苍山贴脐温宫法对肾虚血瘀型患者冻融胚胎移植结局及子宫内膜容受性影响  

Effects of Cangshan Sticking Umbilical Warming Method on the Outcome of Frozen-Thawed Embryo Transfer and Endometrial Receptivity of Patients with Kidney Deficiency and Blood Stasis

作　　者：于琴 赵以琳 周娟 贾兰 贾林娜 严骅[1] YU Qin;ZHAO Yilin;ZHOU Juan;JIA Lan;JIA Linna;YAN Hua(Shuguang Hospital Affiliated to Shanghai University of TraditionalChinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《辽宁中医药大学学报》2022年第7期82-86,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC1704100,2018YFC1704102);上海市卫生健康委员会中医药科研项目(2020LP052)。

摘　　要：目的观察苍山贴脐温宫法对肾虚血瘀型患者冻融胚胎移植(frozen-thawed embryo transfer,FET)结局及子宫内膜容受性(endometrial receptivity,ER)的影响,为临床运用外治法改善冻融胚胎移植患者妊娠结局及子宫内膜容受性提供了新的方法和思路。方法选择2019年6月—2020年12月就诊于曙光医院生殖中心准备行冻融胚胎移植的患者,最终纳入109例患者,随机分成药物贴组(n=37)、发热贴组(n=37)、对照组(n=35)。对照组予激素替代方法进行内膜准备,发热贴组予内膜准备加空白发热贴,药物贴组予内膜准备加苍山贴脐片。观察指标:(1)一般情况:年龄、不孕年限、不孕原因及类型、身体质量指数(body mass index,BMI)。(2)中医证候积分、总有效率。(3)3组患者实验室指标:月经第2~3天及内膜转化日的卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)、孕酮(P)及移植后14 d的β-绒毛膜促性腺激素(β-HCG)。(4)3组患者超声学指标:月经第2~3天内膜厚度、内膜转化日的内膜形态、血流、厚度、搏动指数(PI)、阻力指数(RI)及妊娠患者移植后28 d的监测情况。(5)妊娠情况:种植率、妊娠率及持续妊娠率。结果(1)中医证候评分:治疗后药物贴组评分明显低于对照组,差异有统计学意义(P<0.05)。(2)中医证候疗效:药物贴组总疗效明显高于发热贴组及对照组,差异有统计学意义(P<0.05)。(3)内膜转化日内膜形态及血流:药物贴组A型内膜及Ⅲ型血流明显高于发热贴组及对照组,差异有统计学意义(P<0.05)。(4)内膜转化日PI、RI比较:药物贴组PI、RI低于对照组,差异有统计学意义(P<0.05)。(5)妊娠结局比较:对于<35岁的患者无论移植囊胚还是卵裂期胚胎,药物贴组种植率、妊娠率及持续妊娠率均有高于发热贴组及对照组的趋势,仅<35岁患者移植囊胚的种植率比较差异有统计学意义(P<0.05),其余差异均无统计学意义。结论对于肾虚血�Objective To observe the effect of Cangshan umbilical warming method on the outcome of frozen-thawed embryo transfer and endometrial receptivity of patients with kidney deficiency and blood stasis,and also to provide a new method and idea for clinical application of external treatment in improving pregnancy outcome of FET and ER.Methods A total of 109 patients who met the criteria from June 2019 to December 2020 in the reproductive center of Shuguang hospital were collected,including drug patch group(37 patients),fever patch group(37 patients),and control group(35 patients).The control group received hormone replacement therapy for endometrium preparation.The fever patch group was added with a blank fever patch on the basis of the control group,and the drug patch group was added with a Cangshan umbilical patch on the basis of the control group.Observation indicators:(1)General conditions:age,infertility years,infertility cause and type,BMI.(2)TCM syndrome index and total effective rate before and after treatment.(3)Laboratory indicators:FSH,LH,E2,P on the 2-3 days of the menstrual cycle and embryo transfer day,β-HCG on the 14th day after FET.(4)Ultrasonic indicators:membrane thickness on the third day of the menstrual cycle,blood flow,thickness,PI,RI on the embryo transfer day,and 28 days after FET.(5)Pregnancy:implantation rate,pregnancy rate and continuous pregnancy rate.Results(1)TCM syndrome:After treatment,the three groups of patients were lower than before treatment(P<0.05).After treatment,the comparison between the groups found that the drug patch group was significantly lower than the control group(P<0.05).(2)Curative effect of TCM syndromes:the total curative effect of drug patch group was significantly higher than the fever patch group and the control group(P<0.05).(3)Endometrial morphology and blood flow on the embryo transfer day:The blood flow of type A and typeⅢof the drug patch group was significantly higher than that of the fever patch group and the control group(P<0.05).(4)Uterine artery PI an

关 键 词：中医外治法 肾虚血瘀 子宫内膜容受性 苍山贴脐温宫法 

分 类 号：R271.14[医药卫生—中医妇科学] R321-33[医药卫生—中医学]