补胞汤联合针刺对高龄不孕症患者子宫血流动力学及新鲜移植周期妊娠结局的影响  

The effect of Bilbao Decoction combined with acupuncture on uterine hemodynamics and pregnancy outcome in the fresh transplantation period in the elderly patients with infertility

作　　者：王玮 马大正[2] 滕依丽[3] 黄镇华 陈浩波 Wang Wei

机构地区：[1]浙江省温州市中西医结合医院,3250014 [2]浙江省温州市中医院,325000 [3]温州医科大学附属第一医院,325000

出　　处：《浙江临床医学》2020年第1期33-35,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省中医药科技计划青年人才基金项目(2016ZQ030)。

摘　　要：目的观察补胞汤联合针刺对行体外受精/卵母细胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)高龄不孕患者HCG日子宫血流动力学和妊娠结局的影响.方法2016年1月至2018年1月行IVF/ICSI助孕的高龄(年龄>35周岁)肾虚型不孕症患者80例.采用单盲随机数字表法分为观察组和对照组,每组各40例.对照组常规行IVF/ICSI-ET方案,观察组在常规方案基础上于Gn启动日至移植后2周给予补胞汤口服及针刺治疗.观察比较两组HCG日子宫内膜厚度,子宫血流动力学参数,salle评分,中医肾虚证候积分变化情况及获卵数、优质胚胎率、胚胎移植数、临床妊娠率.结果观察组脱落6例(4例中断治疗,2例取消周期),对照组脱落4例(取消周期),最终完成70例,其中观察组34例,对照组36例.治疗后观察组中医肾虚证候积分比治疗前显著改善,且观察组中医肾虚证候积分比对照组显著降低,差异均有统计学意义(P<0.01).在HCG日,观察组内膜血流搏动指数(PI)、阻力指数(RI)、收缩期峰值流速/舒张末期流速(S/D)显著低于对照组,差异均有统计学意义(P<0.01).子宫动脉血流mPI、mRI、mS/D显著低于对照组,差异有统计学意义(P<0.01).观察组Salle评分显著高于对照组,差异有统计学意义(P<0.01).观察组优质胚胎率及临床妊娠率显著高于对照组,差异有统计学意义(P<0.01).结论对于常规行IVF/ICSI-ET的高龄不孕女性,在Gn启动日加用补胞汤联合针刺能改善高龄不孕女性的临床症状,提高优胚率,增强子宫血流灌注,有利于子宫内膜容受性提高,从而有助于提高妊娠率.Objective To observe the effect of Bubao Decoction combined with acupuncture on uterine hemodynamics and pregnancy outcome in elderly infertile patients(age>35)undergoing IVF/ICSI-ET.Methods A prospective randomized controlled clinical design was used to enroll 80 cases of infertility of kidney deficiency type who underwent IVF/ICSI assisted pregnancy in our hospital and reproductive center of the First Affiliated Hospital of Wenzhou Medical University from 2016.01 to 2018.01.The patients were further divided into treatment group and control group with 40 cases in each group by single blind random number table method.The control group was treated with IVF/ICSI-ET routinely,while the treatment group was treated with Bubao Decoction orally and acupuncture on the basis of routine treatment from Gn start-up day to 2 weeks after transplantation.The changes of endometrial thickness,uterine hemodynamic parameters,Salle score on HCG days and the syndrome score of kidney deficiency in TCM,egg numbers,high quality embryo rate,embryo transfer rate and clinical pregnancy rate were observed in two groups.Results During the experiment period,6 cases in the treatment group dropped off(4 cases interrupted treatment,2 cases cancelled cycle),4 cases in the control group dropped off(cancelled cycle),and 70 cases completed the experiment,of which 34 cases in the treatment group and 36 cases in the control group.As for the scores of TCM kidney deficiency syndrome,the scores of the treatment group was significantly improved after treatment compared with the previous one(P<0.01).After treatment,the scores of treatment group were significantly lower than those in control group(P<0.01).On HCG day,endometrial blood flow PI(P<0.05),RI(P<0.01)and S/D(P<0.01)of the treatment group were significantly lower than those of the control group.The mPI,mRI and mS/D of uterine artery blood flow were significantly lower than those of the control group(P<0.01).The Salle score of the treatment group was significantly higher than that of the control grou

关 键 词：高龄 补胞汤 针刺 子宫内膜血流 子宫动脉血流 Salle评分 中医肾虚证候积分 

分 类 号：R71[医药卫生—妇产科学]