穴位埋线联合人工周期疗法治疗卵巢早衰:随机对照研究

Premature ovarian failure treated with acupoint catgut implantation and artificial periodic therapy: a randomized controlled trial

目的:比较穴位埋线联合人工周期疗法与单纯人工周期疗法治疗卵巢早衰的疗效差异,并探讨其作用机制。方法:将65例卵巢早衰患者随机分为两组。西药组32例,采用口服安宫黄体酮片等西药人工周期疗法;埋线西药组33例,采用穴位埋线联合人工周期疗法治疗,穴位埋线穴取内关、足三里、关元、三阴交为主,两组均连续治疗半年、随访半年。根据Kupperman指数(MI)评分法评定临床症状的改善情况,于治疗前后对患者血清促卵泡素(FSH)及雌二醇(E2)等血清性激素水平进行评估,并比较两组疗效。结果:两组治疗后、随访时临床症状评分均显著改善(P<0.01,P<0.05),治疗后6个月随访时埋线西药组优于西药组(8.17±1.19vs 13.68±1.08,P<0.01);两组治疗后FSH降低(均P<0.01)、E2升高(均P<0.05);埋线西药组治疗后及随访愈显率分别为75.8%(25/33)和81.8%(27/33),优于西药组的67.9%(19/28)、53.6%(15/28,P<0.05,P<0.01)。结论:穴位埋线联合人工周期疗法对改善卵巢早衰患者的临床症状有明显作用,优于单纯西药治疗,且疗效稳定,远期效果明显占优,其机制与改善血清性激素水平有关。

Objective To compare the difference in the clinical efficacy on premature ovarian failure （POF） be- tween the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism. Methods Sixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral ad- ministration of medroxyprogesterone acetate tablets. In a catgut implantation ^- western medication group, 33 ca- ses were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan （PC 6）, Zusanli （ST 36）, Guanyuan （CV 4） and Sanyinjiao （SP 6） were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone （FSH） and estradiol （E2） were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups. Results The scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups （P〈0.01, P〈0. 05）. In the 6-month follow-up visit after treatment, the result in the catgut implantation ＋ western medication group was better than that in the western medication group （8.17±1.19 vs 13.68±1.08, P〈0.01）. FSH was reduced after treatment in the two groups （all P〈0.01） and E2 was increased （all P〈0.05）. The curative and remarkably effective rates were 75.8% （25/33） and 81.8% （27/22） after treatment and in the follow-up visit in the catgut im- plantation ＋ western medication group, which were better than 67.9% （19/28） and 53.6% （15/28） in the wes- tern medication group separately （P〈0.05, P〈0.01）. Conclusion The acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.