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[目的]为美国中医诊所中西医结合促排卵治疗寻求一种非损伤性的孕酮评估方法。[方法]不孕妇女42例随机分为克罗米酚(CC)治疗组、绝经期妇女尿促性腺激素(HMG)治疗组和中西医结合(CC+TCM)治疗组。治疗后以放射免疫法测定促排卵周期之黄体期及正常妇女21例配对血清及唾液标本的孕酮浓度。[结果]治疗组之黄体期唾液孕酮值范围为(294.0±31.0)pg/mL至(499.0±75.0)pg/mL,与正常月经周期组之孕酮值非常接近;而治疗组中配对之血清孕酮范围则是(28.6±4.2)ng/mL至(51.4±16.6)ng/mL。治疗后各治疗组妊娠妇女的唾液与血清孕酮含量较非孕妇女高(P<0.05);血清与唾液孕酮值呈正相关关系。不孕妇女治疗后的妊娠率CC+TCM组为46.7％,CC组为42.9％,HMG组为46.0％,3组总妊娠率比较差异无显著性(p>0.05)。[结论]测定唾液孕酮浓度,是一种替代检测血清孕酮的实用、有效而简便的评估方法;中医中药在促排卵治疗中的效果与CC和HMG相仿。
[Objective] To seek a non-invasive progesterone evaluation method for ovulation induction by integrated traditional Chinese and western medicine in the American Chinese Medicine Clinic. [Methods] Forty-two infertile women were randomly divided into clomiphene citrate (CC) group, menopausal women with gonadotropin (HMG) group and CC + TCM group. After treatment, radioimmunoassay was used to determine the progesterone concentrations in ovulation-promoting luteal phase and 21 paired serum and saliva samples from normal women. [Results] The progesterone value of the luteal phase in the treatment group was (294.0 ± 31.0) pg / mL to (499.0 ± 75.0) pg / mL, which was very close to that of the normal menstrual cycle group. Serum progesterone ranged from (28.6 ± 4.2) ng / mL to (51.4 ± 16.6) ng / mL. After treatment, the salivary and serum progesterone levels of pregnant women in each treatment group were higher than those of non-pregnant women (P <0.05). There was a positive correlation between serum and saliva progesterone. The pregnancy rate of infertile women after treatment was 46.7% in CC + TCM group, 42.9% in CC group and 46.0% in HMG group. There was no significant difference in the total pregnancy rate between the three groups (p> 0.05). [Conclusion] The determination of salivary progesterone concentration is a practical, effective and simple alternative method for the detection of serum progesterone. The effect of traditional Chinese medicine in ovulation induction is similar to that of CC and HMG.