世界中医药

目的：分析知柏地黄丸对卵巢储备功能低下（DOR）患者性激素水平级妊娠结局的影响，探究其可能的作用机制。方法：选取2015年1月至2017年1月泸州市中医医院收治的DOR患者104例作为研究对象，按照随机数字表法随机分为对照组（n=53）和观察组（n=51）。对照组采用激素人工周期治疗，观察组在对照组治疗基础上予以知柏地黄丸加减辨证治疗，连续治疗6个月为1个疗程。比较2组患者治疗前、后卵巢血流动力学指标、Treg免疫细胞情况、性激素指标及2组患者随访期内的妊娠结局、药物不良反应。结果：观察组在下调DOR患者的收缩期峰值流速（S）/舒张末期流速（D）值、搏动指数（PI）、阻力指数（RI）基础卵泡刺激素（FSH）、基础雌二醇（E2）、FSH/LH水平方面较对照组更具优势，且在提升患者Treg细胞占比、CD4+T、CD8+T、CD4+T/CD8+T、自然受孕率、辅助生育技术受孕率方面效果更优（均P<0.05）；且并未提高患者的药物不良反应率（P>0.05）。结论：知柏地黄丸辅助激素人工周期治疗法加减辨治DOR，可有效提升患者Treg细胞免疫功能，改善卵巢血流动力学水平，降低性激素水平，提升DOR患者妊娠结局水平，且安全性高，具有较高的临床价值。

English Summary:

To analyze the effects of Zhibai Dihuang Pill on the outcome of pregnancy with sex hormone level in patients with low ovarian reserve(DOR)and explore the possible mechanism.Methods:A total of 104 patients were randomly divided into a control group(n=53)and a study group(n=51).The control group was treated with hormone artificial cycle，and the study group was treated with Zhibai Dihuang Pill on the basis of the control group，with a course of 6 months.The ovarian hemodynamics，Treg immune cells，sex hormones，pregnancy outcome and adverse drug reactions were compared between the 2 groups before and after treatment.Results:Zhibai Dihuang Pill was superior to the control group in reducing the levels of S/D，RI，PI，FSH，E2 and FSH/LH in patients with low ovarian reserve function，and it had better effects in increasing Treg cell proportion，CD4+T，CD8+T，CD4+T/CD8+T，natural conception rate and assisted reproductive technology conception rate(P<0.05)，and did not increase the adverse drug reaction rate(P>0.05).Conclusion:Zhibai Dihuang pill can effectively improve Treg cell immune function，improve the level of ovarian hemodynamics，reduce the level of sexual hormones，improve the level of pregnancy outcome of DOR patients，and has high safety，with high clinical value.

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