电针联合吲哚美辛栓在经阴道超声引导下穿刺取卵术中镇痛作用的临床研究  

Clinical Study on the Analgesic Effect of Electroacupuncture Combined with Indomethacin Suppository in Transvaginal Ultrasound-Guided Oocyte Retrieval

作　　者：王怡心 殷燕云[2] 寇玉佳 董雨萌 张燕妮 高志浩 刘小翠 WANG Yixin;YIN Yanyun;KOU Yujia;DONG Yumeng;ZHANG Yanni;GAO Zhihao;LIU Xiaocui(The First School of Clinical Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学第一临床医学院,江苏南京210023 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《南京中医药大学学报》2024年第6期628-632,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：江苏省中医药科技发展专项项目(2020ZX02)。

摘　　要：目的观察电针合谷、内关联合吲哚美辛栓治疗对经阴道超声引导下穿刺取卵术(TUGOR)患者的辅助镇痛作用及对体外受精(IVF)结局的影响。方法64例接受TUGOR的IVF-ET患者随机分成治疗组和对照组各32例,治疗期间治疗组脱落1例。对照组予吲哚美辛栓直肠给药,治疗组在对照组治疗基础上加予电针合谷、内关治疗。TUGOR术前后评估患者压痛阈值、VAS评分、疼痛等级、呼吸频率、脉搏次数;TUGOR术后评估2组患者获卵数、2个卵原核(2PN)率、胚胎利用率、优质胚胎率;术中及术后监测2组患者不良反应发生情况。结果TUGOR术后,治疗组VAS评分和疼痛等级明显低于对照组(P<0.01);2组患术后者压痛阈值均明显降低(P<0.05,P<0.01),治疗组优于对照组(P<0.05);治疗组在术中的恶心发生率,术后48 h的腹胀、恶心发生率均优于对照组(P<0.05);治疗组优质胚胎率优于对照组(P<0.05)。结论电针合谷、内关联合吲哚美辛栓可有效辅助镇痛,不同程度减轻患者TUGOR术中及术后不良反应发生率,并在提高优质胚胎率上可能具有一定优势。OBJECTIVE To observe the auxiliary analgesic effect of electroacupuncture at Hegu and Neiguan combined with indomethacin suppository in patients undergoing transvaginal ultrasound-guided oocyte retrieval(TUGOR)and its effect on the outcome of in vitro fertilization(IVF).METHODS 64 IVF-ET patients undergoing TUGOR were randomly divided into a treatment group and a control group,32 cases in each group.One case dropped out of the treatment group during the treatment.The control group was given indomethacin suppository rectal administration,and the treatment group was given electroacupuncture at Hegu and Neiguan in addition to the treatment of the control group.The patients’tenderness threshold,VAS score,pain grade score,respiratory rate,and pulse rate were evaluated before and after TUGOR operation.The number of oocytes obtained,the rate of two pronuclei(2PN),embryo utilization rate,and high-quality embryo rate were evaluated after TUGOR operation.The adverse reactions of the two groups were monitored during and after operation.RESULTS After TUGOR operation,the VAS score and pain grade of the treatment group were significantly lower than those of the control group(P<0.01);the tenderness threshold of the two groups was significantly reduced after operation(P<0.05,P<0.01),and the treatment group was better than the control group(P<0.05);the incidence of nausea during operation,abdominal distension and nausea 48 h after operation in the treatment group were better than those in the control group(P<0.05);the high-quality embryo rate in the treatment group was better than that in the control group(P<0.05).CONCLUSION Electroacupuncture at Hegu and Neiguan combined with indomethacin suppository can effectively assist in analgesia,and can reduce the incidence of adverse reactions during and after TUGOR to varying degrees,and may have certain advantages in improving the rate of high-quality embryos.

关 键 词：体外受精-胚胎移植 经阴道超声引导下穿刺取卵术 电针 压痛阈 针刺镇痛 合谷 内关 

分 类 号：R271.4[医药卫生—中医妇科学]