“调冲任、固肾元”针灸法对黄体功能不全患者卵泡发育及妊娠结局的影响  

Effect on follicular development and pregnancy outcome treated with acupuncture and moxibustion therapy of Tiaochongren Gushenyuan in patients with luteal phase defect

作　　者：杨丽洁[1] 吴节[1] 杨林 周特[1] 李鸿儒 苗润青[1] YANG Li-jie;WLJ Jie;YANG Lin;ZHOU Te;LI Hong-ru;MIAO Run-qing(Center for Disease Prevention, Affiliated Hospital of Chengdu University of TCM, Chengdu 610072, Sichun Province, China;Chengdu University of TCM)

机构地区：[1]成都中医药大学附属医院治未病中心

出　　处：《中国针灸》2019年第9期927-931,共5页Chinese Acupuncture & Moxibustion

基　　金：四川省中医院/成都中医药大学附属医院科技发展基金项目：2013-D-YY-05;成都中医药大学校基金项目：ZRMS201325;成都市卫计委项目：2016015

摘　　要：目的:观察"调冲任、固肾元"针灸法对脾肾阳虚型黄体功能不全患者排卵情况及胚胎着床情况的影响。方法:将80例患者随机分为观察组和对照组,每组40例。观察组予针灸疗法,穴取神庭、神阙、关元、气穴、列缺、公孙、太溪、足三里、太冲,卵泡期于太溪加用灸盒施灸,排卵期加强对太冲穴的刺激,黄体期于神阙至关元、足三里、太溪加用灸盒施灸;对照组取关元、大赫、三阴交、次髎、秩边、神阙,卵泡期于三阴交加用灸盒施灸,黄体期于神阙至关元加用灸盒施灸。两组患者每周一、三、五治疗,经期停止治疗,连续治疗3个月经周期,随访3个月经周期。治疗结束后观察患者临床妊娠率,并比较两组治疗前后排卵率、排卵期最大卵泡直径及最大卵泡直径差值、血清孕酮(P)、基础体温类型(BBT)。结果:观察组有6例在治疗过程中顺利受孕,10例在随访期顺利受孕,临床妊娠率为40.0%(16/40);对照组有1例治疗过程中顺利受孕,5例在随访期顺利受孕,临床妊娠率为15.0%(6/40),观察组妊娠率高于对照组(P<0.05)。观察组治疗后正常排卵率为90.0%(36/40),对照组为70.0%(28/40),两组治疗后均较治疗前明显提高(P<0.05),观察组有高于对照组的趋势,但差异无统计学意义(P>0.05)。治疗后,两组排卵期最大卵泡直径及最大卵泡直径差值、血清P均较治疗前明显改善(P<0.05);与对照组比较,观察组治疗后最大卵泡直径及最大卵泡直径差值、血清P改善更明显(P<0.05)。两组治疗后基础体温类型均优于治疗前(P<0.05);治疗后,观察组BBT正常型33例,对照组正常型22例(P<0.05)。结论:"调冲任、固肾元"针灸法可促进脾肾阳虚型黄体功能不全患者卵泡发育,改善优势卵泡形态,提高血清孕酮水平,在提高排卵率、改善妊娠结局方面疗效优于常规针灸。Objective To observe the effect of acupuncture and moxibustion therapy of Tiaochongren Gushenyuan on ovulation and embryo implantation in luteal phase defect patients with spleen-kidney yang deficiency. Methods A total of 80 patients were randomly divided into an observation group and a control group, 40 cases in each one.In the observation group,acupuncture was applied at Shenting(GV 24), Shenque(CV 8), Guanyuan(CV 4), Qixue(KI 13), Lieque(LU 7), Gongsun(SP 4), Taixi(KI 3), Zusanli(ST 36) and Taichong(LR 3). And moxibustion was given at Taixi(KI 3) using moxibustion box during follicular phase, the stimulation of Taichong(LR 3) was strengthened during ovulatory phase, moxibustion was adopted at Shenque(CV 8) to Guanyuan(CV 4), Zusanli(ST 36) and Taixi(KI 3) during luteal phase. In the control group, acupuncture was applied at Guanyuan(CV 4), Dahe(KI 12), Sanyinjiao(SP 6), Ciliao(BL 32), Zhibian(BL 54) and Shenque(CV 8). Moxibustion was given at Sanyinjiao(SP 6) using moxibustion box during follicular phase, and moxibustion was adopted at Shenque(CV 8) to Guanyuan(CV 4) during luteal phase. The treatment were given every Monday, Wednesday and Friday, and the treatment were stoped during menstrual period in the two groups. Totally 3 menstrual cycle treatment were required, and 3 menstrual cycles were followed up. The pregnancy rate was observed after treatment, the ovulation rate, maximum folliclular diameter and difference of maximum folliclular diameters in ovulatory phase, serum progesterone(P) and basal body temperature(BBT) were compared before and after treatment in the two groups. Results In the observation group, 6 cases of successful pregnancy during treatment,10 cases in follow-up, the clinical pregnancy rate was 40.0%(16/40). In the control group, 1 case of successful pregnancy during treatment, 5 cases in follow-up, the clinical pregnancy rate was 15.0%(6/40). The clinical pregnancy rate in the observation group was higher than the control group(P<0.05). The ovulation rate after treatment in the observ

关 键 词：黄体功能不全 调冲任、固肾元针灸法 卵泡发育 妊娠结局 

分 类 号：R246.3[医药卫生—针灸推拿学]