中醫合併使用促排卵藥物治療女性不孕症之探討

Combine Chinese Medicine with Clomiphene to Treat Female Infertility in Taiwan

吳育倩(Yu-Chien Wu) ； 邢郁欣(Yi-Shin Eng)

《中醫藥研究論叢》 24卷1期 (2021/03) Pp. 1-8

https://doi.org/10.6516/TJTCM.202103_24(1).0001

摘要

目的：比較中藥合併使用促排卵藥物Clomiphene治療女性不孕症之效度。方法：回溯台灣全民健康保險資料庫（National Health Insurance Research Database, NHIRD）從2000至2011年20－50歲育齡女性，至西醫門診使用排卵藥（Clomiphene）治療不孕症者，依是否合併中醫治療分析其懷孕率。結果：在大於等於35歲的族群以排卵藥合併使用中藥治療其懷孕率（12.06％）高於只使用排卵藥（8.43％）治療。再進一步分析排卵藥合併使用中藥治療常見不孕相關合併症，其中合併排卵障礙（Ovarian dysfunction）和多囊性卵巢（PCOS）的患者合併使用中藥及排卵藥物者的懷孕率也相對高於單純使用排卵藥者；但在子宮內膜異位症（Endometriosis）和子宮肌瘤（Myoma）的患者懷孕率則沒有因中藥合併使用而提升。結論：使用促排卵藥物Clomiphene合併使用中藥治療女性不孕症在以大於35歲或者合併排卵障礙（Ovarian dysfunction）或多囊性卵巢（PCOS）的婦女們具有正面的效果。

關鍵字

不孕症 ； Clomiphene ； 中藥 ； 卵巢功能障礙

並列摘要

Objective: To compare the efficiency of ovulation-stimulating drug Clomiphene with or without the combination of Chinese medicine in the treatment of female infertility. Methods: We used the retrospective data from the National Health Insurance Research Database (NHIRD) between 2000 and 2011for 20-50 years old female who have been diagnosed infertility and prescribed Clomiphene to analyze the pregnancy rate difference between those who have combined Traditional Chinese Medical treatments and those who have not. Result: The pregnancy rate of the population aged 35 years or older who used Clomiphene combined with traditional Chinese medicine was higher than those who used Clomiphene alone. The pregnancy rate of those patients with the diagnosis of Ovarian Dysfunction or Polycystic Ovarian Syndrome (PCOS) was also higher if the use of Clomiphene was combined with traditional Chinese medicine. Conclusion: The use of Chinese medicine combined with ovulation-stimulating drug Clomiphene has a positive effect in the treatment of female infertility. Especially for women (i) over 35 years old, or (ii) with diagnosis of Ovarian Dysfunction or Polycystic Ovarian Syndrome (PCOS).

並列關鍵字

Infertility ； Clomiphene ； Chinese Medicine ； Ovarian Failure

參考文獻

Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on the diagnostic categories of infertility. Hum Reprod 2008; 23(3): 538-42.

ESHRE Capri Workshop Group. Fertility and ageing. Hum Reprod Updat 2005; 11: 261-76.

Practice Committee of tAmerican Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril 2008; 90: S60.

Hull MG, Glazener CM, Kelly NJ, et al. Population study of causes, treatment, and outcome of infertility. Br Med J (Clin Res Ed) 1985; 291: 1693.

https://www.nhi.gov.tw/DL.aspx?sitessn=292&u=LzAwMS9VcGxvYWQvT2xkRmlsZS9OaGlQdWJXZWIvcmVzb3VyY2UvYnVsbGV0aW4vNjcyMF8xMDUwMDgwNzI3QS0zLm9kdA%3D%3D&n=NjcyMF8xMDUwMDgwNzI3QS0zLm9kdA%3D%3D