穴位注射联合超激光治疗反复IVF-ET失败者宫腔环境不良临床疗效观察  

Clinical Observation of Acupoint Injection Combined with Ultra-laser Irradiation in Treatment of Uterine Cavity Dysfunction Caused by Repeated IVF-ET Failure

作　　者：苏文武[1] 高修安[1] 田菊升 SU Wen-Wu;GAO Xiu-An;TIAN Ju-Sheng(Dept.of Traditional Chinese Medicine,Foshan Women and Children Hospital,Foshan 528000 Guangdong,China;Dept.of Acup-moxibustion and Tuina,the Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510375 Guangdong,China)

机构地区：[1]佛山市妇幼保健院中医科,广东佛山528000 [2]广州中医药大学第三附属医院针灸推拿科,广东广州510375

出　　处：《广州中医药大学学报》2019年第11期1730-1735,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：佛山市卫生和计划生育局医学科研课题（编号：20190145）;佛山市科技局中西医结合治疗不孕症研究平台建设项目（编号：2015AG10022)

摘　　要：[目的]观察胎盘组织液穴位注射联合超激光照射治疗反复体外授精联合胚胎移植(IVF-ET)失败者宫腔环境不良的临床疗效,探讨胎盘组织液穴位注射联合超激光照射调节子宫的作用机制.[方法]将68例反复IVF-ET失败、宫腔环境不良(内膜形态不均、血供不足、内膜偏薄)、准备再次行胚胎移植的患者,随机分成研究组和对照组,每组各34例.在胚胎移植前3个月,研究组于月经干净后卵泡期开始给予胎盘组织液穴位注射联合超激光照射治疗,排卵后给予口服地屈孕酮片治疗;对照组于月经干净后卵泡期开始给予超激光照射治疗,排卵后给予口服地屈孕酮片治疗.共治疗3个月经周期,直至行胚胎移植前1 d.观察2组患者宫腔环境变化情况、胚胎种植率及临床妊娠率.[结果](1)治疗3个月经周期后,2组患者在尿黄体生成素(LH)峰日的子宫内膜厚度及内膜回声a型率和内膜血供A型率均明显高于治疗前,差异均有统计学意义(P<0.01);且研究组治疗后内膜厚度及内膜回声a型率和内膜血供A型率均明显高于对照组,差异均有统计学意义(P<0.01),提示治疗后研究组宫腔环境改善较对照组良好.(2)治疗3个月经周期后,研究组的胚胎种植率和临床妊娠率均高于对照组,差异均有统计学意义(P<0.01).[结论]胎盘组织液穴位注射联合超激光照射可能是通过增加宫腔血流供应,增强宫腔自我修复能力,为子宫内膜生长发育到适合胚胎种植状态提供营养支持,从而改善反复IVF-ET失败患者的宫腔环境及子宫内膜容受性,提高胚胎种植率及临床妊娠率.Objective To observe the clinical effect of Human Placenta Tissue Hydrolysate acupoint injection combined with ultra-laser irradiation in the treatment of uterine cavity dysfunction caused by repeated in-vitro fertilization and embryo transfer(IVF-ET)failure,and to explore the possible therapeutic mechanism in regulating the uterus.Methods Sixty-eight repeated IVF-ET failure patients with poor uterine environment(uneven endometrial morphology,poor endometrial blood supply,and thin endometrium)who were scheduled to undergo embryo transfer again were enrolled into the study.The patients were randomized into trial group and control group,34 cases in each group.Three months before embryo transfer,the patients in the two groups started the treatment of ultra-laser irradiation in the follicular phase after menstruation and took Dydrogesterone Tablets orally after ovulation;and additionally,the patients in the trial group also started the treatment of Human Placenta Tissue Hydrolysate acupoint injection in the follicular phase after menstruation.The treatment for the two groups lasted 3 menstrual cycles until the day before embryo transfer.The changes of uterine environment,embryo implantation rate and clinical pregnancy rate were observed in the two groups.Results(1)After treatment for 3 menstrual cycles,the endometrial thickness and the rates of endometrial echo type a and endometrial blood supply type A at the day of urine luteinizing hormone(LH)arriving at peak level in the two groups were higher than those before treatment(P<0.01),and the observation indexes in the trial group were higher than those in the control group after treatment(P<0.01),indicating the uterine environment improvement in the trial group was superior to that in the control group.(2)After treatment for 3 menstrual cycles,the embryo implantation rate and clinical pregnancy rate in the trial group were higher than those in the control group,the difference being significant(P<0.01).Conclusion For the treatment of repeated IVF-ET failure patients wi

关 键 词：胎盘组织液 穴位注射 超激光照射 反复IVF-ET失败 宫腔环境 胚胎种植率 临床妊娠率 

分 类 号：R245.95[医药卫生—针灸推拿学]