针药结合治疗抗米勒管激素相关卵泡发育障碍性不孕症疗效观察  

Therapeutic Effect of Acupuncture and Moxibustion Combined with Medicine on Infertility with Anti-Müllerian Hormone-related Follicular Dysplasia

作　　者：施冬青[1] 唐艳[1] 唐李梅[1] 张庆[1] 陈冬梅[1] 邢玉[2] 万朝霞[1] SHI Dongqing;TANG Yan;TANG Limei;ZHANG Qing;CHEN Dongmei;XING Yu;WAN Zhaoxia(Nantong Hospital of Traditional Chinese Medicine,Nantong 226000,China;Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100071,China)

机构地区：[1]南通市中医院,南通226000 [2]北京中医药大学附属东方医院,北京100071

出　　处：《世界中医药》2023年第24期3567-3571,共5页World Chinese Medicine

基　　金：国家自然科学基金青年基金项目(81904241);南通市卫生健康委员会青年基金项目(QA2019020)。

摘　　要：目的:观察针药结合治疗抗米勒管激素(AMH)相关卵泡发育障碍性不孕症的临床效果。方法:选取符合纳入标准的肾虚肝郁型AMH相关卵泡发育障碍性不孕症120例作为研究对象,其中多囊卵巢综合征(PCOS)患者60例,卵巢早衰(POF)患者60例,将2类患者分别随机分为观察组和对照组,每组30例。观察组给予中药补肾疏肝方联合针灸治疗,对照组给予枸橼酸氯米芬片治疗,疗程为3个月经周期。观察各组治疗前后排卵情况、促黄体素(LH)、促卵泡素(FSH)、雌二醇(E_(2))、睾酮(T)、AMH和、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、三酰甘油(TG)。结果:PCOS患者2组的LH、T、AMH水平较治疗前明显下降,E_(2)水平较治疗前明显升高(均P<0.05),观察组FSH水平较治疗前升高(P<0.05),且观察组在改善LH、AMH水平方面明显优于对照组(均P<0.05)。POF患者观察组LH、FSH水平较治疗前明显下降,E_(2)、AMH水平较治疗前明显升高(均P<0.05)。PCOS及POF患者观察组HDL水平较治疗前均升高,TC、LDL、TG水平较治疗前均下降(均P<0.05)。观察组妊娠率高于对照组,流产率低于对照组(均P<0.05)。结论:针药结合治疗肾虚肝郁型的AMH相关卵泡发育障碍性不孕症患者疗效显著,能改善内分泌状况,降低血脂水平,提高临床妊娠率,降低流产率。Objective:To observe the clinical effect of acupuncture and moxibustion combined with medicine in the treatment of infertility with anti-Müllerian hormone(AMH)-associated follicular dysplasia.Methods:A total of 120 patients of infertility with AMH-related follicular dysplasia and kidney deficiency and liver depression who conformed to the inclusion criteria were selected.Among them,60 patients had polycystic ovary syndrome(PCOS),and 60 had premature ovarian failure(POF).The two kinds of patients were randomly divided into observation group and control group,30 in each group.The observation group was treated with Bushen Shugan Prescription combined with acupuncture and moxibustion,while the control group was given Clomiphene Citrate Tablets.The course of treatment was 3 menstrual cycles.Ovulation,Luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E_(2)),testosterone(T),AMH,fasting blood glucose(FPG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),and triacylglycerol(TG)of each group before and after treatment were observed.Results:The LH,T and AMH in PCOS patients of both groups were lower,while E_(2) was higher than those before treatment(all P<0.05),and the FSH in the observation group was higher than that before treatment(P<0.05).The observation group was better than the control group in the improvement of LH and AMH(both P<0.05).The LH and FSH of POF patients in the observation group decreased after treatment compared with the conditions before treatment,while E_(2) and AMH increased(all P<0.05).The HDL of PCOS and POF patients in the observation group was elevated compared with the conditions before treatment,while TC,LDL and TG were lowered(all P<0.05).The pregnancy rate of the observation group was higher and the abortion rate was lower than those of the control group(both P<0.05).Conclusion:Acupuncture and moxibustion combined with medicine has a significant therapeutic effect on the infertility with AMH-related follicular dysplasia and kidney deficiency a

关 键 词：补肾疏肝方 针灸 枸橼酸氯米芬片 肾虚肝郁型 抗米勒管激素相关卵泡发育障碍 多囊卵巢综合征 卵巢早衰 临床疗效 

分 类 号：R246[医药卫生—针灸推拿学] R271.14[医药卫生—中医临床基础]