| Objective:In this study,the method of tonifying kidney and activating blood circulation was used to intervene in different stages of ovulation induction cycle(middle or late follicles,ovulation stage)of LUFS patients,and to observe its effects on follicular development,ovulation rate and recurrence rate of LUFS patients.By observing the similarities and differences of different stages of Chinese herbs for tonifying kidney and activating blood circulation and whether they can interfere with LUFS stimulation cycle,this paper explores the appropriate stage of adding Chinese herbs for tonifying kidney and activating blood circulation in ovulation induction cycle,and pro,vides reference for clinical treatment of LUFS.Methods:Ninety patients who met the diagnostic and inclusion criteria were randomly divided into three groups,30 in each group.The basic sex hormones and vaginal ultrasound were examined in all three groups on 2-3 days of menstrual cycle.Those who met the criteria were to be treated by ovulation induction.On the basis of the control group,the treatment group was supplemented with Kidney-Tonifying and Blood-Activating drugs,group A with Kidney-Tonifying and Blood-activating drugs in the middle or late follicles,and group B with Kidney-Tonifying and Blood-activating drugs in ovulation.The differences of ovulation rate,recurrence rate of LUFS cycle,sex hormone level at different stages of follicular development,Gn dosage,days needed for follicular development,cycle outcome,clinical pregnancy rate,TCM syndrome score,curative effect and comprehensive clinical efficacy were observed in the three groups.Results:?Gn dosage and follicular development days:treatment group A was significantly less than treatment group B and control group C,the difference was statistically significant(P<0.05).There was no significant difference between treatment group B and control group C(P>.0.05).?Sex hormone levels in the middle or late stages of follicles(when the diameter of dominant follicles was more than 14 mm):Compared with group B and control group C,the level of E2 and LH in group A were significantly higher and lower in the middle or late stages of follicles(P<0.05).There was no difference in E2,LH levels and P levels between treatment group B and control group C(P>0.05).There was no significant difference in P level among the three groups(P>0.05).?Sex hormone levels during ovulation(when the diameter of dominant follicles was more than 18 mm during ovulation):E2 and LH levels in treatment group A were significantly higher than those in treatment group B and control group C(P<0.05).There was no difference in E2,LH levels and P levels between treatment group B and control group C(P>0.05).There was no significant difference in P level among the three groups(P>0.05)?.Cycle outcome:ovulation rate was 75.58%in group A and recurrence rate of LUFS cycle was 16.28%.The ovulation rate was 69.41%in group B and the recurrence rate of LUFS cycle was 22.35%.The ovulation rate of control group C was 50.56%,and the recurrence rate of LUFS cycle was 39.33%.Compared with the control group C,the ovulation rate of group A and group B was significantly higher and the recurrence rate of LUFS was significantly lower(P<0.05).There was no significant difference in ovulation rate and LUFS recurrence rate between group A and group B(P>0.05).?Clinical Outcome and Clinical Effect of Western Medicine:The clinical pregnancy rate of group A was 33.33%,and the total effective rate was 86.67%.The clinical pregnancy rate was 23.33%and the total effective rate was 80.00%in group B.The clinical pregnancy rate was 13.33%and the total effective rate was 70.00%in control group C.There was no significant difference in clinical pregnancy rate and total effective rate among the three groups(P>0.05),which may be related to the small sample size.?TCM syndrome score and curative effect:There was no difference in TCM syndrome score between the three groups before treatment(P>0.05),which was comparable.The scores of TCM syndromes in the three groups before and after treatment were all<0.01,with significant difference.After treatment,the scores of TCM syndromes in group A and B were significantly lower than those in group C(P<0.01).The total effective rate of group A was 76.67%,that of group B was 73.33%,and that of group C was 53.33%.The total effective rate of group A and group B was higher than that of group C(P<0.05).There was no significant difference between group A and group B in TCM syndrome score and total effective rate(P>0.05).Conclusion:?The intervention of tonifying kidney and activating blood circulation in the mid-late follicular phase can significantly increase the levels of E2 and LH in the mid-late follicular phase and before ovulation,prevent the early increase of LH,and shorten the dosage of Gn and the days needed for follicle development in the ovulation induction cycle.?In ovulation period,the addition of Chinese herbs for tonifying kidney and activating blood circulation can significantly increase ovulation rate,reduce the recurrence rate of LUFS and improve the symptoms of traditional Chinese medicine.However,Gn dosage,follicular development days and sex hormone levels at different stages of follicular development had little effect.?Compared with the simple ovulation induction therapy,kidney tonifying and blood activating drugs were added in the mid-late follicular phase can significantly shorten the dosage of Gn and the days needed for follicular development in the ovulation induction cycle,increase the levels of E2 and LH in the mid-late follicular phase of follicles and before ovulation,prevent the early increase of LH,significantly increase the ovulation rate,reduce the recurrence rate of LUFS and improve the symptoms of traditional Chinese medicine.In conclusion,the intervention of invigorating kidney and activating blood circulation in the mid-late follicular phase in the ovulation induction cycle of LUFS patients can be regarded as the appropriate step to add. |
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