| Objective: To explore the difference in the clinical efficacy of progynova,Bushen Jianpi Yangxue Decoction,and Bushen Jianpi Yangxue Decoction combined with progynova in the treatment of thin endometrial infertility of spleen-kidney deficiency type,and preliminarily explore the mechanism of Invigorating the Kidney and Spleen and Nourishing Blood Methods: A total of 99 patients who met the inclusion criteria of Thin Endometrial Infertility of Spleen and Kidney Deficiency were selected from the gynecological clinic of Renai Hospital Affiliated to Guangxi University of Traditional Chinese Medicine From January 2020 to April2021.According to the random number table method,the patients were divided into three groups.Western medicine group A(n = 33,3 cases dropped out)took progynova,Chinese medicine group B(n = 33,shedding 2 cases dropped out)took Bushen Jianpi Yangxue Decoction.Chinese and western medicine group C(n = 33,0 cases dropped out)took Bushen Jianpi Yangxue Decoction combined with progynova.The menstrual PBAC score,TCM symptoms,clinical pregnancy rate,and early abortion rate were observed before and after treatment in the three groups.The endometrial thickness and classification,uterine artery pulsatility index(PI),uterine artery resistance index(RI),sex hormones were monitored before and after treatment,and the observed indexes were compared and analyzed.Results:(1)Comparison of baseline data before treatment: There were no significant differences in the three groups of patients in terms of general conditions,menstrual PBAC score,total score of TCM symptoms,ultrasound monitoring indicators,and six sex hormones(P>0.05),which were balanced and comparable.(2)Comparison of menstrual PBAC scores : The menstrual PBAC scores of the three groups were improved compared with those before treatment(P < 0.05).In terms of improving menstrual volume,the effect of the Chinese and western medicine group was the best,followed by the Chinese medicine group(P < 0.05),and the two groups were better than the western medicine group(P < 0.05).(3)Comparison of total scores of TCM symptoms : the total scores of TCM symptoms in three groups were lower than those before treatment(P < 0.05).In terms of improving the TCM symptoms,the curative effect of the Chinese and western medicine group and the Chinese medicine group was similar(P > 0.05),and the two groups were better than the western medicine group(P < 0.05).(4)Comparison of ultrasonic monitoring indicators :(1)Comparison of endometrial thickness : The endometrial thickness of the three groups was increased compared with that before treatment(P < 0.05).In terms of improving endometrial thickness,the Chinese and western medicine group was the best(P < 0.05),the Chinese medicine group and the western medicine group had the same curative effect(P>0.05).(2)Comparison of endometrial types: There were statistically significant differences in endometrial types among the three groups after treatment(P<0.05).In terms of increasing A type endometrial,the Chinese and western medicine group had the best effect(P<0.05),the Chinese medicine group and the western medicine group had the same curative effect(P>0.05).(3)Comparison of uterine artery pulsatility index(PI)and resistance index(RI): PI and RI in three groups decreased compared with those before treatment(P < 0.05).In terms of decreasing PI and RI,the Chinese and western medicine group had the best effect,followed by the Chinese medicine group(P < 0.05),and both groups were better than the western medicine group(P < 0.05).(5)Comparison of six sex hormones: After treatment in the three groups,E2 increased compared with before treatment(P<0.05).In terms of improving E2,the Chinese and Western medicine group had the best effect(P<0.05),and the Chinese medicine group and the Western medicine group had the same effect(P>0.05).There was no statistical difference between the three groups of FSH,LH,P,PRL and T before and after treatment(P>0.05),and there was no statistical difference between the three groups after treatment(P>0.05).(6)Comparison of efficacy indicators:(1)Comparison of clinical pregnancy rate: the clinical pregnancy rate of the western medicine group was 10.00%,the clinical pregnancy rate of the Chinese medicine group was 12.90%,and the clinical pregnancy rate of the Chinese and western medicine group was 33.33%.In terms of improving the clinical pregnancy rate,the Chinese and western medicine group had the best effect(P<0.05),and the effect of Chinese medicine group and western medicine group was similar(P>0.05).(2)Comparison of early abortion rate: There was no statistical difference in early spontaneous abortion rate among the three groups(P>0.05).(3)Comparison of the efficacy of TCM symptoms: after treatment,the effective rate of western medicine group was 76.67%,the effective rate of Chinese medicine group was 87.10%,and the effective rate of Chinese and western medicine group was93.94%.There was no statistical difference in the effective rate of TCM symptoms between the Chinese and western medicine group and the Chinese medicine group(P>0.05),the effective rate of both groups was better than that of western medicine group(P<0.05).(4)Clinical comprehensive curative effect comparison : After treatment,the clinical total effective rate of the western medicine group was 70.00 %,the clinical total effective rate of the Chinese medicine group was 74.19%,and the clinical total effective rate of the Chinese and western medicine group was 90.91%.The clinical comprehensive efficacy of the Chinese and western medicine group was better than that of the Chinese medicine group and the western medicine group(P<0.05),and the clinical comprehensive efficacy of the Chinese medicine group and the western medicine group was comparable(P>0.05).Conclusion:(1)The clinical efficacy of Bushen Jianpi Yangxue Decoction combined with progynova in the treatment of thin endometrial infertility of spleen-kidney deficiency type patients is better than that of Bushen Jianpi Yangxue Decoction alone and progynova alone.Simple Bushen Jianpi Yangxue Decoction and simple progynova two kinds of therapy curative effect is equivalent.(2)Invigorating the kidney and spleen and nourishing blood combined with progynova can better improve the clinical symptoms of patients with thin endometrial infertility due to deficiency of both spleen and kidney,increase menstrual flow,increase endometrial thickness,and optimize endometrial typing,reduce uterine artery blood flow resistance,improve endometrial receptivity,improve the levels of E2,improve clinical pregnancy rate. |
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