目的 探究滋肾育胎丸联合氯米芬治疗排卵障碍性不孕症的临床疗效。方法 选取2015年2月-2016年12月海南省妇幼保健院生殖医学中心门诊收治的141例排卵障碍性不孕症患者，随机分为对照组（70例）和治疗组（71例）。对照组患者口服枸橼酸氯米芬胶囊，月经规律者在月经第5天开始服药，闭经或月经无规律者则在黄体酮诱导撤退性出血后第5天开始服药，50 mg/次，1次/d，连续服用5 d；月经周期的第10天开始隔日超声监测卵泡及子宫内膜生长情况，当优势卵泡直径>18 mm时，肌肉注射人绒毛膜促性腺激素（HCG）10 000 U。治疗组在对照组的治疗基础上口服滋肾育胎丸，自月经周期第5天开始，5 g/次，3次/d，连续治疗20 d。所有患者均连续治疗4~6个月经周期。观察两组的临床疗效，比较两组治疗前后成熟卵泡数、子宫内膜厚度、宫颈黏液评分及内分泌激素变化情况。结果 治疗后，对照组和治疗组的总有效率分别为81.43%、94.37%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者成熟卵泡数、宫颈黏液评分均显著升高，治疗组子宫内膜厚度显著升高，同组治疗前后差异有统计学意义（P<0.05）；治疗后，治疗组成熟卵泡数、子宫内膜厚度、宫颈黏液评分显著高于对照组，两组比较差异有统计学意义（P<0.05）。肌肉注射HCG当日，两组患者血清雌二醇（E₂）、黄体生成素（LH）、卵泡刺激素（FSH）水平均显著高于月经周期第5天时水平，而血清睾酮（T）水平显著降低，同组治疗前后差异有统计学意义（P<0.05）；HCG日，治疗组E₂、LH、FSH水平高于对照组，T水平低于对照组，两组比较差异有统计学意义（P<0.05）。对照组和治疗组的不良反应发生率分别为20.00%、7.04%，两组比较差异有统计学意义（P<0.05）。结论 滋肾育胎丸联合氯米芬治疗排卵障碍性不孕症具有较好的临床疗效，可明显改善患者的内分泌水平，安全性较高，具有一定的临床推广应用价值。

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.