| ObjectiveTo serially investigate changes of endometrial and ovary vascularity and the growth synchronism in infertility Patients with Luteinized Unruptured Follicle Syndrom(LUFS)throughout the menstrual cycle by the three dimensional ultrasound(3D-US)and 4D-view software.Through the changes of the above index to study the targets and the mechanism of Zishen Yutai Pill for the patient with the insufficiency of both spleen and kidney syndrome in order to further confirm the effect of Zishen Yutai Pill and supply imaging basis.Methods1.The study of the synchronicity development of the follicle and the endometrium in LUFS patients with Three-dimensional power doppler ultrasound:used the techonology of the Three-dimensional power doppler ultrasound combined with the 4D-view software contrastive anaylysis the Follicular volume,Follicular volume,Hemodynamic Parameters(VI,FI,VFI)in LUFS group and the normal group at the each period of menstrul cycle(early and medium-term follicular phase,periovulation phase,early period of luteal phase,medium-term period of luteal phase and the late period of the luteal phase),anaylysis the synchronicity development of the follicle and the endometrium based on the parameters and their growth changes graphs.2.The evaluation of the synchronicity development of the follicle and the endometrium promoted by the zishenyutaipill by use of the Three-dimensional power doppler ultrasound:Randomized divided the 28 patients who accorded with the inclusion criteria of spleen and kidney deficiency into three groups:8 patients in group A received the treatment of the clomiphene combined HCG,10 patients in group B received the treatment of the Zishen Yutai Pill,10 patients in group C treated by both the clomiphene combined HCG and Zishen Yutai Pill.To evaluate the effect of the zishenyutaipill by combined the sex hormones level and changes of endometrial and ovary vascularity throughout the menstrual cycle by the three-dimensional ultrasound(3D-US)3.Through statistical data analysis to study both the timing and the targets of Zishen Yutai Pill for the patient with the insufficiency of both spleen and kidney syndrome to discuss the mechanism of Zishen Yutai Pill.Results1.There was no difference in follicle and endometrial volume between LUFS group and normal group in early and medium-term follicular phase.The follicle and endometrial volume were smaller in LUFS group and the difference was significant(P<0.05)compared with normal group.Normal endometrial volume was larger than the LUFS group in luteal phase,but there was no statistically significant difference(P>0.05).2.The results showed that the ovary VI increased with the menstrual cycle in normal group,the compound growth rate of preovulatory correlate was larger,at peak on late luteal phase.Compared with normal group the changes of LUFS groups tend to be gentle,from medium-term follicular phase to late luteal phase.The ovary VI were smaller in LUFS group compared with normal group.mean lower than normal group(P<0.05).3.The ovary FI in normal group showed a periodical change in normal group:from early follicular phase to preovulatory period trend to increase peaked in mid luteal phase,then late luteal phase tend to decreases.There was no periodicity in the whole menstrual cycle in LUFS group and at the same time,the ovary FI is lower than normal group,the.difference was statistically significant(P<0.05).4.The ovary VFI in normal group showed a periodical change in normal group:from early follicular phase to preovulatory period trend to increase peaked in preovulatory phase,declines slightly in the early luteal phase,but rose again in mid luteal phase.There was no periodicity in the whole menstrual cycle in LUFS group and at the same time,the ovary VFI is lower than normal group,the difference was statistically significant(P<0.05).5.The sub-endometrial blood flow indexs VI?FI?VFI in two groups is likely the same to showed a periodical change,but the concentration in normal group is higher than those of in LUFS group,the difference was statistically significant(P<0.05).6.After 3 months treatment,follicle volume increased oviposit period of three groups,the in terms of growth rate,group C>A>B group;B and C groups around ovulation endometrial volume increases,the earlier does not change significantly in group A.7.After 3 months treatment,ovary VI increased during the ovulatory time and luteal phase and ovary FI VFI increased only during the ovulatory time in group A.Ovary VI FI VFI increased during the ovulatory time and luteal phase in group B and C(P<0.05),the rest of the blood flow parameters at each time point change is not obvious.The density of blood vessels and blood perfusion increase in group Band C,only ovarian vascular density increase in group A.8.After 3 months treatment,there were no differences in sub-endometrial blood flow indexs VI FI VFI in group A compared with before treatment(P>0.05),sub-endometrial VI FI VFI increased during the ovulatory time and luteal phase in group B and C(P<0.05).B and C can increase endometrial density of blood vessels and blood perfusion,there was no obvious effect in group A.Conllusion1.The development of follicle and endometrial of spleen kidney deficiency syndrome LUFS patients are not synchronized.Ovarian and endometrial vascular maybe were factors to influence follicular develo pment.Ovarian and endometrial perfusion with menstrual cycle change cycle was an important factor to maintain normal function of ovarian and endometrial.The microvascular density was low under the endometrium during the menstrual cycle blood perfusion was likely to be less and the receptivity of endometrium low important factor.2.Ovary microvessel density were only increase in periovulation phase and luteal phase buy using ovulation stimulants.There were no significant effects buy using ovulation stimulants to influence endometrium blood perfusion.There were no obvious difference about the follicular volume and endometrial volume between the LUFS group and the normal group in the early follicular,middle follicle and the whole luteal phase.After the treatment,since mid follicular phase,in both the blood vessels density and blood perfusion were promoted in the ovary and endometrium.It was helpful for the follicular development and ovum eduction.Just use stimulate ovulation drugs(group A)can only increase ovarian vascular density but had little influence on blood perfusion of ovary and endometrium.3.Zishen Yutai Pill to spleen and kidney deficiency syndrome LUFS patients ovarian follicles and endometrial development exert time synchronization effect for all middle follicle,ovulation,corpus luteum period.Specific performance increase in patients with middle follicle,ovulation,corpus luteum period edge around the follicle microvascular density,blood flow index,promote the follicular development and ovum eduction,under the same period increased endometrial density of new blood vessels and blood perfusion,to improve the receptivity of endometrium..4.Serum LH,FSH hormone P level was the important factor of ovarian and endometrial perfusion,under its level and ovarian and endometrial blood flow parameters VI FI VFI correlation.Zishen Yutai Pill pills can increase ovulation around serum LH,FSH P level,it may be by improving the sex hormone levels,in turn,improve ovarian and endometrial blood flow perfusion,synchronously promote follicle and endometrial development... |
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