| [Objective]To study the Etiological Distribution and TCM Constitution of 259 patients with infertility,observe the improvement effect of Bushen Huoxue recipe combined with Acupoint Application on endometrial receptivity of infertility patients with kidney deficiency and blood stasis,and further understand the role of traditional Chinese medicine combined with Acupoint Application in improving clinical symptoms and increasing pregnancy rate,so as to provide new ideas and references for the comprehensive treatment of infertility with traditional Chinese medicine.[Methods]The clinical data of 25Cases of infertility treated by traditional Chinese medicine(TCM)such as TCM acupoint application of Salvia miltiorrhiza,kidney deficiency and blood stasis were collected and analyzed.The TCM clinical symptom score,endometrial receptivity ultrasound evaluation(endometrial thickness,type,myometrial echo,subendometrial blood flow and uterine artery blood flow resistance index),cytokines(IL-6 and TNF)were observed before and after treatment-a)And the pregnancy rate within half a year after treatment.After the course of treatment,the self indexes measured by the patients before and after treatment were statistically processed by SPSS 23.0 statistical analysis software.[Results]1.In terms of etiological distribution,the main factors of female infertility are immune factors(41.57%),ovulation disorder(29.36%)and pelvic factors(29.07%).2.The autoimmune abnormalities were anticardiolipin antibody(26.40%),antinuclear antibody(25.60%),thyroid antibody(16.00%),antisperm antibody(11.20%),immunoglobulin(10.40%),anti trophoblast membrane antibody(2.40%),blood group antibody(2.40%),anti ovarian antibody(1.60%),anti zona pellucida antibody(1.60%)and anti endometrial antibody(1.60%)The anti hCG antibody was abnormal(0.80%).3.Alloimmune abnormalities were blocking antibody low(50%)and lymphocyte abnormality(50%).4.Ovulation disorders were polycystic ovary syndrome(38.61%),low AMH(27.72%),hypothyroidism(26.73%)and hyperprolactinemia(6.94%).5.Pelvic factors were intrauterine adhesion(34.00%),endometriosis(29.00%),hysteromyoma(21.00%),peritubal adhesion(12.00%)and hydrosalpinx(4.00%).6.In the multivariate etiological analysis,there were more than two factors(56.76%),only one factor(28.18%)and two factors(15.06%).7.In the constitution distribution of traditional Chinese medicine,52 cases were mild(9.90%);The biased constitution was Yang deficiency(19.24%),damp heat(15.62%),qi depression(15.62%),phlegm dampness(13.15%),Qi deficiency(12.00%),yin deficiency(8.38%),blood stasis(3.62%)and special quality(2.47%).8.In terms of concurrent constitution,there were 171 cases(66.02%)of concurrent biased constitution and 52 cases(20.08%)of simple biased constitution.9.The total score of TCM symptoms in the study group after treatment was significantly different from that before treatment(P<0.05).The curative effect of TCM symptoms:2 cases were cured(5.71%),3 cases were markedly effective(8.57%),24 cases were improved(68.57%),and 6 cases were ineffective(17.15%).10.The thickness of endometrium in the study group increased from(7.13±1.42)mm to(8.39+0.91)mm after treatment,and the difference was statistically significant(P<0.05).11.The average volume of endometrium in the study group increased from 2.34(1.02)ml to 4.14(2.42)ml after treatment(P<0.05).12.The proportion of endometrial types A,B and C in the study group after treatment was statistically different from that before treatment(P<0.05).13.There was significant difference in the proportion of grade 0,grade Ⅰ,grade Ⅱ and grade Ⅲ of subendometrial blood flow between the study group and the treatment(P<0.05).14.The RI,S/D and of the study group after treatment were significantly different from those before treatment(P<0.05).15.Serum IL-6 and TNF in the study group after treatment-α There was significant difference between the levels before and after treatment(P<0.05).16.Among the 35 patients in the study group,13 were pregnant within half a year of follow-up,including 2 biochemical pregnancies,11 continued pregnancies and 22 non pregnancies.The final pregnancy rate was 37.14%.[Conclusion]1.In 259 cases of infertility,immune factors,ovulation disorders and pelvic factors are the main factors leading to female infertility.2.Among the immune factors,abnormal anticardiolipin antibody,abnormal antinuclear antibody,abnormal thyroid antibody,abnormal antisperm antibody and immunoglobulin are the main factors leading to autoimmune abnormalities.Low blocking antibody and abnormal lymphocytes are the main factors leading to alloimmune abnormalities.3.Polycystic ovary syndrome,low AMH,hypothyroidism and hyperprolactinemia are the main factors leading to ovulation disorder.4.Intrauterine adhesion,endometriosis,hysteromyoma,peritubal adhesion and hydrosalpinx are the main pelvic factors leading to infertility..5.The incidence of female infertility is complex,often with two or more factors.6.Yang deficiency,damp heat and qi depression are the most common constitution of infertile women.7.Women with infertility often have multiple biased constitutions.8.Bushen Huoxue Decoction Combined with acupoint application can effectively improve the symptoms and signs of infertility patients with kidney deficiency and blood stasis,increase the thickness and volume of endometrium,improve the type of endometrium and subendometrial blood perfusion,reduce the blood flow resistance of uterine artery and reduce serum IL-6 and TNF-α It may further improve endometrial receptivity by inhibiting the expression of inflammatory factors in vivo,so as to improve the clinical pregnancy rate. |
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