| Objective:By observing the improvement of luteal function,endometrial receptivity and related clinical symptoms,the clinical efficacy of TCM tonifying kidney and regulating circumference in the treatment of luteal insufficiency infertility with kidney deficiency and blood stasis syndrome was evaluated,the mechanism of action was preliminarily discussed,which provided scientific basis for its wide application and more treatment schemes for infertile patients.Methods:The case came from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.From January 2020 to December 2020,a total of 64 patients who met the diagnostic criteria of luteal insufficiency infertility were included in the gynecological outpatient department.Random grouping method was used to divide the therapeutic group(TCM group)and the control group(western medicine group),32 cases in each group.Treatment group: traditional Chinese medicine tonifying the kidney and cycle method treatment;Control group: western medicine dydrogesterone tablets treatment.Three menstrual cycles are a course of treatment.The total clinical efficacy,pregnancy rate,hyperthermia phase score(HPS),middle luteal hormone(E2、P)level,endometrial receptivity and TCM syndrome score were compared between the two groups after treatment.Drug-related adverse reactions during treatment are also concerned.Results:1.Clinical efficacy: The total effective rate of the TCM tonifying the kidney and cycle method group was 86.2%,the western medicine dydrogesterone tablets group was 75%,The two groups were statistically different in clinical efficacy(P<0.05).2.TCM Syndrome integral: The scores of TCM syndromes,such as menstruation and clinical symptoms,all decreased(P<0.01),and the score of the TCM tonifying the kidney and cycle method group was lower than that of the western medicine dydrogesterone tablets group,two groups were statistically different in TCM syndrome integral(P<0.01).3.Clinical pregnancy rate: The clinical pregnancy rate of the TCM tonifying the kidney and cycle method group was 31.00 %,which was higher than 10.70 % that of the western medicine dydrogesterone tablets group,but the difference was not statistically significant after comparison(P>0.05).4.HPS score: The HPS score of basal body temperature was improved in both groups,the difference was statistically significant(P<0.01),and the score of TCM tonifying the kidney and cycle method group was higher than that of the western medicine dydrogesterone tablets group,two groups were statistically different in HPS score(P<0.05).5.Theormone level: The E2 level in the TCM tonifying the kidney and cycle method group was higher than before(P<0.01),although the E2 level in the western medicine dydrogesterone tablets group was higher than before,but the difference was not statistically significant(P>0.05),two groups were statistically different in E2 level(P<0.01);The middle luteal P level was increased in both groups than before(P<0.01),but there was no significant difference(P>0.05).6.Ultrasonic indicators: The endometrium in both groups was thicker than before(P<0.01),the TCM tonifying the kidney and cycle method group was better than that of the the western medicine dydrogesterone tablets group,the difference was statistically significant(P<0.05);The endometrial typing in the TCM tonifying the kidney and cycle method group was better than that of the western medicine dydrogesterone tablets group(P<0.05);The pulsatility index and resistance index(PI、RI)of the two groups were lower than those before treat(P<0.01),compared with the the western medicine dydrogesterone tablets group,the TCM tonifying the kidney and cycle method group was lower,the difference was statistically significant(P<0.05);The subintimal blood flow classification in the TCM tonifying the kidney and cycle method group was better than that in the western medicine dydrogesterone tablets group(P<0.05);The comprehensive score Salle score of both groups increased to more than13 points(P<0.01),and the TCM tonifying the kidney and cycle method group was higher than the western medicine dydrogesterone tablets group,the difference was statistically significant(P<0.01).Conclusion:1.The TCM treatment of tonifying kidney and regulating circumference can significantly reduce the TCM syndrome scores in luteal insufficiency infertility patients with kidney deficiency and blood stasis syndrome,and has the function of regulating menstrual disorder and improving the symptoms of kidney deficiency,the curative effect is better than that of western medicine dydrogesterone tablets treatment.2.The TCM treatment of tonifying kidney and regulating circumference can improve the luteal function in luteal insufficiency infertility patients with kidney deficiency and blood stasis syndrome.In terms of raising levels of related hormones,The curative effect is similar to that of western medicine dydrogesterone tablets treatment.3.The TCM treatment of tonifying kidney and regulating circumference can improve endometrial receptivity in luteal insufficiency infertility patients with kidney deficiency and blood stasis syndrome by improving uterine arterial blood supply,endometrial blood supply and increasing endometrial thickness,and it has more sanative effect than that of dydrogesterone tablets treatment.4.TCM tonifying kidney and regulating circumference in the treatment of luteal insufficiency infertility patients with kidney deficiency and blood stasis syndrome can improve the luteal function,improve the endometrial receptivity,and then improve the clinical pregnancy rate,with definite curative effect. |
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