经皮穴位电刺激对肝郁肾虚排卵障碍型不孕症患者的影响  

Influence of TEAS on Ovulatory Disorder Infertility Patients of Liver Depression and Kidney Deficiency Pattern

作　　者：杨柳[1] 方舟[2] 周雪源[2] 徐露 闻姬[2] YANG Liu;FANG Zhou;ZHOU Xueyuan;XU Lu;WEN Ji(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;The Second Affiliated Hospital to Shandong University of Traditional Chinese Medicine,Jinan 250013,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学第二附属医院,山东济南250013

出　　处：《西部中医药》2025年第3期144-148,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81771557)。

摘　　要：目的:通过监测外周血清及卵泡液中脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的含量变化,观察经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)对肝郁肾虚排卵障碍型不孕症患者体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的影响。方法:选择行IVF-ET的肝郁肾虚排卵障碍型不孕症患者160例,以是否接受TEAS分为观察组80例和对照组80例。两组均给予促排卵的基础治疗,对照组在此基础上采用安慰型韩式穴位神经刺激仪进行治疗,观察组则在促排卵的基础上给予LH202H型韩氏穴位神经刺激仪进行治疗。两组均治疗2个月经周期。观察两组中医证候评分变化情况、BDNF含量变化情况、促性腺激素(gonadotropin,Gn)使用情况和获卵数、妊娠结局及不良反应发生情况。结果:治疗后两组患者中医证候评分均比本组治疗前降低,且观察组降低更明显(P<0.05)。对照组治疗前后月经第3天血清中BDNF含量无明显变化(P>0.05);观察组治疗后月经第3天血清中BDNF含量高于治疗前(P<0.05),且末次月经第1天血清及卵泡液中BDNF含量高于对照组(P<0.05)。两组患者Gn用药天数无明显差异(P>0.05),但观察组Gn用量低于对照组(P<0.05);两组获卵数无明显差异(P>0.05),观察组受精率、优胚率、胚胎种植率、临床妊娠率、活产率均高于对照组,但差异无统计学意义(P>0.05)。结论:TEAS可上调肝郁肾虚排卵障碍型患者血清及卵泡液中BDNF的表达,改善患者症状,减少患者IVF-ET治疗过程中Gn用量,改善卵巢功能及妊娠结局。Objective:To observe the influence of transcutaneous electrical acupoint stimulation(TEAS)on in vitro fertilization-embryo transfer(IVF-ET)in patients with ovulatory disorder infertility of liver depression and kidney deficiency pattern by monitoring the contents of brain-derived neurotrophic factor(BDNF)in peripheral serum and follicular fluid.Methods:A total of 160 patients who accepted IVF-ET were selected as the subjects,and they were allocated to the observation group and the control group with 80 cases in each group according to whether they accepted TEAS,both groups accepted basic therapy of promoting ovulation,and the control group was treated with placebo-type Korean acupoint neural stimulation device based on the therapy the control group received,and the observation group was given the treatment of LH202H type Korean acupoint neural stimulation device on the foundation of Western medicine.Both groups were treated for two menstrual cycles,to observe TCM syndrome integrals,the contents of BDNF,the application of Gn,the number of the eggs received,pregnancy outcome and the incidence of adverse reactions between the two groups.Results:After the treatment,TCM syndrome integrals in the two groups were lower than these before the treatment within the same group,and the observation group was reduced more evidently(P<0.05).No significant change was found in the contents of BDNF before and after the treatment on the third day of menstruation within the control group(P>0.05);the contents of BDNF after the treatment were higher than these before the treatment in the observation group(P<0.05),and the contents of BDNF in the serum and follicular fluid on the first day of the last menstruation were higher than these in the control group(P<0.05).There was no significant difference in the days of Gn administration between both groups(P>0.05),while the dose of Gn in the observation group was lower than that of the control group(P<0.05);and no obvious difference was seen in the number of the eggs received between both gr

关 键 词：不孕症 肝郁肾虚 排卵障碍 脑源性神经营养因子 经皮穴位电刺激 体外受精-胚胎移植 

分 类 号：R271[医药卫生—中医妇科学]