分期针灸配合药物对多囊卵巢综合征排卵率和妊娠率的影响  

Effects of staged acupuncture-moxibustion plus medication on ovulation and pregnancy rates in polycystic ovary syndrome

作　　者：庄海娜 徐金龙 邢利威 何喆 梅瑞 杨泽冠 李育红 赵荣 ZHUANG Haina;XU Jinlong;XING Liwei;HE Zhe;MEI Rui;YANG Zeguan;LI Yuhong;ZHAO Rong(Yunnan University of Traditional Chinese Medicine,Kunming 650500,China;Chuxiong Yi Autonomous Prefecture Traditional Chinese Medicine Hospital,Chuxiong 675000,China;Yunnan Maternal and Child Health Care Hospital,Kunming 650051,China;The Cooperation of Chinese and Western Medicine Hospital of Yunnan Province,Kunming 650000,China;Dali Nursing Vocational College,Dali 671006,China)

机构地区：[1]云南中医药大学,昆明650500 [2]楚雄彝族自治州中医医院,楚雄675000 [3]云南省妇幼保健院,昆明650051 [4]云南省中西医结合医院,昆明650000 [5]大理护理职业学院,大理671006

出　　处：《上海针灸杂志》2024年第10期1056-1062,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：云南省科技厅应用基础研究联合重点项目(2019FF002-004);楚雄医学高等专科学校-校本课题(2020YYXM04);兴滇人才计划支持项目云南省“万人计划”名医专项(YNWR-MY-2018-052);云南省中医药科技资源开放共享公共科技服务平台;云南省中医药领军人才项目。

摘　　要：目的观察分期针灸配合药物对多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕患者排卵率和妊娠率的影响。方法将72例PCOS不孕患者随机分为观察组和对照组,每组36例。对照组自月经周期第5天或黄体酮撤退性出血的第5天开始口服枸橼酸氯米芬片促排,观察组在对照组基础上从月经周期第1天或黄体酮撤退性出血的第1天接受基于“冲为血海”的分期针灸治疗。观察两组治疗前后各项血清性激素[促黄体生成素(luteinizing hormone,LH)、促卵泡激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E2)、睾酮(testosterone,T)]水平变化情况,比较人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)日平均子宫内膜厚度及周期排卵率、妊娠率。结果观察组治疗后FSH、LH、T水平较之前不同程度的降低,E2水平较之前升高,且各指标数据差异有统计学意义(P<0.05)。对照组治疗后LH、T水平较之前不同程度的降低,E2水平较之前升高,且各指标数据差异有统计学意义(P<0.05)。两组治疗后各项血清性激素水平差异有统计学意义(P<0.05)。此外,组间对比分析可知观察组HCG日平均内膜厚度更佳,且两组数据差异有统计学意义(P<0.05)。两组治疗后周期排卵率和妊娠率比较,差异有统计学意义(P<0.05)。结论基于“冲为血海”的分期针灸配合药物能明显提高PCOS不孕患者周期排卵率和妊娠率,其作用机制可能为降低患者LH、T水平,上调E2水平,同时改善HCG日子宫内膜厚度。Objective To observe the effects of staged acupuncture-moxibustion plus medication on ovulation and pregnancy rates in patients with polycystic ovary syndrome(PCOS).Method Seventy-two PCOS patients suffering from infertility were randomly allocated to an observation group and a control group,with 36 cases in each group.The control group started to receive oral Clomiphene citrate tablets since the 5th day of the menstrual cycle or progesterone withdrawal bleeding to promote ovulation.In addition to the treatment in the control group,the observation group was offered staged acupuncture-moxibustion treatment from the 1st day of the menstrual cycle or progesterone withdrawal bleeding based on the theory that“the Thoroughfare Vessel is the sea of blood”.The two groups were observed for changes in serum sex hormone levels[luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E2),and testosterone(T)]before and after the treatment,and the average endometrium thickness based on human chorionic gonadotropin(HCG),ovulation rate,and pregnancy rate were also compared.Result After the treatment,the observation group showed decreased levels of FSH,LH,and T and an increased E2 level,all showing statistical significance(P<0.05);the control group had decreased levels of LH and T and an increased E2 level,showing statistical significance(P<0.05).There were statistical differences in the serum sex hormone levels between the two groups after the intervention(P<0.05).Besides,the between-group comparison and analysis indicated that the observation group had better HCG-based average endometrium thickness,and the between-group difference was statistically significant(P<0.05).There were statistical differences in the ovulation and pregnancy rates between the two groups after the treatment(P<0.05).Conclusion Staged acupuncture-moxibustion,based on the theory that“the Thoroughfare Vessel is the sea of blood”,plus medication can enhance the ovulation and pregnancy rates in infertile PCOS patients,and the mechanism possi

关 键 词：针灸疗法 多囊卵巢综合征 不育 女性 不孕症 冲为血海 性激素 

分 类 号：R246.3[医药卫生—针灸推拿学]