| Objective:The study aims at treating DOR(decline in ovarian reserve)infertility patients with Bushen Jianpi decoction,so to examine the function of Bushen Jianpi decoction in improving ovarian reserve and ovulation induction of patients taking letrozole after pretreatment.By discussing the possible mechanism of Bushen Jianpi decoction in treating DOR,this study may find effective ways in recovering ovary reserve function,delaying ovary function decline and preventing POF(premature ovarian failure)Methods:A total of 60 cases with DOR infertility who visited the gynecological and reproductive outpatients of Jiangsu Provincial Hospital of TCM from March 2016 to December 2017 were randomly divided into two groups,30 cases a group.The control group was given oral femoston(specification:2/1 Omg,28 pellet/box,Abbot Healthcare products B.V,Netherlands,menstrual cycle from d3 to take one pellet/once day),while the experimental group oral femoston plus Bushen Jianpi decoction(respectively are:taking Bushen Jianpi decoction in premenstruum and postmenstrua,each 14 days).After a course of treatment,which is 3 menstrual cycles,we observed the changes in menstruation and symptoms,serum basic follicle stimulating hormone(bFSH),luteinizing hormone(bLH),Estradiol(bE2),follicle stimulating hormone/luteinizing hormone(FSH/LH),anti-mullerian hormone(AMH),ovarian volume(OV),antral follicle count(AFC)and ovarian blood flow index(including PSV,VI,FI,VFI)etc.before and after treatment,as well as the ovulation rate and pregnancy rate of patients taking letrozole(Trade name:Fry,10 tablets/box,Jiangsu Hengrui Pharmaceutical Co.LTD,usage:menstrual cycle from d5 to take one tablet/once day,continuous use for 5 days)one month after pretreatment.The findings were statistically analyzed.Results:?On the aspects of menstruation:the total integral of the two groups are decreased,P<0.05,there is statistical significance,to compare the two groups,the experimental group is better.?TCM symptoms:the effective rate of experimental group and control group is 93.3%and 70.0%,the comparison between them,P<0.05,it is significantly statistical differences,pertaining to Chinese medicine can better relieve the clinical symptoms of patients.,improve quality of life.?Symptom total score and curative effect comparison:after treatment,the symptom total score of the two groups were lower than that before treatment,and the experimental group were obviously lower than the control group,but the symptom curative effect analysis showed that both groups could obviously improve menstruation and clinical symptoms,and there was no significant difference between the two groups,? Sex hormones and AMH levels:after the treatment,the levels of bFSH,bLH,FSH/LH were lower and the level of bE2 and AMH was higher,P ? 0.05,was statistically significant.?Ovary volume and sinus follicle number:the comparison in the same group,the ovary and AFC were both increased after treatment,and P ? 0.05 was statistically significant.At the same time,In the comparison of the two groups,the experimental group were superior to the control group in increasing the number of sinus follicles,but the mean of AFC in the two groups were all less than 7,but in the change of OV,P>0.05,no significant difference was found.?Ovarian blood flow parameters:the comparison in the same group,the PSV?VI?V?VFI and the FI of experimental group were higher after the treatment,P?0.05,statistically significant,but after the treatment,the FI of control group,p?0.05,no significant difference;Compared with the control group,the experimental group increased PSV,VI,FI and VFI better.which indicated that it could effectively improve ovarian blood flow,increase blood supply and improve ovarian reserve.?Treating the Infertility of DOR for three months,during the next menstrual,using the letrozole for row,comparing the two groups,the experimental group in the enlarged follicle diameter line is better than that of control group,but in the terms of ovulation rate,experimental group was 60.0%,the control group was 46.7%,P?0.05,no significant difference.?Total clinical efficacy:the total effective rate of the experimental group and the control group was 96.7%and 76.7%respectively,after three months,and the pregnancy rate of the experimental group and the control group was 16.7%and 6.7%,the experimental group is especially higher.Conclusion:Bushen Jianpi decoction can treat DOR by improving blood supply to ovary and uterus.Some of the drugs in the decoction have hormone-like bidirectional regulation effects,which are beneficial to restore the function of ovarian reserve,increase the responsiveness of letrozole to promote ovulation,facilitate the growth and development of follicles,and increase the pregnancy rate.The experimental group is superior to the control group,indicating that Bushen Jianpi Decoction is an effective and long-lasting method for the treatment of DOR infertility.It can be widely used in clinical practice. |
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