基于“冲为血海”的分期针灸对薄型子宫内膜反复移植失败患者子宫内膜容受性和焦虑情绪的影响  

Effects of staged acupuncture on endometrial receptivity and anxiety in patients with recurrent implantation failure of thin endometrium based on"thoroughfare vessel is the sea of blood"theory

作　　者：邢利威 何喆 孙玉环 贺明 余顺 陈阳 徐金龙 梅瑞 赵荣 XING Liwei;HE Zhe;SUN Yu-huan;HE Ming;YU Shun;CHEN Yang;XU Jin-long;MEI Rui;ZHAO Rong(First Clinical Medical College,Yunnan University of CM,Kunming 650500,China;Second Clinical Medical College,Yunnan University of CM,Kunming 650500,China;Department of TCM,Hainan Women and Children Medical Center;ADepartment of TCM,Yunnan Maternal and Child Health Care Hospital;Department of TCM,Yunnan Integrated Hospital of Traditional Chinese and Western Medicine)

机构地区：[1]云南中医药大学第一临床医学院,昆明650500 [2]云南中医药大学第二临床医学院,昆明650500 [3]海南省妇女儿童医学中心中医科 [4]云南省妇幼保健院中医科 [5]云南省中西医结合医院中医科

出　　处：《中国针灸》2023年第3期289-293,共5页Chinese Acupuncture & Moxibustion

基　　金：云南省科技厅应用基础研究联合重点项目:2019FF002-004;云南省教育厅科学研究基金项目:2021Y458。

摘　　要：目的:比较基于“冲为血海”的分期针灸联合常规激素替代周期方案与常规激素替代周期方案治疗薄型子宫内膜反复移植失败(RIF)的临床疗效。方法:将72例薄型子宫内膜RIF患者随机分为观察组和对照组,各36例。对照组采用常规激素替代周期方案治疗;在对照组治疗基础上,观察组加用基于“冲为血海”的分期针灸,主穴取内关、公孙,根据月经周期及辨证选取相应配穴,隔日1次,每周3次,连续治疗3个月经周期。观察两组患者治疗前后着床窗口期子宫内膜厚度及形态、汉密尔顿焦虑量表(HAMA)评分;比较两组临床妊娠率、活产率、周期取消率;分析子宫内膜厚度与HAMA评分的相关性。结果:治疗后,两组患者子宫内膜厚度和观察组A+B型子宫内膜比例较治疗前增加(P<0.05),两组HAMA评分较治疗前降低(P<0.05),且观察组上述指标均优于对照组(P<0.05)。观察组临床妊娠率、活产率高于对照组(P<0.05),周期取消率低于对照组(P<0.05)。薄型子宫内膜RIF患者子宫内膜厚度和HAMA评分呈负相关(P<0.05)。结论:在常规激素替代周期方案基础上,加用基于“冲为血海”的分期针灸能改善薄型子宫内膜RIF患者子宫内膜厚度及形态,缓解焦虑情绪,提高临床妊娠率及活产率,降低周期取消率,疗效优于单纯常规激素替代周期方案。Objective To compare the clinical efficacy between staged acupuncture based on"thoroughfare vessel is the sea of blood"theory combined with routine hormone replacement cycle treatment and routine hormone replacement cycle treatment for patients with recurrent implantation failure(RIF)of thin endometrium.Methods A total of 72 RIF patients with thin endometrium were randomly divided into an observation group and a control group,36 cases in each group.The patients in the control group were treated with routine hormone replacement cycle treatment.Based on the treatment of the control group,the patients in the observation group were treated with staged acupuncture based on"thoroughfare vessel is the sea of blood"theory.The main acupoints were Neiguan(PC 6)and Gongsun(SP 4),and the supplementary acupoints were selected according to the menstrual cycle and syndrome differentiation;the acupuncture was given once every other day,3 times a week,for 3 consecutive menstrual cycles.The thickness and shape of endometrium,and Hamilton anxiety scale(HAMA)score were observed at implantation window before and after treatment;the clinical pregnancy rate,live birth rate and cycle cancellation rate were compared between the two groups;the correlation between endometrial thickness and HAMA score was analyzed.Results Compared before treatment,the endometrial thickness in the two groups and the proportion of type A+B endometrium in the observation group were increased(P<0.05),and the HAMA scores in the two groups were decreased(P<0.05)after treatment.The above indexes in the observation group were superior to those in the control group(P<0.05).The clinical pregnancy rate and live birth rate in the observation group were higher than those in the control group(P<0.05),and the cycle cancellation rate was lower than that in the control group(P<0.05).There was a negative correlation between endometrial thickness and HAMA score(P<0.05).Conclusion Based on the routine hormone replacement cycle treatment,the addition use of staged acupuncture b

关 键 词：反复移植失败 薄型子宫内膜 针灸 冲为血海 子宫内膜容受性 焦虑 随机对照试验 

分 类 号：R246.3[医药卫生—针灸推拿学]