A Clinical Study Of The Yangmo Zhuyun Decoction On Artificial Insemination Of Thin Endometrial Infertility With Kidney Deficiency And Blood Stasis

ObjectiveTo observe the effects of Yangmo Zhuyun Recipe combined with estradiol gel on the TCM syndrome score,endometrial thickness,endometrial morphology,uterine artery blood flow parameters,the blood luteinizing hormone,the blood estradiol,and clinical pregnancy rate in patients with thin endometrium with kidney deficiency and blood stasis during ovulation promotion cycle by artificial insemination,and to explore the clinical efficacy of this treatment method,so as to provide reference for the combination of Chinese and Western medicine in the treatment of this disease.MethodA total of 72 patients with thin endometrium of kidney deficiency and blood stasis type who met the inclusion criteria were divided into 36 cases each in the experimental group and control group by random number table method.The control group was treated with estradiol gel,and the experimental group was treated with oral membrane-enhancing formula on the basis of the control group.The clinical efficacy of the two treatments was evaluated by observing the TCM evidence score,endometrial thickness,endometrial morphology,uterine artery blood flow pulsatility index,resistance index,the blood luteinizing hormone and estradiol on the day of HCG,and clinical pregnancy rate before and after treatment in the IUI ovulation cycle,and the data were analyzed statistically.Results1.Comparison of general data:The differences in age,years of infertility,type of infertility,basal sex hormones,pre-treatment endometrial thickness,pre-treatment endometrial morphology,pre-treatment uterine artery blood flow PI,pre-treatment uterine artery blood flow RI,and pre-treatment TCM syndrome score between the two groups were not statistically significant（P>0.05）and were comparable.2.Comparison of endometrial thickness,endometrial morphology,and uterine artery blood flow parameters:The endometrial thickness increased in the experimental group after treatment compared with the control group,and the difference was statistically significant（P<0.05）.The endometrial morphology of the experimental group was better than that of the control group after treatment,and the difference was statistically significant（P<0.05）.The PI and RI of the experimental group were lower than those of the control group after treatment,and the difference was statistically significant（P<0.05）.3.Comparison of the level of LH and E₂on the day of HCG:After treatment,there was no significant difference on the LH on the day of HCG in the experimental and control groups（P>0.05）.After treatment,the E₂on the day of HCG was elevated in the experimental group compared with the control group,and the difference was statistically significant（P<0.05）.4.Comparison of TCM syndrome score and curative effect:After treatment,the TCM syndrome score of both groups decreased compared with that before treatment（P<0.05）,and the TCM syndrome score of the experimental group was lower than that of the control group after treatment,and the difference was statistically significant（P<0.05）.The total efficacy rate of TCM symptoms in the experimental group was 94.12%higher than that in the control group 75.76%,and the difference was statistically significant（P<0.05）.5.Comparison of clinical pregnancy rate:A total of 170 cycles of IUI were performed,and the clinical pregnancy rates were 16.41%,16.07%,and 14.89%in the three treatment cycles,and the cumulative clinical pregnancy rates in the cycles were 16.41%,16.26%,and15.88%,respectively,with no statistically significant differences（P>0.05）.The clinical pregnancy rate in the experimental group was 19.04%after treatment,which was higher than that in the control group of 12.79%,and the difference was not statistically significant（P>0.05）.There was no significant difference in the clinical pregnancy rate when the endometrial thickness was 7 mm to 9 mm and>9 mm after treatment（P>0.05）.The clinical pregnancy rates of endometrium after treatment were 27.94%,9.21%and 3.85%for types A,B and C,respectively,with statistically significant differences（P<0.05）.ConclusionYangmo Zhuyun Decoction combined with estradiol gel can improve the TCM symptoms score of IUI ovulation-promoting cycles in patients with thin endometrium with kidney deficiency and blood stasis,increased endometrial thickness,optimized endometrial morphology,reduced uterine artery blood flow resistance,increased the level of E₂on the day of HCG,and tended to improve clinical pregnancy rate,but increasing the number of IUI cycles did not significantly improve cumulative pregnancy rate.