益肾健脾汤对脂代谢异常多囊卵巢综合征患者再次冻融胚胎移植结局的影响

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摘要目的：探讨益肾健脾汤对脂代谢异常多囊卵巢综合征（PCOS）患者血脂的影响，评定患者再次冻融胚胎移植（FET）的临床结局。方法：选取2016年10月至2017年12月在温州医科大学附属第一医院生殖中心首次行FET治疗失败后的PCOS合并血脂异常患者227例，采用非盲随机对照分组给予不同干预治疗。A组55
例，单纯生活方式干预治疗；B组85例，生活方式干预联合二甲双胍片口服；C组87例，生活方式干预联合中药益肾健脾汤治疗。比较3组治疗前后BMI、腰臀比（WHR）、血清睾酮（T）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）的变化，同时评定再次FET后临床结局，如胚胎种植率、临床妊娠率、早期流产率及活产率。结果：治疗后3组T、TC、TG，B、C组LDL-C、HDL-C及C组WHR均较治疗前明显好转（P＜0.05）；治疗后与A组比，B、C组T、TC、LDL-C明显下降，HDL-C明显上升（P＜0.05）。胚胎种植率C组（为43.98%）明显高于A组（为31.68%）和B组（为35.06%）（P＜0.05）。3组临床妊娠率、早期流产率和活产率比较，差异无统计学意义（P＞0.05）。结论：脂代谢异常PCOS患者经积极生活方式干预、二甲双胍片口服或益肾健脾汤治疗后，血脂均能得到明显改善，为再次FET妊娠结局带来有利影响，尤其益肾健脾汤能显著提高胚胎种植率。

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	滕依丽
	余蓉
	徐芝慧
	潘洁雪
	杨海燕

关键词 ：多囊卵巢综合征, 脂代谢异常, 冻融胚胎移植

Abstract：Objective: To study the effectiveness of YiShenJianPi decoction on blood lipid in women with polycystic ovary syndrome, and to investigate the impact on the outcome of FET cycles. Methods: A prospective study was performed in 227 women with PCOS and dyslipidemia who underwent the failure of first FET cycle. Patients in group A (n=55) received lifestyle modification programs. Patients in group B (n=85) received lifestyle modification and metformin. Patients in group C (n=87) received lifestyle modification and YiShenJianPi decoction. BMI, WHR, T, TC, TG, LDL-C, HDL-C were compared before and after treatment in all patients. Clinical outcome of re-FET was valued, including embryo implantation rate,clinical pregnancy rate, early abortion rate and live birth delivery rate. Results: T, TC, and TG of 3 groups, LDL-C and HDL-C of group B, C, WHR of group C, were all significantly improved after treatment (P<0.05), and meanwhile compared to group A, T, TC, LDL-C declined obviously and HDL-C increased remarkably in group B, C (P<0.05). The embryo implantation rate of group C (43.98%) was significantly higher than that of group A (31.68%) and B (35.06%) (P<0.05). No significant differences were detected in the clinical pregnancy rate early abortion rate and live birth delivery rate among 3 groups (P>0.05). Conclusion: The three strategies mentioned above could obviously alter dyslipidemia and help patients produce ideal pregnancy outcome, with YiShenJianPi decoction in particular, as it could remarkably increase the embryo implantation rate of FET.

Key words： polycystic ovary syndrome dyslipidemia frozen embryo transfer

收稿日期: 2019-01-25

基金资助:国家自然科学基金青年基金资助项目（81801411）。

通讯作者: 杨海燕，副主任医师，Email：haiyanyang@163.com。

作者简介: 滕依丽（1978-），女，浙江永嘉人，主治中医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2019/V49/I6/418

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