腹针联合枸橼酸氯米芬片对排卵障碍性不孕症患者子宫内膜容受性、焦虑状态及妊娠结局的影响  

Effects of abdominal acupuncture plus Clomifene citrate tablets on endometrial receptivity,anxiety,and pregnancy outcome in patients with anovulatory infertility

作　　者：王轲 张万龙 孙旖旎 朱玲 李艺 WANG Ke;ZHANG Wanlong;SUN Yini;ZHU Ling;LI Yi(Beijing Tongzhou District Maternal and Child Health Hospital,Beijing 101100,China)

机构地区：[1]北京市通州区妇幼保健院,北京101100

出　　处：《上海针灸杂志》2023年第11期1125-1129,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：北京市中医药管理局第六批北京市级中医药专家学术经验继承工作项目。

摘　　要：目的观察腹针联合枸橼酸氯米芬片对肝郁肾虚型排卵障碍性不孕症患者子宫内膜容受性、焦虑状态及妊娠结局的影响。方法将70例排卵障碍性不孕症患者随机分为A组和B组,每组35例。A组采用口服枸橼酸氯米芬片治疗,B组在A组的基础上采用腹针治疗。比较两组排卵率、未破裂卵泡黄素化综合征(luteinized unruptured follicle syndrome,LUFS)发生率、妊娠率及流产率,经阴道彩色多普勒B超测量两组排卵期子宫内膜的厚度和子宫动脉阻力指数(resistance index,RI),并采用焦虑自评量表(self-rating anxiety scale,SAS)评价患者的焦虑状态。结果B组的周期性排卵率高于A组,差异无统计学意义(P>0.05)。B组LUFS的发生率低于A组,差异有统计学意义(P<0.05)。B组妊娠率高于A组,流产率低于A组,差异有统计学意义(P<0.05)。B组子宫内膜厚度和A型子宫内膜的比例高于A组,子宫动脉RI低于A组,差异有统计学意义(P<0.05)。B组治疗后SAS评分低于治疗前和A组,差异有统计学意义(P<0.05)。结论腹针联合枸橼酸氯米芬片能提高排卵障碍性不孕症患者的妊娠率,降低流产率,其原因主要与腹针能减少LUFS发生率、促进卵泡生长排出、改善枸橼酸氯米芬片对子宫内膜容受性的抑制作用及改善患者的焦虑紧张情绪有关。Objective To observe the effects of abdominal acupuncture plus Clomifene citrate tablets on endometrial receptivity,anxiety,and pregnancy outcome in patients with anovulatory infertility of liver stagnation and kidney deficiency pattern.Method Seventy patients with anovulatory infertility were randomized into groups A and B,with 35 cases in each group.Group A was treated with oral administration of Clomifene citrate tablets,and group B was additionally intervened by abdominal acupuncture.The ovulation rate,incidence of luteinized unruptured follicle syndrome(LUFS),pregnancy rate,and miscarriage rate were compared;the thickness of endometrium during ovulation and uterine artery resistance index(RI)were determined by the transvaginal color Doppler ultrasound,and the self-rating anxiety scale(SAS)was used to assess the patient’s anxiety level.Result Group B had a higher periodic ovulation rate than group A,but the difference was statistically insignificant(P>0.05).The incidence of LUFS was lower in group B than in group A,presenting statistical significance(P<0.05).Group B had a higher pregnancy rate and a lower miscarriage rate than group A,both showing statistical significance(P<0.05).The endometrium was thicker,the A-type endometrium ratio was higher,and the uterine artery RI was lower in group B than in group A;the differences were all statistically significant(P<0.05).The SAS score dropped in group B after the treatment and was lower than that in group A(P<0.05).Conclusion The combining use of abdominal acupuncture and Clomifene citrate tablets can increase pregnancy rate and lower miscarriage rate in patients with anovulatory infertility;the mechanism may be related to the effects of abdominal acupuncture in lowering the incidence of LUFS,promoting follicle growth and excretion,improving the inhibition on endometrial receptivity,and reducing the patient’s anxiety.

关 键 词：腹针 针药并用 不孕症 不育 女性 子宫内膜容受性 焦虑 

分 类 号：R246.3[医药卫生—针灸推拿学]