【目的】探讨基于月经周期的中药序贯疗法联合克罗米芬治疗排卵障碍性不孕 （ODI） 的临床疗效。【方法】将2021年7月 至2023年8月郑州市第七人民医院妇产科收治的120例ODI患者随机分为对照组和观察组，每组各60例。对照组给予克罗米 芬治疗，观察组在对照组的基础上接受基于月经周期的“养阴补血—温肾化痰通络—补肾健脾”的中药序贯疗法治疗， 疗程为3个月经周期。观察2组患者治疗前后中医证候积分的变化情况，对比2组患者治疗3个月经周期后的临床疗效、子 宫内膜厚度、卵泡直径、排卵率、妊娠率、静息基础体温 （BBT） 双相率及不良反应发生率。【结果】（1） 治疗3个月经周期后， 观察组的总有效率为96.67% （58/60） ，对照组为83.33% （50/60） ，组间比较，观察组的疗效明显优于对照组，差异有统计学 意义 （χ2 =5.926，P < 0.05） 。 （2） 治疗3个月经周期后，2组患者的中医证候积分均较治疗前明显下降 （P < 0.01） ，且观察组的下 降幅度明显优于对照组，差异有统计学意义 （P < 0.01） 。 （3） 治疗3个月经周期后，观察组的卵泡直径较对照组长，BBT双相 率[60.00%（36/60） ]、排卵率[63.33%（38/60） ]及妊娠率[25.00%（15/60） ]较对照组的 31.67%（19/60）、41.67%（25/60）、 10.00% （6/60） 高，差异均有统计学意义 （P < 0.05或P < 0.01） ；而2组患者的子宫内膜厚度及不良反应发生率比较，差异均无 统计学意义 （P > 0.05）。【结论】采用基于月经周期的中药序贯疗法联合克罗米芬治疗ODI患者疗效确切，可有效减轻患者临 床症状，改善BBT状况，提升排卵率与妊娠率，且具有良好的用药安全性。

Objective To investigate the clinical efficacy of Chinese medicine sequential therapy combined with Clomiphene in the treatment of ovulatory disorder infertility（ODI），and to observe the effects of the combined therapy on the endometrial thickness，ovarian diameter，ovulation rate and pregnancy rate of the patients. Methods A total of 120 patients with ODI admitted to the Department of Obstetrics and Gynecology of the 7th People􀆳s Hospital of Zhengzhou from July 2021 to August 2023 were randomly divided into the control group and the observation group， with 60 patients in each group. The two groups were treated with Clomiphene，and additionally the observation group was treated with Chinese medicine sequential therapy of “nourishing yin and enriching blood， warming kidney to resolve phlegm and unblock collaterals，and tonifying kidney and strengthening spleen” in accordance with the menstrual cycle. Three menstrual cycles constituted a course of treatment. Before and after treatment，the changes in the traditional Chinese medicine （TCM） syndrome scores of the two groups were observed. After treatment for three menstrual cycles，the clinical efficacy，endometrial thickness，follicle diameter，ovulation rate， pregnancy rate， incidence of biphasic basal body temperature （BBT）， and the incidence of adverse reactions after in the two groups were compared. Results（1）After three menstrual cycles of treatment，the total effective rate of the observation group was 96.67%（58/60）and that of the control group was 83.33%（50/60），and the comparison between the two groups showed that the efficacy of the observation group was significantly superior to that of the control group，the difference being statistically significant（χ2=5.926，P < 0.05）.（2）After three menstrual cycles of treatment，the TCM scores of patients in both groups were decreased significantly compared with those before treatment（P < 0.01），and the decrease of the scores in the observation group was significantly superior to that in the control group，with statistically significant differences（P < 0.01）.（3）After three menstrual cycles of treatment，the follicle diameter of the observation group was longer than that of the control group，and the incidence of biphasic BBT [60.00%（36/60）]，ovulation rate [63.33%（38/60）]，and pregnancy rate [25.00%（15/ 60）] were higher than those of the control group，which were 31.67%（19/60），41.67%（25/60），and 10.00%（6/60）， respectively. The differences of the above four indicators between the two groups were statistically significant（P < 0.05 or P < 0.01）. However，the differences of endometrial thickness and the incidence of adverse reactions between the two groups were not statistically significant（P > 0.05）. Conclusion Chinese medicine sequential therapy combined with Clomiphene exerts certain efficacy in treating patients with ODI，which can effectively relieve clinical symptoms， improve the BBT conditions，enhance the ovulation rate and pregnancy rate，with high safety.

R271.9

河南省科技攻关项目 （编号：232102311216）