目的 观察针药结合联合二甲双胍治疗多囊卵巢综合征不孕患者的临床疗效，并探讨其对子宫内膜容受性的影响。方法 将多囊卵巢综合征不孕患者90例随机分为对照组及观察组，对照组采用二甲双胍治疗，观察组在采用二甲双胍治疗的基础上，加用自拟补肾化痰活血方和针刺治疗，两组均治疗6个月，治疗结束后观察两组临床疗效，观察妊娠率及流产率，比较子宫内膜厚度及子宫动脉RI情况，比较治疗前后两组中医证候积分变化。结果 两组临床疗效的分布比较，差异具有统计学意义（P<0.05），观察组疗效优于对照组。①妊娠率：治疗后观察组的妊娠率高于对照组（P<0.05）。②流产率：治疗后观察组的流产率较对照组下降，但差异无统计学意义（P>0.05）。③子宫内膜厚度与子宫动脉RI：治疗后两组方案均能增加患者子宫内膜厚度、降低子宫动脉RI，且观察组较对照组子宫内膜增厚，子宫动脉RI降低（P<0.05）。④中医证候评分：治疗后观察组中医证候积分较对照组明显降低（P<0.01）。结论 针药结合联合二甲双胍能提高PCOS不孕患者妊娠率，降低流产率，其机制可能与改善子宫内膜容受性有关。

Objective To observe the clinical efficacy of acupuncture combined with medicine and metformin in the treatment of polycystic ovary syndrome (PCOS), and to explore its influence on endometrial receptivity.Methods 90 infertile patients with polycystic ovary syndrome were randomly divided into control group and observation group. The control group was treated with metformin, while the observation group was treated with Bushen Huatan Huoxue Decoction and acupuncture on the basis of metformin. Both groups were treated for 6 menstrual cycles. After treatment, the clinical efficacy, pregnancy rate and abortion rate of the two groups were observed, The endometrial thickness and RI of uterine artery were compared, and the changes of TCM syndrome scores before and after treatment were compared between the two groups.Results There was significant difference in the distribution of clinical efficacy between the two groups (P < 0.05). The curative effect of the observation group was better than that of the control group. (P < 0.05)。① Pregnancy rate: after treatment, the pregnancy rate of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05). ② Abortion rate: after treatment, the abortion rate of the observation group was lower than that of the control group, but the difference was not statistically significant (P > 0.05). ③ Endometrial thickness and uterine artery RI: after treatment, the two groups could increase endometrial thickness and reduce uterine artery RI, and the endometrium of the observation group was thicker and the RI of uterine artery was lower than that of the control group (P < 0.05). ④ TCM syndrome score: after treatment, TCM syndrome score of the observation group was significantly lower than that of the control group (P < 0.01).Conclusion acupuncture combined with metformin can improve the pregnancy rate, reduce the abortion rate and improve the endometrial receptivity of PCOS infertility patients.

上海市杏林新星培养计划