温针灸配合补肾祛瘀汤对肾虚血瘀型不孕症预后妊娠及外周血PAg T、D-D水平影响  

Effects of Warm Needling Combined with Bushen Quyu Decoction on the Prognosis of Pregnancy and Peripheral Blood PAg T and D-D Levels in Patients with Infertility of Kidney Deficiency and Blood Stasis Pattern

作　　者：刘淑君[1] 张占波 苏丽梅 郝斌彬 刘宇明 LIU Shu-jun;ZHANG Zhan-bo;SU Li-mei;HAO Bin-bin;LIU Yu-ming(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)

机构地区：[1]唐山市中医医院,唐山063000 [2]华北理工大学附属医院,唐山063000

出　　处：《上海针灸杂志》2020年第12期1576-1581,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局科技支撑项目(2015242)。

摘　　要：目的观察温针灸配合补肾祛瘀汤对肾虚血瘀型不孕症预后妊娠及外周血血小板聚集率(PAg T)、D-二聚体(D-D)水平的影响。方法选取肾虚血瘀型不孕症患者90例,以简单随机化法分为观察组、对照A组、对照B组,每组30例。对照A组予以常规西医治疗,对照B组在常规西医基础上采取补肾祛瘀汤治疗,观察组在常规西医基础上采取温针灸配合补肾祛瘀汤治疗,均治疗3个月。比较3组治疗前和治疗后子宫内膜厚度、卵泡直径、血清性激素指标[雌二醇(E2)、促卵泡激素(FSH)、黄体生成素(LH)]、子宫内膜血流参数[阻力指数(RI)、搏动指数(PI)]、血PAg T、D-D水平,治疗后进行6个月随访,对比3组排卵率、妊娠率。结果3组治疗后子宫内膜厚度、卵泡直径较治疗前增高(P<0.05),且观察组高于对照A组、对照B组(P<0.05);3组治疗后血清E2水平较治疗前增高(P<0.05),且观察组高于对照A组、对照B组(P<0.05),血清FSH、LH水平较治疗前降低(P<0.05),且观察组低于对照A组、对照B组(P<0.05);3组治疗后RI、PI与血浆PAg T、D-D水平较治疗前降低(P<0.05),且观察组低于对照A组、对照B组(P<0.05);治疗后6个月,观察组排卵率、妊娠率分别为90.0%、46.7%,均高于对照A组的63.3%、16.7%,且妊娠率高于对照B组的20.0%(P<0.05)。结论在常规西医治疗基础上,应用温针灸配合补肾祛瘀汤治疗肾虚血瘀型不孕症患者可提高子宫内膜厚度、卵泡直径,改善性激素、子宫内膜血流参数表达,降低血浆PAg T、D-D水平,提升预后排卵率、妊娠率。Objective To observe the effects of warm needling plus Bushen Quyu decoction on the prognosis of pregnancy and the levels of peripheral blood platelet aggregation rate(PAg T)and D-dimer(D-D)in patients with infertility of kidney deficiency and blood stasis pattern.Method Ninety patients with infertility of kidney deficiency and blood stasis pattern were enrolled and divided using simple randomization method into an observation group,control group A and control group B,with 30 cases in each group.Control group A was intervened by conventional Western medicine,control group B was given Bushen Quyu decoction in addition to the conventional Western medicine in control group A,and the observation group was treated with warm needling and Bushen Quyu decoction in addition to the conventional Western medicine,all for 3 months.Before and after treatment,the endometrial thickness,follicular diameter,serum sex hormone indexes[estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)],endometrial blood flow parameters[resistance index(RI)and pulsatility index(PI)],blood PAg T and D-D levels were compared amongst the three groups.A 6-month follow-up was conducted to compare the ovulation and pregnancy rates among the three groups.Result The endometrial thickness and follicular diameter increased after treatment in the three groups(P<0.05),and were higher in the observation group than in control group A and control group B(P<0.05).The serum E2 level increased after treatment in the three groups(P<0.05),and was higher in the observation group than in control group A and control group B(P<0.05);the serum FSH and LH levels decreased after treatment(P<0.05),and were lower in the observation group than in control group A and control group B(P<0.05).The RI,PI and blood PAg T and D-D levels declined after treatment in the three groups(P<0.05),and were lower in the observation group than in control group A and control group B(P<0.05).At the 6-month follow-up,the ovulation rate was 90.0%and the pregnancy rate was 46.7%

关 键 词：针药并用 不孕症 温针疗法 肾虚血瘀 妊娠率 不育 女性 

分 类 号：R246.3[医药卫生—针灸推拿学]