针刺脐周八穴对肥胖型多囊卵巢综合征所致不孕症患者妊娠结局及脂肪相关因子的影响  

Retrospective analysis on pregnancy outcomes and fat-related factors of treatment of endomorph PCOS infertility patients by acupuncture of 8 acupoints around umbilicus

作　　者：窦真 马赛花 宋佳怡 夏天[1] DOU Zhen;MA Sai-hua;SONG Jia-yi;XIA Tian(Reproduction Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学第一附属医院生殖中心,天津300193

出　　处：《针刺研究》2021年第2期158-163,共6页Acupuncture Research

基　　金：国家自然科学基金面上项目(No.81774351)。

摘　　要：目的:观察针刺脐周八穴对肥胖型多囊卵巢综合征(PCOS)所致不孕症患者代谢水平及生殖功能的影响。方法:回顾性分析肥胖型PCOS所致不孕症患者96例,针刺组56例行针刺脐周八穴治疗,来曲唑组40例予来曲唑促排卵治疗。针刺组自月经第5天开始隔日针刺1次,每次留针30 min;来曲唑组自月经第5天开始服用来曲唑,每日2.5 mg,连续服用5 d。若未怀孕则继续治疗,两组均治疗3个月经周期。比较两组患者的妊娠结局(妊娠率、持续妊娠率、排卵率、流产率),治疗前后测量体质量指数(BMI)、腰臀比(WHR),检测稳态模型胰岛素抵抗指数(HOMA-IR),ELISA法检测血清瘦素(LEP)、脂联素(APN)水平。结果:与来曲唑组比较,针刺组妊娠率和APN水平升高(P<0.05),BMI、WHR、HOMA-IR、LEP水平均降低(P<0.05);而在持续妊娠率、排卵率、流产率方面,两组差异无统计学意义(P>0.05)。结论:针刺脐周八穴能够改善肥胖型PCOS患者的BMI、WHR、HOMA-IR、LEP、APN水平,诱导排卵,提高妊娠率。Objective To assess the therapeutic effect of acupuncture of eight acupoints around the umbilicus in improving the metabolic level and reproductive function in endomorph polycystic ovary syndrome(PCOS) infertile patients. Methods Retrospective analysis was performed on 96 cases of endomorph type PCOS infertility patients who were admitted to the clinic of the Reproductive Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 2015 to June 2018. Among them, fifty-six cases of the acupuncture group received treatment with acupuncture stimulation of eight acupoints(Shuifen [CV9], Yinjiao [CV7], Tianshu [ST25], Wailing [ST26], Huaroumen [ST24], etc.) around the umbilicus, and 40 cases of the control group were treated by oral administration of Letrozole. Acupuncture was performed once every other day, and Letrozole(2.5 mg/day) given once daily for 5 days, if no pregnancy got, the treatment procedure was repeated once again next menstruation cycle, continuously for 3 months. The pregnancy outcomes including the pregnancy rate, persistent pregnancy rate, ovulation rate and the first trimester abortion rate, and the levels of fat-related factors including body mass index(BMI), waist-to-hip ratio(WHR), homeostasis model of insulin resistance(HOMA-IR=fasting insulin x fasting blood glucose/22.5), leptin(LEP) and adiponectin(APN) of the two groups were compared. The ovulation rate(number of effective ovulation cycles/number of observation cycles) x 100%, the first trimester abortion rate(number of spontaneous abortion within 12 weeks÷pregnancy cases) X100% were calculated. The fasting blood samples were taken for assaying serum LEP and APN contents using ELISA, blood glucose level using hexokinase assay, and serum insulin by using chemiluminescent microparticle immunoassay, separately. Results After the treatment, the pregnancy rate and the level of APN were significantly higher(P<0.05), and the BMI, WHR, HOMA-IR and LEP levels were all obviously lower in the acupuncture

关 键 词：针刺 脐周八穴 多囊卵巢综合征 妊娠结局 脂肪相关因子 

分 类 号：R246.3[医药卫生—针灸推拿学]