针刺对排卵障碍性不孕症患者冻融胚胎移植妊娠结局的影响  

Effect of acupuncture on pregnancy outcomes of frozen embryo transfer in patients with anovulatory infertility

作　　者：许林玲 周雪[2] 张彩荣[1] 张建斌 XU Lin-ling;ZHOU Xue;ZHANG Cai-rong;ZHANG Jian-bin(Department of Acupuncture and Moxibustion,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210001,Jiangsu Province,China;Reproductive Center,Nanjing Maternity and Child Health Care Hospital;Departinent of Acupuncture and Moxibustion,Second Affiliated Hospital of Nanjing University of Chinese Medicine/Second Chinese Medicine Hospital of Jiangsu Province,Nanjing 210017)

机构地区：[1]南京中医药大学附属南京中医院针灸科,江苏南京210001 [2]南京市妇幼保健院生殖中心 [3]南京中医药大学第二附属医院/江苏省第二中医院针灸科,南京210017

出　　处：《中国针灸》2022年第2期150-154,共5页Chinese Acupuncture & Moxibustion

基　　金：江苏省重点研发计划(社会发展)项目:BE2020624。

摘　　要：目的:比较常规促排卵方案与针刺联合促排卵方案对排卵障碍性不孕症患者冻融胚胎移植(FET)妊娠结局的影响。方法:将60例排卵障碍性不孕症患者随机分为观察组和对照组,每组30例。对照组采用常规促排卵方案准备内膜。观察组在对照组治疗基础上,自月经周期第2天开始行针刺治疗,穴取百会、命门、膈俞、关元、气海等,隔日1次,至移植前1d。比较两组患者临床妊娠率、胚胎种植率、HCG扳机日子宫内膜形态、排卵率、周期取消率,观察两组患者治疗前及HCG扳机日子宫内膜厚度、治疗前后中医症状评分。结果:观察组患者胚胎种植率及临床妊娠率均高于对照组(P<0.05),HCG扳机日子宫内膜厚度及形态优于对照组(P<0.05)。治疗后观察组患者中医症状评分较治疗前降低(P<0.05),且降低幅度大于对照组(P<0.01)。结论:在常规促排卵方案基础上,针刺可提高排卵障碍性不孕症患者FET的胚胎种植率及临床妊娠率,改善其子宫内膜容受性。Objective To observe the effect of conventional ovulation induction protocol and acupuncture combined with conventional ovulation induction protocol on pregnancy outcomes of frozen embryo transfer(FET)in patients with anovulatory infertility.Methods A total of 60 patients with anovulatory infertility were randomized into an observation group and a control group,30 cases in each group.In the control group,conventional ovulation induction protocol was applied to prepare endometrium.On the basis of the control group,acupuncture was started on the 2 nd day of menstrual cycle in the observation group,Baihui(GV 20),Mingmen(GV 4),Geshu(BL 17),Guanyuan(CV 4),Qihai(CV 6),etc.were selected,once every other day,until 1 day before transplantation.The clinical pregnancy rate,embryo implantation rate,endometrial morphology on HCG trigger day,ovulation rate and cycle cancellation rate were compared in the two groups.The endometrial thickness before treatment and on HCG trigger day,TCM symptom score before and after treatment were observed in the two groups.Results In the observation group,the embryo implantation rate and clinical pregnancy rate were higher than the control group(P<0.05),endometrial thickness and endometrial morphology on HCG trigger day were superior to the control group(P<0.05).After treatment,the TCM symptom score in the observation group was decreased compared with before treatment(P<0.05),and the variation was greater than the control group(P<0.01).Conclusion On the basis of the conventional ovulation induction protocol,acupuncture could enhance the embryo implantation rate and clinical pregnancy rate of FET,improve the endometrial receptivity of patients with anovulatory infertility.

关 键 词：排卵障碍性不孕症 针刺 冻融胚胎移植 内膜容受性 妊娠结局 

分 类 号：R246.3[医药卫生—针灸推拿学]