve the quality of oocytes and embryos、improve the implantation rate and pregnancy rate, and it can appear to regulate drop significantly improved after kidney yin deficiency syndrome of traditional Chinese medicine, while the single western medicine does not have this advantage. Combine traditional Chinese and Western medicine in the treatment of this disease has great advantages, is worthy of promotion and applied.