清热化瘀法联合针刺对早发性卵巢功能不全患者血清性激素、抗苗勒管激素和窦卵泡计数及miR-21、mRNA表达水平影响  

Effect of Clearing Heat and Removing Stasis Method Combined with Acupuncture on Serum Sex Hormone,Anti-Mullerian Hormone,Antral Follicle Count and miR-21,mRNA Expression in Patients with Premature Ovarian Dysfunction

作　　者：陈咏 修银玲 王艺杰 于月新 CHEN Yong;XIU Yinling;WANG Yijie;YU Yuexin(General Hospital of Northern Theater Command,Shenyang 110016,Liaoning,China)

机构地区：[1]中国人民解放军北部战区总医院,辽宁沈阳110016

出　　处：《辽宁中医药大学学报》2022年第10期11-14,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省科技攻关项目(2020JH2/10300118)。

摘　　要：目的观察清热化瘀法联合针刺对早发性卵巢功能不全患者血清性激素、抗苗勒管激素和窦卵泡计数及miR-21、mRNA表达水平的影响,方法将2020年9月—2021年6月中国人民解放军北部战区总医院收治的100例早发性卵巢功能不全患者随机分为对照组(n=50)和研究组(n=50),前者行雌二醇片/雌二醇地屈孕酮片治疗,后者在此次基础上给予清热化瘀法联合针刺治疗,均治疗12周,检测雌二醇(E)、促卵泡刺激素(FSH)、卵泡刺激素(T)、抗苗勒氏管激素(AMH)、抑制素B(INHB)、miR-21、外周血单核细胞(PBMC)中Peli1 mRNA水平,检测基础窦卵泡计数及左/右卵巢血流频谱峰值流速(PSV),比较中医证候积分、Kupperman评分和临床疗效。结果治疗后,研究组FSH、T、INHB、AMH水平低于对照组(P<0.05),E、miR-21、PBMC Peli1 mRNA水平高于对照组(P<0.05)。研究组患者基础窦卵泡计数、左卵巢PSV、右卵巢PSV水平和总有效率高于对照组(P<0.05),中医证候积分、Kupperman评分低于对照组(P<0.05)。结论清热化瘀法联合针刺治疗早发性卵巢功能不全患者,可调节患者性激素水平,降低INHB、AMH水平,提升卵巢功能,提升miR-21、PBMC Peli1 mRNA水平及基础窦卵泡计数,改善卵巢血流动力学,缓解临床症状,提升临床疗效。Objective To observe the effect of clearing heat and removing stasis method combined with acupuncture on serum sex hormone,anti Mullerian hormone,antral follicle count,miR-21 and mRNA expression level in patients with premature ovarian insufficiency.Methods 100 patients with early-onset ovarian insufficiency from September 2020 to June 2021 were randomly divided into study group(50 cases)and control group(50 cases).The control group was treated with estradiol tablets/estradiol and progesterone tablets,while the study group was treated with clearing heat and removing stasis method combined with acupuncture on the basis of the control group.Before and after treatment,the levels of estradiol(E),follicle stimulating hormone(FSH),follicle stimulating hormone(T),anti Mullerian hormone(AMH),inhibin B(INHB),miR-21 and Peli1 mRNA in peripheral blood mononuclear cells(PBMC)were detected.The basal antral follicle count and left/right ovarian peak flow velocity(PSV)were detected.The TCM syndrome score,Kupperman score and clinical efficacy were compared.Results After treatment,the levels of FSH,T,INHB and AMH in the study group were lower(P<0.05),and the levels of E,miR-21and PBMC Peli1 mRNA in the study group were higher(P<0.05).The basic antral follicle count,left ovary PSV,right ovary PSV level in the study group were higher than those in the control group(P<0.05),the TCM syndrome score and Kupperman score in the study group were lower(P<0.05).Conclusion Clearing heat and removing stasis method combined with acupuncture can regulate the sex hormone levels,reduce the levels of INHB and AMH,improve ovarian function,increase the mRNA levels of miR-21 and PBMC Peli1and the number of basal antral follicles in patients with premature ovarian insufficiency,improve ovarian hemodynamics.

关 键 词：清热化瘀法 针刺 早发性卵巢功能不全 性激素 抗苗勒管激素 窦卵泡计数 MIR-21 

分 类 号：R711.75[医药卫生—妇产科学]