卵巢储备功能减退患者中医证候特征与卵巢功能及体外受精与胚胎移植结局关系  

Relationship between traditional Chinese medicine syndrome and ovarian function,in vitro fertilization and embryo transfer outcomes in patients with diminished ovarian reserve

作　　者：辛喜艳[1] 魏佳俐 高宇 祝雨田 徐静[1] 张家诚 胡航绮 叶阳 李东[1] XIN Xiyan;WEI Jiali;GAO Yu;ZHU Yutian;XU Jing;ZHANG Jiacheng;HU Hangqi;YE Yang;LI Dong(Department of Traditional Chinese Medicine,Peking University Third Hospital,Beijing 100191,China;Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京大学第三医院中医科,北京100191 [2]北京中医药大学第三附属医院,北京100029

出　　处：《中华中医药杂志》2024年第11期6113-6118,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82074193);首都卫生发展科研专项项目(No.2022-2-4097);北京大学第三医院院队列建设项目(No.BYSYDL2022013);中华中医药学会求实项目(No.2023-QNQS-14)。

摘　　要：目的:研究卵巢储备功能减退(DOR)患者中医证候特征与卵巢功能及体外受精与胚胎移植(IVF-E T)结局的关系。方法:以2021年5月至2023年5月就诊于北京大学第三医院中医科的169例D OR患者为研究对象,调查患者临床信息并随访IVF-ET结局。对患者一般特征、中医证候特征、卵巢功能及IVF-ET结局进行Logistic回归分析及关联分析可视化。结果:中医症状频数较高者为怕冷或四肢偏凉[147例(86.98%)]、易困倦[141例(83.43%)]和脱发明显[138例(81.66%)];肾虚证+脾虚证组合占比最高[67例(39.64%)],其次为脾虚证+痰湿证[31例(18.34%)]与肾虚证+血瘀证[28例(16.57%)]。不同证候组合卵泡刺激素(FSH)差异有统计学意义(P<0.05),肝郁证+血瘀证组FSH水平偏高;每日睡眠时间≤6 h与窦卵泡数(AFC)≤5个、抗米勒管激素(AMH)≤1.1 ng/mL、FSH>10 mIU/mL关联程度较大,心理状况≥3分及久坐时间≥6 h与AMH≤1.1 ng/mL关联程度较大。结论:DOR患者睡眠时间、心理状况及中医证候特征与卵巢功能可能存在一定相关性,但不直接影响IVE-ET结局。Objective:To study the relationship between traditional Chinese medicine syndrome characteristics,ovarian function,and in vitro fertilization and embryo transfer(IVF-ET)outcomes in patients with diminished ovarian reserve(DOR).Methods:A total of 169 DOR patients who visited the Department of Traditional Chinese Medicine,Peking University Third Hospital from May 2021 to May 2023 were selected as the research subjects.Clinical information of the patients was investigated and IVF-ET outcomes were followed up.Perform logistic regression analysis and correlation analysis visualization on the general characteristics of patients,traditional Chinese medicine syndrome characteristics,ovarian function,and IVF-ET outcomes.Results:The frequency of symptoms in traditional Chinese medicine was relatively high,with a fear of cold or cold limbs[147(86.98%)],susceptibility to drowsiness[141(83.43%)],and significant hair loss[138(81.66%)];The combination of kidney deficiency syndrome and spleen deficiency syndrome had the highest proportion[67(39.64%)],followed by the combination of spleen deficiency syndrome and phlegm dampness syndrome[31(18.34%)]and the combination of kidney deficiency syndrome and blood stasis syndrome[28(16.57%)].There were statistical differences in FSH levels among different syndrome combinations(P<0.05),with the combination of liver depression syndrome and blood stasis syndrome group having higher FSH levels;The correlation between sleep time≤6 h and AFC≤5,AMH≤1.1 ng/mL,and FSH>10 mIU/mL was greater,and the correlation between psychological score≥3 and sedentary time≥6 h with AMH≤1.1 ng/mL was greater.Conclusion:There may be a certain correlation between sleep time,mental health status,traditional Chinese medicine syndrome characteristics,and ovarian function in DOR patients,but it does not directly affect the outcome of IVE-ET.

关 键 词：卵巢储备功能减退 中医证候 体外受精与胚胎移植 肝郁证 血瘀证 

分 类 号：R271.9[医药卫生—中西医结合]