基于随机对照试验针灸治疗不孕症的文献计量学研究  

Literature metrology study on acupuncture and moxibustion in treatment of infertility based on randomized controlled trials

作　　者：吴楚婷 黄琴峰[2] 谢晨[2] 杨光 张春雁[1] WU Chuting;HUANG Qinfeng;XIE Chen;YANG Guang;ZHANG Chunyan(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市针灸经络研究所,上海200030

出　　处：《上海中医药大学学报》2022年第4期84-91,共8页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科研计划项目(19401934500);上海市“科技创新行动计划”启明星项目(扬帆专项)(22YF1444200);上海申康医院发展中心临床三年行动计划项目(SHDC2020CR3093B);上海中医药大学“杏林百人”计划杏林学者项目;上海中医药大学预算内科研项目(2021WK127)。

摘　　要：目的:归纳分析针灸治疗不孕症的随机对照试验文献,总结针灸治疗不孕症的选穴规律、治疗方法规律、临床疗效及效应指标,为针灸治疗优势病症提供科学证据。方法:采用计算机检索《中医针灸信息库》、中国知网(CNKI)、万方(Wanfang)、维普(CQVIP)数据库中2015年1月1日~2022年4月30日针灸治疗不孕症的文献,对符合纳入标准的文献中穴位和治疗方法进行分析总结,并比较不同病因不孕症及不同治疗方法对不孕症的总有效率、妊娠率、排卵率、子宫内膜厚度和血清性激素水平。结果:共纳入文献407篇,以排卵障碍性不孕症最多。针灸治疗不孕症共涉及穴位129个,高频穴位为关元、三阴交、子宫、足三里、中极、气海、肾俞和太冲。聚类分析显示,高频穴位的有效聚类为血海-太冲-肾俞、气海-中极-足三里-子宫、三阴交-关元。穴位分布以任脉穴位和腹部穴位频次最高。常采用针刺、灸法联合中药或西药治疗。针灸治疗后不同病因不孕症的妊娠率和排卵率不同;对于排卵障碍性不孕患者,针灸+西药和针灸+中药的总有效率、妊娠率和排卵率均高于针灸疗法、西药和中药;针灸+西药治疗后患者子宫内膜厚度增加高于针灸疗法和针灸+中药疗法,且不同疗法均能调节性激素水平。结论:针灸治疗不孕症选穴以局部穴位为主,结合经脉所主病选穴,关元和三阴交可作用主穴。针灸疗法单独应用或联合药物应用均能有效提高患者的妊娠率和排卵率,增加子宫内膜厚度,调节性激素水平。不孕症可作为针灸优势病症。Objective:To summarize and analyze the literatures of randomized controlled trials of acupuncture and moxibustion in the treatment of infertility,and to summarize the laws of acupoints selection,treatment methods,clinical efficacy and effective indexes of acupuncture and moxibustion in the treatment of infertility so as to provide scientific evidence for the advantages of acupuncture and moxibustion in the treatment.Methods:The literatures on acupuncture and moxibustion treatment of infertility from January 1,2015 to April 30,2022 in TCM Acupuncture Information Database,China national knowledge infrastructure(CNKI),Wanfang academic journal full-text database(Wanfang) and Chongqing VIP database(CQVIP) databases were retrieved by computer,and the acupoints and treatment methods in the literatures met the inclusion criteria were analyzed and summarized. The total effective rate,pregnancy rate,ovulation rate,endometrial thickness,and serum sex hormone levels of infertility of different etiologies and different treatment methods were compared.Results:A total of 407 literatures were included,most of which were ovulatory dysfunction infertility. Acupuncture and moxibustion treatment of infertility involved 129 acupoints,with high-frequency acupoints being Guanyuan,Sanyinjiao,Zigong,Zusanli,Zhongji,Qihai,Shenshu and Taichong. Cluster analysis showed that the effective clustering of high-frequency acupoints are XuehaiTaichong-Shenshu,Qihai-Zhongji-Zusanli-Zigong and Sanyinjiao-Guanyuan. The frequency of acupoint distribution was highest on Ren Channel and abdominal acupoints. Acupuncture and moxibustion combined with traditional Chinese medicine or western medicine were often used for treatment. After acupuncture and moxibustion treatment,the pregnancy rate and ovulation rate of infertility of different etiologies were different. For patients with ovulatory dysfunction infertility,the total effective rate,pregnancy rate and ovulation rate of acupuncture + western medicine group and acupuncture + traditional Chinese medici

关 键 词：针灸疗法 不孕症 女性 随机对照试验 

分 类 号：R246.3[医药卫生—针灸推拿学] G353.1[医药卫生—中医临床基础]