调经促孕针刺法治疗早发性卵巢功能不全行体外受精-胚胎移植术患者的效果

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摘要目的观察调经促孕针刺法对早发性卵巢功能不全（POI）行体外受精-胚胎移植（IVF-ET）术患者的效果。方法选取2018年11月—2020年10月深圳市中医院针灸科和深圳市妇幼保健院中医科就诊的计划行IVF-ET术的POI患者80例为研究对象，按照随机数字表法分为针刺组和对照组，每组40例。所有患者先接受3个月的人工周期预处理，随后采用拮抗剂方案促排卵。对照组在整个过程中不予任何针刺治疗，针刺组在预处理的同时给予调经促孕针刺法治疗。比较治疗前后两组性激素水平，促性腺激素使用情况；注射人绒毛膜促性腺激素（hCG）日成熟卵泡数（≥1.8 cm）、子宫内膜厚度、雌二醇（E2）水平及获卵数。结果治疗前后，两组基础卵泡刺激素（bFSH）、基础黄体生成激素（bLH）、基础雌二醇（bE2）和抗缪勒管激素（AMH）水平比较，差异无统计学意义（P > 0.05）。治疗后，两组bFSH、bLH水平均低于治疗前，差异均有高度统计学意义（均P < 0.01）；两组治疗后bE2和AMH与治疗前比较，差异无统计学意义（P > 0.05）。针刺组注射用尿促卵泡素用量、启动量及总使用时间低于对照组，差异均有高度统计学意义（均P ＜ 0.01）；hCG日≥1.8 cm卵泡数、子宫内膜厚度、A+B型内膜比例、获卵数高于对照组，差异有统计学意义（P ＜ 0.05或P ＜ 0.01）；针刺组E2水平高于对照组，差异有统计学意义（P ＜ 0.05）。结论调经促孕针法能提高POI行IVF-ET术患者对促性腺激素的敏感性，增加子宫内膜厚度，改善卵巢排卵功能及子宫内膜容受性。

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	卓缘圆1 黄杏贤1 黄奕珊1 吴家满2

关键词 ：早发性卵巢功能不全, 针刺法, 调经促孕, 体外受精-胚胎移植, 效果比较

Abstract：Objective To observe the effect of regulating menstruation and promoting pregnancy acupuncture in the treatmen of patients with premature ovarian insufficiency (POI) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods From November 2018 to October 2020, Eighty POI patients who admitted to Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital and Department of Chinese Medicine, Shenzhen Maternal ＆ Child Healthcare Hospital Affiliated to Southern Medical University and planned to undergo IVF-ET were selected as the research subjects. They were divided into the acupuncture group and the control group according to the random number table method, with 40 cases in each group. All patients were preconditioned artificially for three months, followed by an antagonist regimen for ovulation induction. The control group was not given any acupuncture treatment in the whole process, while the acupuncture group was given acupuncture therapy. The sex hormone levels, gonadotropin use between the two groups were compared before and after treatment; the number of mature follicles (≥1.8 cm), endometrial thickness, the level of estradiol (E2) and the number of eggs obtained on injection human chorionic gonadotropin (hCG) day. Results Before and after treatment, there were no significant differences in the levels of basic follicle-stimulating hormone (bFSH), basic luteinizing hormone (bLH), basic estradiol (bE2) and antimullerian hormone (AMH) between the two groups (P > 0.05). After treatment, the levels of bFSH and bLH in both groups were lower than those before treatment, and the differences were highly statistically significant (all P < 0.01). There were no significant differences in bE2 and AMH between the two groups after treatment and before treatment (P > 0.05). The amount of Urinary Follicle-Stimulating Hormone for injection, the starting amount and total use time in the acupuncture group were lower than those in the control group, and the differences were highly statistically significant (all P < 0.01); On hCG day, the number of mature follicles ≥1.8 cm, endometrial thickness, the proportion of A+B type endometrium and the number of eggs obtained were higher than those in the control group, and the differences were statistically significant (P < 0.05 or P < 0.01); the level of E2 in the acupuncture group was higher than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion Regulating menstruation and promoting pregnancy acupuncture can improve the sensitivity to gonadotropin, increase the thickness of endometrium, improve the ovarian ovulation function and endometrial receptivity.

Key words： Premature ovarian insufficiency Acupuncture Regulating menstruation and promoting pregnancy In vitro fertilization embryo transfer Effect comparison

基金资助: 广东省中医药局科研项目（20201294）。

通讯作者: 吴家满（1982.5-），男，硕士，主任医师，硕士生导师；研究方向：针灸治疗妇科疾病。

引用本文:

卓缘圆1 黄杏贤1 黄奕珊1 吴家满2. 调经促孕针刺法治疗早发性卵巢功能不全行体外受精-胚胎移植术患者的效果[J]. 中国医药导报, 2021, 18(15): 125-128,132.
ZHUO Yuanyuan1 HUANG Xingxian1 HUANG Yishan1 WU Jiaman2. Effect of regulating menstruation and promoting pregnancy acupuncture in the treatment of patients with premature ovarian insufficiency undergoing in vitro fertilization and embryo transfer. 中国医药导报, 2021, 18(15): 125-128,132.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I15/125

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