传统针刺疗法对波塞冬第三分组POR患者IVF-ET辅助治疗效果及细胞因子的影响:随机对照研究  

Effect of traditional acupuncture on IVF-ET adjuvant therapy and cytokines in POR patients in Poseidon group 3:a randomized controlled study

作　　者：杨婷[1] 苟文婕 王薇[1] 赵翠[1] 陈学良 马晓玲[1] 王雅琦 张学红[1] YANG Ting;GOU Wen-jie;WANG Wei;ZHAO Cui;CHEN Xue-liang;MA Xiao-ling;WANG Ya-qi;ZHANG Xue-hong(Reproductive Medicine Center of the 1 st Hospital of Lanzhou University,Key Laboratory for Reproductive Medicine and Embryo,Lanzhou 730000)

机构地区：[1]兰州大学第一医院生殖医学中心,甘肃省生殖医学与胚胎重点实验室,兰州730000

出　　处：《生殖医学杂志》2022年第11期1513-1519,共7页Journal of Reproductive Medicine

基　　金：甘肃省中医药管理局科研项目(GZK-2019-43,GZK-2017-49);甘肃省青年科技基金计划(21JR11RA072);兰州大学第一医院院内科研项目(2020-69)。

摘　　要：目的探讨传统针刺疗法用于波塞冬卵巢低反应(POR)第3分组患者IVF-ET辅助治疗的疗效,观察传统针刺治疗对POR患者卵泡液中卵子发育相关因子和炎症因子表达、颗粒细胞线粒体DNA(mtDNA)拷贝数的影响。方法选取2017年10月至2020年10月于我中心行IVF-ET治疗、符合波塞冬POR第3分组的109名患者为研究对象,随机分为针刺组(n=50)与对照组(n=59),针刺组取卵前辅助传统针刺治疗3个周期。比较两组患者的基础资料、促排卵结局及累计活产率;测定两组患者卵泡液中β-内啡肽(β-EP)、间隙连接蛋白43(Cx43)、骨形态发生蛋白-4(BMP-4)、细胞间黏附分子-1(ICAM-1)、环氧合酶-2(COX-2)水平;检测颗粒细胞mtDNA拷贝数。结果两组患者的基础资料无显著性差异(P>0.05)。针刺组和对照组的获卵数[(3.89±2.35)vs.(4.31±0.87)]、2PN数[(2.71±1.71)vs.(1.69±1.43)]、优质胚胎率(84.21%vs.86.36%)、累计活产率(52.00%vs.50.84%)均无统计学差异(P>0.05);针刺组的MⅡ卵率显著高于对照组(86.72%vs.71.76%)(P<0.05)。两组患者间卵泡液中β-EP、BMP-4、Cx43水平均无显著差异(P>0.05),针刺组患者卵泡液中ICAM-1、COX-2水平显著低于对照组[分别为(389.81±61.68)IU/ml vs.(471.56±93.60)IU/ml,(21.55±4.78)IU/ml vs.(29.42±6.53)IU/ml,P<0.05]。两组间颗粒细胞mtDNA拷贝数比较无统计学差异(P>0.05)。结论传统针刺治疗3个周期可以提高波塞冬POR第3分组患者IVF-ET治疗中的MⅡ卵率,但不能提高累计活产率;针刺治疗可以降低卵泡液中部分炎症因子水平,可能一定程度上影响卵泡发育微环境。Objective:To explore the effect of traditional acupuncture on IVF-ET adjuvant therapy in the patients with low ovarian response(POR)of Poseidon group 3,and investigate the influence of acupuncture on the factors related to oocyte development and inflammatory expression and copy number of mitochondrial DNA(mtDNA)in granulosa cells.Methods:A total of 109 POR patients with Poseidon group 3 who were treated with IVF-ET in our center from October 2017 to October 2020 and who were selected as the study subjects.The patients were randomly divided into the treatment group(n=50)and control group(n=59).The patients in the treatment group were treated with acupuncture for three cycles.The general data,outcome of induction of ovulation,and the cumulative live birth rate were compared between the two groups.The levels ofβ-endorphin(β-EP),connexin 43(Cx43),bone morphogenetic protein-4(BMP-4),intercellular adhesion molecule-1(ICAM-1)and cyclooxygenase-2(COX-2)in follicular fluid were measured,and the copy number of mtDNA in granulosa cells were detected.Results:There was no significant difference in the general data(P>0.05).The number of retrieved oocytes[(3.89±2.35)vs.(4.31±0.87)],2PN[(2.71±1.71)vs.(1.69±1.43)],high-quality embryos rate(84.21%vs.86.36%)and cumulative live birth rate(52.00%vs.50.84%)were not significantly different between the two groups(P>0.05).The MⅡoocytes rate of the treatment group were significantly higher than that of the control group(86.72%vs 71.76%,P<0.05).There was no significant difference in the expression ofβ-EP,BMP-4,Cx43 in follicular fluid between two groups(P>0.05),while the expression of ICAM-1[(389.81±61.68)IU/ml vs.(471.56±93.60)IU/ml]and COX-2[(21.55±4.78)IU/ml vs.(29.42±6.53)IU/ml]in follicular fluid was significantly reduced in the treatment group(P<0.05).There was no significant difference in the copy number of mtDNA in granulosa cells between two groups(P>0.05).Conclusions:Traditional acupuncture treatment for 3 cycles can improve the MⅡoocytes rate in the POR patients i

关 键 词：针刺疗法 卵巢低反应 累计活产率 MⅡ卵率 颗粒细胞 线粒体DNA 

分 类 号：R711.6[医药卫生—妇产科学]