观察益气血法经后增殖方（由党参、白术、茯苓、熟地黄、白芍、当归、川芎、鹿角霜、山萸肉、菟丝子、杜 仲等组成）对多囊卵巢综合征（PCOS）所致排卵障碍性不孕患者促排卵治疗中的排卵率和妊娠率的影响，探讨其治疗效果及可 能的作用机制。【方法】将60例PCOS所致排卵障碍性不孕患者随机分为治疗组和对照组，每组各30例。对照组给予枸橼酸 氯米芬胶囊促排卵治疗，治疗组在对照组的促排卵方案基础上于月经或孕激素撤退性出血第5天开始同时服用经后增殖方， 2组患者均以治疗1个月经周期为1个疗程。观察2组患者月经第2～5天的血清雌二醇（E2）、促卵泡生成素（FSH）、促黄体 生成素（LH）、孕酮（P）等性激素水平情况以及月经第2～5天和注射人绒毛膜促性腺激素（HCG）日的血清生长分化因子9 （GDF9）、骨形态发生蛋白15（BMP15）水平变化情况，分析2组患者的排卵率、妊娠率和临床疗效。【结果】（1）性激素水平方 面：于月经第2～5天，2组患者的血清性激素E2、FSH、LH、P水平比较，差异均无统计学意义（P＞0.05）。（2）血清GDF9、 BMP15水平方面：于月经第2～5天和HCG 日，2组患者的血清GDF9、BMP15水平比较，差异均无统计学意义（P＞0.05）。 （3）排卵率和妊娠率方面：治疗组的排卵率和妊娠率分别为93.33%（28/30）、26.67%（8/30），均显著高于对照组的70.00% （21/30）、13.33%（4/30），组间比较（χ2检验），差异均有统计学意义（P＜0.05）。（4）疗效方面：治疗组的总有效率为93.33% （28/30），对照组为70.00%（21/30）；组间比较（秩和检验），治疗组的疗效明显优于对照组，差异有统计学意义（P＜0.05）。 【结论】益气血法经后增殖方能提高PCOS所致排卵障碍性不孕患者促排卵治疗中的排卵率和妊娠率，由此推断经后增殖方 能提高促排卵治疗中的卵细胞质量及胚胎着床潜能。

To observe the effects of Postmenstrual Proliferative Prescription（mainly composed of Codonopsis Radix， Atractylodis Macrocephalae Rhizoma， Poria， Rehmanniae Radix Praeparata， Paeoniae Radix Alba， Angelicae Sinensis Radix， Chuanxiong Rhizoma， Cervi Cornu Degelatinatum， Corni Fructus， Cuscutae Semen，and Eucommiae Cortex）through replenishing qi and blood on the ovulation rate and pregnancy rate in patients with ovulatory dysfunction infertility caused by polycystic ovarian syndrome （PCOS） during ovulation- induction treatment， and to explore the therapeutic effects and possible therapeutic mechanism. Methods Sixty patients with ovulatory dysfunction infertility due to PCOS were randomly divided into a treatment group and a control group，with 30 patients in each group. The control group was given Clomifene Citrate Capsules to promote ovulation，and the treatment group was given Postmenstrual Proliferative Prescription on the basis of the ovulation- induction program of the control group starting from the fifth day of menstruation or progesterone withdrawal bleeding. The two groups were treated for one menstrual cycle as a course of treatment. The changes in the serum sex hormones of estradiol（E2），follicle-stimulating hormone（FSH），luteinizing hormone（LH），and progesterone（P）on the 2nd to 5th day of menstruation， as well as the changes in serum growth differentiation factor 9（GDF9）and bone morphogenetic protein 15（BMP15）levels on the 2nd to 5th day of menstruation and on the day of human chorionic gonadotropin（HCG） injection were observed in the two groups. Moreover， the ovulation rate，pregnancy rate and clinical efficacy of the patients in the two groups were analyzed. Results（1）No statistically significant differences in serum levels of sex hormones E2，FSH，LH and P on the 2nd to 5th day of menstruation were shown between the two groups of patients（P＞0.05）.（2）On the 2nd to 5th day of menstruation and on the day of HCG injection， there were no significant differences in the serum GDF9 and BMP15 levels between the two groups（P＞0.05）.（3）The ovulation rate and pregnancy rate in the treatment group were 93.33% （28/30）and 26.67%（8/30）respectively， which were significantly higher than 70.00%（21/30）and 13.33% （4/30）in the control group. And the differences tested by chi-square test were statistically significant between the two groups（P＜0.05）.（4）The total effective rate of the treatment group was 93.33%（28/30）， and that of the control group was 70.00% （21/30）. The intergroup comparison （tested by rank sum test） showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group，and the difference was statistically significant（P＜0.05）. Conclusion Postmenstrual Proliferative Prescription through replenishing qi and blood can improve the ovulation rate and pregnancy rate during ovulation-induction treatment in the patients with ovulatory dysfunction infertility due to PCOS. It is indicated that Postmenstrual Proliferative Prescription can enhance the quality of the oocytes and the potential of embryo implantation during the ovulation- induction treatment

R271.9

广东省自然科学基金项目（编号：2020A1515011175）；广东省中医药局科研项目（编号：20201412）