目的 探究滋腎育胎丸聯(lián)合氯米芬治療排卵障礙性不孕癥的臨床療效。方法 選取2015年2月-2016年12月海南省婦幼保健院生殖醫(yī)學(xué)中心門診收治的141例排卵障礙性不孕癥患者，隨機(jī)分為對照組（70例）和治療組（71例）。對照組患者口服枸櫞酸氯米芬膠囊，月經(jīng)規(guī)律者在月經(jīng)第5天開始服藥，閉經(jīng)或月經(jīng)無規(guī)律者則在黃體酮誘導(dǎo)撤退性出血后第5天開始服藥，50 mg/次，1次/d，連續(xù)服用5 d；月經(jīng)周期的第10天開始隔日超聲監(jiān)測卵泡及子宮內(nèi)膜生長情況，當(dāng)優(yōu)勢卵泡直徑>18 mm時(shí)，肌肉注射人絨毛膜促性腺激素（HCG）10 000 U。治療組在對照組的治療基礎(chǔ)上口服滋腎育胎丸，自月經(jīng)周期第5天開始，5 g/次，3次/d，連續(xù)治療20 d。所有患者均連續(xù)治療4~6個(gè)月經(jīng)周期。觀察兩組的臨床療效，比較兩組治療前后成熟卵泡數(shù)、子宮內(nèi)膜厚度、宮頸黏液評分及內(nèi)分泌激素變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為81.43%、94.37%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者成熟卵泡數(shù)、宮頸黏液評分均顯著升高，治療組子宮內(nèi)膜厚度顯著升高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組成熟卵泡數(shù)、子宮內(nèi)膜厚度、宮頸黏液評分顯著高于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。肌肉注射HCG當(dāng)日，兩組患者血清雌二醇（E₂）、黃體生成素（LH）、卵泡刺激素（FSH）水平均顯著高于月經(jīng)周期第5天時(shí)水平，而血清睪酮（T）水平顯著降低，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；HCG日，治療組E₂、LH、FSH水平高于對照組，T水平低于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對照組和治療組的不良反應(yīng)發(fā)生率分別為20.00%、7.04%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 滋腎育胎丸聯(lián)合氯米芬治療排卵障礙性不孕癥具有較好的臨床療效，可明顯改善患者的內(nèi)分泌水平，安全性較高，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Zishen Yutai Pills combined with clomiphene in treatment of anovulatory infertility. Methods Patients (141 cases) with anovulatory infertility in Department of Reproductive Medicine Center outpatient service of Hainan Maternity and Child Care Hospital from February 2015 to December 2016 were randomly divided into control (70 cases) and treatment (71 cases) groups. Patients with menstrual cycles in the control group were po administered with Clomifene Citrate Capsules from day 5 of menstruation for 5 d, and patients with amenorrhea or irregular menstruation were po administered with Clomifene Citrate Capsules from day 5 after progesterone induces withdrawal hemorrhage for 5 d, 50 mg/time, once daily. On day 10 of the menstrual cycle, ultrasonic monitoring of follicular and endometrial growth was started on the next day. When the diameter of the dominant follicle was > 18 mm, patients were im administered with HCG (10 000 U). Patients in the treatment group were po administered with Zishen Yutai Pills on the basis of the control group from day 5 of the menstrual cycles for 20 d, 5 g/time, three times daily. All patients were continuously treated for 4-6 menstrual cycles. After treatment, the clinical efficacy was evaluated, and the mature follicle number, endometrial thickness, cervical mucus score and endocrine hormone in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.43% and 94.37%, respectively, and there was difference between two groups (P<0.05). After treatment, mature follicle number and cervical mucus score in two groups significantly increased, and endometrial thickness in the treatment group was significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, mature follicle number, endometrial thickness, and cervical mucus score in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). On the muscle injection HCG day, E₂, LH and FSH in two groups were higher than those on day 5 of menstrual cycle, but the level of T was significantly decreased, and the difference was statistically significant in the same group (P<0.05). On the muscle injection HCG day, E₂, LH and FSH in the treatment group were higher than those in the control group, but the level of T was lower than that in the control group, and there was difference between two groups (P<0.05). After treatment, the incidence of adverse reaction in the control and treatment groups were 20.00% and 7.04%, respectively, and there was difference between two groups (P<0.05). Conclusion Zishen Yutai Pills combined with clomiphene has a significant effect in treatment of anovulatory infertility, and can obviously improve the endocrine levels, and the security is higher, which has a certain clinical application value.