参苓白术散防治卵巢过度刺激综合征的临床研究

Clinical study of Shenling Baizhu Powder on Prevention and treatment of Ovarian Hyperstimulation Syndrome

摘要:

〔摘 要〕 目的：研究参苓白术散防治卵巢过度刺激综合征（OHSS）的临床疗效，为临床实践提供依据。方法：选取 2019 年 1 月至 2021 年 1 月佛冈县妇幼保健计划生育服务中心收治的脾虚证 OHSS 患者 82 例，随机分为对照组和观察组， 各 41 例。对照组患者给予鼓励其增加液体摄入及监测腹围、尿量、体质量等常规临床观察，观察组在对照组基础上加用参 苓白术散治疗。比较两组患者的 OHSS 发生率、获卵数、获胚数、人绒毛膜促性腺激素（HCG）扳机日血清雌二醇（E2） 水平、周期取消率、临床妊娠率、流产率及安全性评估。结果：治疗后，两组患者的获胚数比较，差异无统计学意义 （P ＞ 0.05）；观察组患者的 HCG 扳机日 E2 水平低于对照组，获卵数少于对照组，差异具有统计学意义（P ＜ 0.05）； 两组患者鲜胚移植周期取消率比较，差异无统计学意义（P ＞ 0.05）；观察组患者 OHSS 总发生率和临床流产率均明显低 于对照组，临床妊娠率高于对照组，差异具有统计学意义（P ＜ 0.05）；治疗期间两组患者均未出现肝功能和肾功能异常， 未出现不良反应事件。结论：参苓白术散方对预防脾虚证 OHSS 有一定疗效，有助于降低脾虚证 OHSS 发生率，有效提高 妊娠率及降低流产率。 〔关键词〕 卵巢过度刺

Abstract:

〔Abstract〕 Objective To investigate the clinical efficacy of Shenling Baizhu Powder in the prevention and treatment of ovarian hyperstimulation syndrome (OHSS), and to provide reliable evidence for clinical practice. Methods 82 patients with OHSS enrolled from Fogang County Maternal and Child Health and Family Planning Service Center from January 2019 to January 2021 were randomly divided into control group and observation group, with 41 cases in each group. Patients in the control group were encouraged to increase fl uid intake and their abdominal circumference, urine volume and body mass were measured during the study process. Patients in the observation group were treated in the control group in the foundation, given Shenling Baizhu Powder. The incidence of OHSS, the number of oocyte retrieval, the number of embryos obtained, the E2 level of HCG day, cycle cancellation rate, clinical pregnancy rate, abortion rate and safety evaluation were compared between the two groups. Results After treatment,there was no signifi cant difference in the number of embryos obtained between the two groups (P > 0.05). Compared with the control group, the E2 level of HCG day in the observation group was lower, and the number of oocyte retrieval was less, and the difference were signifi cant (P < 0.05). In terms of the fresh embryo transplantation cycle cancellation rate, no signifi cant difference was detected between the two groups (P > 0.05), while the total incidence of OHSS and clinical abortion rate in the observation group were lower than that in the control group, and the clinical pregnancy rate was higher in the observation group, with signifi cant difference (P < 0.05). No liver and kidney damage or adverse events occurred during the treatment period between the two groups. Conclusion Shenling Baizhu Powder was a promising strategy to prevent OHSS with the reassuring evidence of reducing the incidence of OHSS, and effectively increasing the pregnancy rate and reduce the abortion rate.