Clinical Observation Of Bushen Yuluan Decoction In The Treatment Of Small Follicle Ovulation Infertility With Kidney Qi Deficiency Syndrome

Objective: to treat patients with small follicle ovulation infertility with kidney qi deficiency syndrome with self-made Bushen Yuluan Decoction,and to evaluate the clinical efficacy of Bushen Yuluan Decoction more objectively by observing its effects on the size of dominant follicles before ovulation,the thickness and shape of endometrium on the day of ovulation,the level of serum estradiol and progesterone on the 7th day after ovulation,the score of TCM symptoms and the clinical pregnancy rate,so as to provide a more therapeutic scheme for the treatment of this disease,To provide clinical experience reference for gynecologists in the treatment of small follicle ovulation infertility with kidney qi deficiency syndrome with traditional Chinese medicine.Methods: 60 patients with small follicle ovulation infertility(kidney qi deficiency syndrome)in the gynecological clinic of the First Affiliated Hospital of Guangxi University of traditional Chinese medicine from March2020 to September 2021 were randomly divided into two groups.Using the controlled clinical research method,30 cases in the experimental group of traditional Chinese medicine(Bushen Yuluan Decoction)and 30 cases in the control group of Western Medicine(clomiphene citrate).Three menstrual cycles were used as a course of treatment,and each group was treated for one course of treatment.The dominant follicle size before ovulation,endometrial thickness and morphology on the day of ovulation,progesterone(P)and estradiol(E2)levels on the 7th day after ovulation,TCM symptom score,treatment process and pregnancy rate of 3 months after one course of follow-up treatment were observed.According to the observation indexes,evaluate the clinical effect of Bushen Yuluan Decoction on small follicle ovulation infertility(kidney qi deficiency syndrome).Results: 1.Comparison of dominant follicle size before ovulation: both groups could increase the diameter of dominant follicles after treatment,and the difference was statistically significant compared with that before treatment(P<0.05);Two groups after treatment,the difference was statistically significant(P<0.05).The western medicine group had more advantages than the traditional Chinese medicine group in increasing the dominant follicle diameter before ovulation.2.Comparison of endometrial thickness and morphology on ovulation day: the treatment of traditional Chinese medicine group can increase the endometrial thickness on ovulation day,which is statistically significant compared with that before treatment(P<0.05).There is no significant difference between western medicine group and that before treatment(P>0.05).After treatment,the difference between the two groups is statistically significant(P<0.05).The curative effect of traditional Chinese medicine group is better than that of Western medicine group in increasing the endometrial thickness on ovulation day;After treatment,the proportion of type a endometrium in traditional Chinese medicine group was 66.66%,and that in western medicine group was 20.68%.There was significant difference between the two groups(P<0.05),indicating that the curative effect of traditional Chinese medicine group on improving endometrial morphology on ovulation day was better than that of Western medicine group.3.Comparison of E2 and P levels on the 7th day after ovulation: both groups can increase the E2 level on the 7th day after ovulation,and the difference before and after treatment is statistically significant(P< 0.05).After treatment,the difference between the two groups is statistically significant(P<0.05),indicating that the traditional Chinese medicine group can increase the E2 level on the 7th day after ovulation more effectively than the western medicine group;Both groups can increase the P level 7 days after ovulation,and the difference before and after treatment is statistically significant(P<0.05).There is no statistically significant difference between the two groups after treatment(P>0.05),indicating that the curative effect of traditional Chinese medicine group and Western medicine group is the same in increasing the P level 7 days after ovulation.4.Comparison of TCM symptom score and TCM symptom curative effect: the TCM symptom score of the two groups after treatment is lower than that before treatment,and the difference is statistically significant(P<0.05).After treatment,the comparison difference between the two groups is statistically significant(P<0.05).The TCM group can reduce the TCM symptom score more effectively than the western medicine group;Comparison of the curative effects of traditional Chinese medicine symptoms after treatment between the two groups: the effective rate of traditional Chinese medicine group in improving traditional Chinese medicine symptoms was 83.33% and that of Western medicine group was 48.27%,the difference was statistically significant(P<0.05),indicating that the curative effect of traditional Chinese Medicine group in improving traditional Chinese medicine symptoms was better than that of Western medicine group.5.Comparison of pregnancy rate: according to the statistics of the pregnancy situation during the treatment and the pregnancy situation three months after a course of follow-up treatment,there were 11 cases of pregnancy in the traditional Chinese medicine group,with a pregnancy rate of36.66%,and 8 cases of pregnancy in the western medicine group,with a pregnancy rate of 27.58%.There was no significant difference between the two groups(P>0.05),indicating that the traditional Chinese medicine group and the western medicine group had the same curative effect in improving the pregnancy rate.Conclusion: 1.In this study,the pregnancy rate of traditional Chinese medicine group and Western medicine group is similar,suggesting that oral Bushen yuluan Decoction can also promote the development and maturation of follicles and improve the pregnancy rate.It can provide another treatment scheme for patients with small follicle ovulation infertility with kidney qi deficiency syndrome,but the premise is that the syndrome differentiation of traditional Chinese medicine should be accurate.2.Bushen Yuluan Decoction can effectively improve the TCM symptoms of small follicle ovulation patients with kidney qi deficiency syndrome(including long marriage infertility,weak waist and knees,mental fatigue,limb fatigue,dizziness and tinnitus,frequent urination at night,etc.),increase the diameter of dominant follicles before ovulation,increase the thickness of endometrium on ovulation day,improve the morphology of endometrium on ovulation day,and increase the level of estrogen and progesterone in luteal phase,so as to improve endometrial receptivity and luteal function,It creates favorable conditions for the formation and implantation of fertilized eggs,improves the clinical pregnancy rate,and has remarkable clinical curative effect.