针刺治疗卵巢储备功能减退不孕症临床研究  

Clinical Study on Acupuncture for Infertility Induced by Diminished Ovarian Reserve

作　　者：文彩玉珠 张晓柯 万留霞 李丽[1] 李俊敏[1] 管一春[1] WEN Caiyuzhu;ZHANG Xiaoke;WAN Liuxia;LI Li;LI Junmin;GUAN Yichun

机构地区：[1]郑州大学第三附属医院生殖医学科,河南商郑州450052

出　　处：《新中医》2023年第2期127-131,共5页New Chinese Medicine

基　　金：国家自然科学基金项目(81904291)。

摘　　要：目的:观察针刺治疗卵巢储备功能减退(DOR)不孕症的疗效及其对促排卵周期胚胎情况的影响。方法:将120例运用体外受精(IVF)或卵胞浆内单精子显微注射(ICSI)助孕治疗的DOR不孕症患者分为对照组和针刺组,每组各60例。对照组接受常规促排卵(COH)周期治疗;针刺组在接受常规促排卵周期治疗前接受针刺治疗,每周3次,治疗12周。比较2组治疗前后血清卵泡刺激素(FSH)、抗缪勒管激素(AMH)水平、双侧卵巢窦卵泡计数(AFC)、双侧卵巢体积、焦虑自评量表(SAS)评分和改良Kupperman评分量表评分,并比较2组治疗后胚胎情况(包括获卵数、正常受精数、可利用胚胎数),同时进行针刺的安全性评价。结果:与治疗前比较,针刺组治疗后FSH水平明显下降,AMH水平升高,差异均有统计学意义(P<0.05)。与治疗前比较,对照组卵巢体积增加,差异有统计学意义(P<0.05)。与对照组治疗后比较,针刺组AFC数量上升,SAS评分降低,可利用胚胎数增多,差异均有统计学意义(P<0.05)。在针刺治疗过程中,无严重不良反应发生。结论:针刺能够降低卵巢储备功能减退不孕症患者血清FSH水平,增加AFC数量,升高AMH水平,改善焦虑症状,改善卵巢功能,增加患者在促排卵周期中的可利用胚胎数,且安全性好。Objective:To observe the curative effect of acupuncture for infertility induced by diminished ovarian reserve(DOR)and its effect on embryos in ovulation induction cycle.Methods:A total of 120 cases of patients with DOR infertility treated by in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)were divided into the control group and the acupuncture group,with 60 cases in each group.The control group was given cycle treatment of routine controlled ovarian hyperstimulation(COH),and the acupuncture group was treated with acupuncture before the cycle treatment of routine COH.Both groups were treated for 12 weeks with 3 times a week.Before and after treatment,the levels of follicle stimulating hormone(FSH)and anti-Müllerian hormone(AMH)in serum,antral follicle count(AFC)in the bilateral ovaries,the volume of bilateral ovaries,and scores of Self-rating Anxiety Scale(SAS)and Modified Kupperman Scale in the two groups were compared.After treatment,the embryo situation including retrieved oocyte number,normal fertilization number and number of available embryos in the two groups were compared,and the safety evaluation of acupuncture was performed.Results:After treatment,the FSH level in the acupuncture group was significantly decreased when compared with that before treatment,and AMH level was increased,differences being significant(P<0.05).The ovarian volume in the control group was increased when compared with that before treatment,the difference being significant(P<0.05).The AFC number and number of available embryos in the acupuncture group were increased when compared with those in the control group after treatment,and the SAS score was decreased,differences being significant(P<0.05).During the treatment of acupuncture,there was no serious adverse reaction.Conclusion:Acupuncture can reduce the FSH levels in serum of patients with DOR infertility,increase the number of AFC and the AMH level,improve the symptom of anxiety and ovarian function,and increase the number of available embryos in the ovulation

关 键 词：卵巢储备功能减退 不孕症 针刺 体外受精 卵巢窦卵泡计数 抗缪勒管激素 可利用胚胎数 焦虑自评量表 

分 类 号：R711.6[医药卫生—妇产科学]