针刺联合穴位贴敷治疗复发性流产临床研究  

Clinical Study on Acupuncture Combined with Acupoint Application for Recurrent Spontaneous Abortion

作　　者：李婷[1] 孙云[1] 胡欣欣[1] 诸小丽 LI Ting;SUN Yun;HU Xinxin;ZHU Xiaoli(Department of Gynecology,Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院妇科,浙江温州325000

出　　处：《新中医》2024年第14期101-106,共6页New Chinese Medicine

基　　金：温州市科技局重大科技创新攻关项目(ZY2022014)。

摘　　要：目的:观察针刺联合穴位贴敷对复发性流产患者子宫内膜容受性、T淋巴细胞亚群及炎性因子的影响。方法:选取2022年6月—2023年8月浙江中医药大学附属温州市中医院收治的72例复发性流产患者,按照随机数字表法分为试验组、对照组各36例。2组均予以常规西药治疗,对照组联用穴位贴敷治疗,试验组在对照组基础上联合针刺治疗,2组均治疗30 d。比较2组治疗前后中医证候积分、子宫内膜容受性指标、T淋巴细胞亚群、炎症因子水平,评估2组临床疗效、妊娠成功率及不良反应发生情况。结果:研究期间,试验组剔除2例,最终纳入研究34例;对照组剔除3例,最终纳入研究33例。治疗后,试验组总有效率88.24%,高于对照组66.67%(P<0.05)。2组中医证候积分、阻力指数(RI)、搏动指数(PI)及血清CD8^(+)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)水平均低于治疗前(P<0.05),且试验组中医证候积分、RI、PI及血清CD8^(+)、IL-2、IL-4、IL-17水平低于对照组(P<0.05)。治疗后,2组子宫内膜厚度、血清CD4^(+)、CD4^(+)CD25^(+)、白细胞介素-10(IL-10)水平及CD4^(+)/CD8^(+)均较治疗前升高(P<0.05),且试验组上述指标高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。随访至孕12周,试验组妊娠成功率55.88%,高于对照组30.30%,差异有统计学意义(P<0.05)。结论:针刺联合穴位贴敷治疗复发性流产疗效确切,能够改善患者子宫内膜容受性与免疫功能,降低炎症反应,安全性较高。Objective:To observe the effect of acupuncture combined with acupoint application on endometrial receptivity,T lymphocyte subsets and inflammatory factors in patients with recurrent spontaneous abortion.Methods:A total of 72 patients with recurrent spontaneous abortion admitted to Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from June 2022 to August 2023 were selected and divided into the trial group and the control group according to the random number table method,with 36 cases in each group.Both groups were treated with routine western medicine;the control group was additionally treated with acupoint application,and the trial group was additionally treated with acupuncture based on the treatment of the control group.Both groups were treated for 30 days.The traditional Chinese medicine(TCM)syndrome scores,endometrial receptivity indicators,and levels of T lymphocyte subsets and inflammatory factors were compared before and after treatment between the two groups.The clinical effects,pregnancy success rate and incidence of adverse reactions were evaluated in the two groups.Results:During the study,two cases were excluded from the trial group,and ultimately 34 cases were included in the study;three cases were excluded from the control group,and 33 cases were ultimately included in the study.After treatment,the total effective rate was 88.24%in the trial group,higher than that of 66.67%in the control group(P<0.05).The TCM syndrome scores,blood flow resistance index(RI),pulsatility index(PI),and levels of CD8^(+),interleukin-2(IL-2),interleukin-4(IL-4),and interleukin-17(IL-17)in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome score,RI,PI,and levels of CD8^(+),IL-2,IL-4,and IL-17 in serum in the trial group were lower than those in the control group(P<0.05).After treatment,the endometrial thickness,and levels of CD4^(+),CD4^(+)CD25^(+),interleukin-10(IL-10),and CD4^(+)/CD8^(+)in serum in the two groups were increased

关 键 词：复发性流产 针刺 穴位贴敷 子宫内膜容受性 T淋巴细胞亚群 炎症反应 

分 类 号：R714.21[医药卫生—妇产科学]