针刺配合滋肾填精方对子宫内膜薄性不孕症的影响  

Effect of Acupuncture Combined with Zi Shen Tian Jing Prescription on Infertility Due to Thin Endometrium

作　　者：李凌云 陈文裕[1] 廖剑艺 冯崇廉[1] 周颖芳[1] 钟冬梅[1] LI Ling-yun;CHEN Wen-yu;LIAO Jian-yi;FENG Chong-lian;ZHOU Ying-fang;ZHONG Dong-mei(The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院,广州510150

出　　处：《上海针灸杂志》2020年第4期411-415,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：广东省中医药局课题(20162094)。

摘　　要：目的观察针刺配合滋肾填精方对子宫内膜薄性不孕症患者的影响。方法选取60例肾阴虚型子宫内膜薄性不孕症患者,随机分为治疗组和对照组,每组30例。治疗组给予针刺配合滋肾填精方治疗,对照组给予戊酸雌二醇片治疗。观察卵泡发育成熟时内膜厚度、子宫内膜螺旋动脉搏动指数和阻力指数以及妊娠率。疗程为3个月经周期。结果两组治疗后患者子宫内膜厚度较治疗前均有增加,差异有统计学意义(P<0.05),治疗组子宫内膜较对照组明显增厚,差异有统计学意义(P<0.05)。治疗组治疗后卵泡成熟时子宫内膜螺旋动脉血流参数PI、RI均降低,差异有统计学意义(P<0.05);对照组治疗后卵泡成熟时子宫内膜螺旋动脉血流参数PI、RI均降低,差异有统计学意义(P<0.05);治疗组子宫内膜螺旋动脉血流参数PI、RI较对照组明显降低,两组比较差异有统计学意义(P<0.05)。治疗组妊娠率明显高于对照组,差异有统计学意义(P<0.05)。治疗过程中,治疗组无不良反应发生,对照组3例出现乳房胀痛,2例出现阴道少量出血,5例出现消化道不良反应。结论针刺配合滋肾填精方治疗子宫内膜薄性不孕症,可促进子宫内膜增长,改善子宫内膜血流,改善子宫内膜容受性,疗效确切,无不良反应,提高临床妊娠率。Objective To observe the effect of acupuncture combined with Zi Shen Tian Jing prescription on patients with infertility due to thin endometrium.Method Sixty patients with infertility due to thin endometrium differentiated as kidney-yin deficiency were recruited and randomized into a treatment group and a control group,with 30 cases in each group.The treatment group was intervened by acupuncture plus Zi Shen Tian Jing prescription,and the control group was treated with estradiol valerate tablets.The endometrium thickness,the pulsatility index(PI)and resistance index(RI)of uterine spiral artery and pregnancy rate were observed using ultrasound scanning when follicle was fully developed.The treatment course lasted 3 menstrual cycles.Result The endometrium thickness increased significantly after treatment in both groups(P<0.05),and it increased more significantly in the treatment group than in the control group(P<0.05).After treatment,the PI and RI of uterine spiral artery decreased significantly when follicle was mature in the treatment group(P<0.05);after treatment,the PI and RI of uterine spiral artery decreased significantly when follicle was mature in the control group(P<0.05);the PI and RI of uterine spiral artery decreased more significantly in the treatment group than in the control group(P<0.05).The pregnancy rate was markedly higher in the treatment group than in the control group(P<0.05).No adverse reactions occurred during intervention in the treatment group,while there were 3 cases of breast distending pain,2 cases of small-amount vaginal bleeding and 5 cases of digestive adverse reactions in the control group.Conclusion In the treatment of infertility due to thin endometrium,acupuncture plus Zi Shen Tian Jing prescription can encourage the increase of endometrium,improve the blood flow and receptivity of endometrium,produce valid efficacy without causing adverse reactions,and enhance the clinical pregnancy rate.

关 键 词：不孕症 针药并用 针刺疗法 子宫内膜 搏动指数 阻力指数 妊娠 

分 类 号：R246.3[医药卫生—针灸推拿学]