麒麟丸预防体外受精胚胎移植术后所致卵巢过度刺激综合征患者的疗效及对血浆相关指标的影响

doi:10.12092/j.issn.1009-2501.2020.02.012

中国临床药理学与治疗学 ›› 2020, Vol. 25 ›› Issue (2): 196-202.doi: 10.12092/j.issn.1009-2501.2020.02.012

麒麟丸预防体外受精胚胎移植术后所致卵巢过度刺激综合征患者的疗效及对血浆相关指标的影响

刘红丹¹，殷一红²

¹宁波市医疗中心李惠利东部医院中医科，宁波 315199，浙江；²宁波市中医院妇科，宁波 315016，浙江

收稿日期:2019-07-01 修回日期:2020-01-14 出版日期:2020-02-26 发布日期:2020-03-06
通讯作者: 殷一红，女，博士，副主任医师，研究方向：中医药治疗女性生殖与内分泌。 Tel：15967866220 E-mail：1049256347@163.com
作者简介:刘红丹，女，硕士，主治医师，研究方向：中西结合内科。 Tel：18868949628 E-mail：bang36651217621@163.com
基金资助:
浙江省中医药科技计划项目（2015ZA189）

Qilin pills prevent ovarian hyperstimulation syndrome of patients after IVF-ET by regulating plasma-related indicators

LIU Hongdan ¹, YIN Yihong ²

¹ Department of Traditional Chinese Medicine, Li Huili Eastern Hospital, Ningbo Medical Center, Ningbo 315199, Zhejiang, China; ²Department of Gynecology, Ningbo Hospital of Traditional Chinese Medicine, Ningbo 315016, Zhejiang, China

Received:2019-07-01 Revised:2020-01-14 Online:2020-02-26 Published:2020-03-06

摘要/Abstract

摘要： 目的:研究麒麟丸预防体外受精胚胎移植（IVF-ET）术后所致卵巢过度刺激综合征（OHSS）患者的疗效及其对血浆中血管内皮细胞生长因子（VEGF）、组织因子（TF）和组织因子通路抑制剂（TFPI）的影响。方法:选取2016年1月至2019年1月我院收治的64例行IVF-ET患者，在促排卵注射人绒毛膜促性腺激素（HCG）日发现有OHSS高风险因素者，简单随机化分组，各32例。对照组给予西医治疗方案，观察组加用麒麟丸，比较两组轻中度OHSS的发生情况、新鲜周期移植取消率、血浆中VEGF、TF、TFPI水平、行IVF-ET者临床结局（HCG阳性率、生化妊娠率、临床妊娠率）。结果:两组均无重度OHSS发生，观察组OHSS发生率（12.50%）、新鲜周期移植取消率（15.63%）低于对照组（50.00%、43.75%）（χ2=6.063，P=0.014）；观察组取卵日、胚胎移植日血浆VEGF、TF水平分别为［（368±103）pg/mL、（392±91）pg/mL］、［（24±4）pg/mL、（29±4）pg/mL］低于对照组的［（436±117）pg/mL、（448±108）pg/mL］、［（26±4）pg/mL、（31±4）pg/mL］（t=2.450、2.237、4.093、5.204，P=0.017、0.029、＜0.001、＜0.001）；观察组取卵日、胚胎移植日血浆TFPI水平分别为［（73±18）ng/mL、（66±12）ng/mL］高于对照组的［（62±16）ng/mL、（58±10）ng/mL］（t=2.550、3.032，P=0.014、0.004）；观察组生化妊娠率（8.70%）低于对照组（42.86%）（χ2=4.147，P=0.042），临床妊娠率（91.30%）高于对照组（57.14%）（χ2=4.147，P=0.042）。结论:麒麟丸能预防IVF-ET术后重度OHSS发生，并减少轻中度OHSS的发生，降低新鲜周期移植取消率，改善IVF-ET术后妊娠结局，其机制可能与调节VEGF、TF和TFPI表达有关。

关键词: 麒麟丸, 卵巢过度刺激综合征, 血管内皮细胞生长因子, IVF-ET术, 组织因子, 组织因子通路抑制剂

Abstract: AIM: To study the preventive effect of Qilin pill on ovarian hyperstimulation syndrome (OHSS) after in vitro fertilization and embryo transfer (IVF-ET) and its effects on vascular endothelial growth factor (VEGF), tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in plasma. METHODS: Sixty-four patients undergoing IVF-ET treated in our hospital from January 2016 to January 2019 were selected. On the day of ovulation induction injection of human chorionic gonadotropin (HCG), 32 patients with high risk factors of OHSS were randomly divided into two groups. The control group received western medicine therapy, while the observation group received extra Qilin pill. The incidence of mild to moderate OHSS, fresh cycle transplant cancellation rate, plasma VEGF, TF, TFPI levels, and clinical outcomes of patients undergoing IVF-ET (HCG positive rate, biochemical pregnancy rate, clinical pregnancy rate) were compared between the two groups.RESULTS:There was no severe OHSS occurred in the two groups, the incidence of OHSS in the observation group (12.50%) and the cancellation rate of fresh cycle transplantation (15.63%) were lower than those in the control group (50.00%, 43.75%)（χ2=6.063,P=0.014）;The levels of VEGF and TF in the observation group on the day of egg retrieval and embryo transfer were ［(368±103) pg/mL, (392±91) pg/mL］,［(24±4)pg/ mL,(29±4) pg/mL］, which were lower than the control group ［(436±117) pg/mL, (448±108) pg/mL］,［(26±4) pg/mL, (31±4) pg/mL］ (t=2.450,2.237,4.093,5.204,P=0.017,0.029,＜0.001,＜0.001);The plasma TFPI levels in the observation group on the day of egg retrieval and embryo transfer were ［(73±18) ng/mL,(66±12) ng/mL］, higher than the control group ［(62±16）ng/mL, (58±10) ng/mL］(t=2.550,3.032,P=0.014,0.004);The biochemical pregnancy rate in the observation group (8.70%) was lower than that in the control group (42.86%) (χ2=4.147, P=0.042),the clinical pregnancy rate (91.30%) was higher than that of the control group (57.14%) (χ2=4.147,P=0.042).CONCLUSION:Qilin pill can prevent the occurrence of severe OHSS after IVF-ET, reduce the occurrence of mild to moderate OHSS, decrease the cancellation rate of fresh cycle transplantation and improve the pregnancy outcome after IVF-ET; Its mechanism may be related to the regulation of the expression of VEGF, TF and TFPI.

Key words: Qilin pill, ovarian hyperstimulation syndrome, vascular endothelial cell growth factor, IVF-ET surgery, tissue factor, tissue factor pathway inhibitor

中图分类号:

R984

刘红丹，殷一红. 麒麟丸预防体外受精胚胎移植术后所致卵巢过度刺激综合征患者的疗效及对血浆相关指标的影响[J]. 中国临床药理学与治疗学, 2020, 25(2): 196-202.

LIU Hongdan, YIN Yihong. Qilin pills prevent ovarian hyperstimulation syndrome of patients after IVF-ET by regulating plasma-related indicators[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(2): 196-202.

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麒麟丸预防体外受精胚胎移植术后所致卵巢过度刺激综合征患者的疗效及对血浆相关指标的影响

Qilin pills prevent ovarian hyperstimulation syndrome of patients after IVF-ET by regulating plasma-related indicators

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