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易铭, 丁嫦娥, 许子煜, 尹思倩, 杨丽丽.补肾活血通络法联合富血小板血浆宫腔灌注对薄型子宫内膜患者子宫内膜厚度、冻融胚胎移植结局的影响[J].湖南中医药大学学报,2026,46(1):158-162[点击复制] |
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| 补肾活血通络法联合富血小板血浆宫腔灌注对薄型子宫内膜患者子宫内膜厚度、冻融胚胎移植结局的影响 |
| 易铭,丁嫦娥,许子煜,尹思倩,杨丽丽 |
| (湖北省荆门市中医医院输血科, 湖北 荆门 448000;湖北省荆门市中医医院妇产科, 湖北 荆门 448000) |
| 摘要: |
| 目的 探究补肾活血通络法联合富血小板血浆（PRP）宫腔灌注对薄型子宫内膜（TE）患者子宫内膜厚度（EMT）、冻融胚胎移植（FET）结局的影响。方法 选取2022年9月至2023年12月于湖北省荆门市中医医院治疗的98例TE患者，采用随机数字表法分为观察组和对照组，每组49例。对照组采用常规治疗＋PRP疗法，观察组在对照组基础上联合补肾活血通络法治疗，均治疗两个月。比较两组治疗后FET结局及治疗前后EMT、中医证候积分、血清血管生成相关因子[血管内皮生长因子（VEGF）、血小板源性生长因子（PDGF）、转化生长因子-β（TGF-β）]、子宫内膜血流动力学[子宫内膜血流搏动指数（PI）及子宫内膜血流阻力指数（RI）]。结果 观察组患者的临床妊娠率为46.94%，显著高于对照组的24.49%（P＜0.05）；观察组患者的胚胎种植率为59.18%，显著高于对照组的30.61%（P＜0.05）；观察组患者的持续妊娠率为38.78%，显著高于对照组的20.41%（P＜0.05）。治疗后，两组患者腰膝酸软、经行腹痛、性欲减退积分及PI、RI水平均降低（P＜0.05），且观察组均低于对照组（P＜0.05）。治疗后，两组EMT及血清VEGF、TGF-β、PDGF水平均升高（P＜0.05），且观察组均高于对照组（P＜0.05）。结论 补肾活血通络法联合PRP宫腔灌注治疗TE患者具有较好的临床效果，可显著改善患者FET结局及其中医证候，增加患者EMT，促进生长因子分泌，有助于患者子宫恢复，并可改善子宫内膜血液灌注，促进胚胎着床。 |
| 关键词: 薄型子宫内膜 补肾活血通络法 富血小板血浆 子宫内膜厚度 冻融胚胎移植 |
| DOI：10.3969/j.issn.1674-070X.2026.01.022 |
| 投稿时间：2025-08-29 |
| 基金项目:湖北省中医药管理局中医药联合基金项目（ZY2025L198）；2024年度荆门市引导性科研计划项目（2024YDKY235）。 |
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| Effects of kidney-tonifying, blood-activating, and collateral-unblocking therapy combined with intrauterine infusion of platelet-rich plasma on endometrial thickness and frozen-thawed embryo transfer outcomes in patients with thin endometrium |
| YI Ming, DING Chang'e, XU Ziyu, YIN Siqian, YANG Lili |
| (Department of Blood Transfusion, Jingmen Hospital of Chinese Medicine, Jingmen, Hubei 448000, China;Department of Obstetrics and Gynecology, Jingmen Hospital of Chinese Medicine, Jingmen, Hubei 448000, China) |
| Abstract: |
| Objective To explore the effects of the kidney-tonifying, blood-activating, and collateral-unblocking therapy combined with intrauterine infusion of platelet-rich plasma (PRP) on endometrial thickness (EMT), frozen-thawed embryo transfer (FET) outcomes in patients with thin endometrium (TE). Methods A total of 98 TE patients treated at Jingmen Hospital of Chinese Medicine in Hubei Province from September 2022 to December 2023 were selected. They were randomly divided into observation group and control group using the random number table method, with 49 cases in each group. The control group received conventional treatment + PRP therapy, while the observation group was treated with the kidney-tonifying, blood-activating, and collateral-unblocking therapy in addition to the treatment given to the control group. Both groups were treated for two months. After treatment, FET outcomes, EMT before and after treatment, Chinese medicine symptom scores, serum angiogenesis-related factors [vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and transforming growth factor-β (TGF-β)], and endometrial hemodynamics [endometrial blood flow pulsatility index (PI) and endometrial blood flow resistance index (RI)] were compared between the two groups. Results The clinical pregnancy rate in the observation group was 46.94%, significantly higher than that in the control group (24.49%) (P＜0.05). The embryo implantation rate in the observation group was 59.18%, significantly higher than that in the control group (30.61%) (P＜0.05). The ongoing pregnancy rate in the observation group was 38.78%, significantly higher than that in the control group (20.41%) (P＜0.05). After treatment, the scores for soreness and weakness of the waist and knees, menstrual abdominal pain, and decreased libido, as well as the levels of PI and RI, decreased in both groups (P＜0.05), and these values in the observation group were lower than those in the control group (P＜0.05). After treatment, EMT and the serum levels of VEGF, TGF-β, and PDGF increased in both groups (P＜0.05), and these values in the observation group were higher than those in the control group (P＜0.05). Conclusion The kidney-tonifying, blood-activating, and collateral-unblocking therapy combined with intrauterine infusion of PRP has good clinical effects in the treatment of TE patients. It can significantly improve FET outcomes and TCM syndromes in patients, increase EMT, promote the secretion of growth factors, facilitate uterine recovery, improve endometrial blood perfusion, and promote embryo implantation. |
| Key words: thin endometrium kidney-tonifying, blood-activating, and collateral-unblocking therapy platelet-rich plasma endometrial thickness frozen-thawed embryo transfer |
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