电针对多囊卵巢综合征患者卵子质量及妊娠结局的影响

Effects of Electroacupuncture Intervention on Changes of Quality of Ovum and Pregnancy Outcome in Patients with Polycystic Ovarian Syndrome

目的:观察电针对多囊卵巢综合征(PCOS)患者卵子质量、干细胞因子(SCF)及妊娠结局的影响,并探讨其作用机制。方法:将接受体外受精-胚胎移植(IVF-ET)的PCOS患者200例按照随机数字表法分为电针组(102例)、对照组(98例),电针组在超促排卵过程中加电针干预,取肾俞、气海、足三里、三阴交、内关、子宫穴,每次30min,每日1次。比较两组患者血清、卵泡液SCF水平,获卵数,受精率,卵裂率,优质胚胎率(优胚率),临床妊娠率,卵巢过度刺激综合征发生率,周期取消率,早期流产率,促性腺激素(Gn)用药量及时间,SCF与优胚率的相关性。结果:1电针干预可显著提高PCOS患者的优胚率(P<0.05),并将临床妊娠率提高8.36%;2电针干预可显著提高血清及卵泡液SCF水平(P<0.01);3妊娠患者血清、卵泡液SCF水平均高于非妊娠患者(P<0.05);4电针组Gn用量及用药时间明显少于对照组(P<0.05);5血清及卵泡液SCF水平与优胚率呈显著正相关性(P<0.01)。结论:电针能够改善PCOS患者卵子质量,提高IVF-ET的临床妊娠率,其机制可能与SCF水平有关。

Objective To observe the effect of electroacupuncture （EA） treatment on the quality of ovum, stem cell factor（SOF） and the pregnancy outcome in patients with polycystic ovarian syndrome （POOS）, so as to explore its mechanism underlying improving pregnancy rate. Methods A total of 200 PCOS patients undergoing in vitro fertilization-embryo transplanta- tion （IVF-ET） were randomly divided into control （medication） group （n =98） and EA group （n = 102）. For patients of the EA group who were undergoing controlled ovarian hyperstimulation, EA stimulation （5 Hz/20 Hz, 15-20 V） was applied to bilateral Shenshu （BL 23）, Qihai （OV 6）, bilateral Zusanli （ST 36）-Sanyinjiao （SP 6）, and bilateral Neiguan （PC 6）-Zigong （EX-OA 1 ） for 30 min, once daily till accepting embryo transplant. Patients of the medication group were treated with controlled ovarian hyperstimulation using Diane-35, Decepepty, Gonadotrophin, human Ohorionic Gonadotrophin, etc. Serum follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, estradiol （E2）, and progesterone （P） contents were detected using chemilu- minescent method. SCF contents in the serum and follicular fluid were assayed by ELISA. The number of retrieved oocytes, fertilization rate, cleavage rate, high quality embryo rate, ovarian hyperstimulation syndrome （OHSS） incidence rate, cycle cancella- tion rate, cli-nical pregnancy rate, early abortion rate, Gn dosage and administration duration, and the correlation between the high quality embryo rate and SCF level were determined. Results Comparison between the two groups showed that the high quality embryo rate, and serum and follicular fluid SCF contents were significantly higher in the EA group than inrthe medication group （P〈0.05, P〈0.01 ）, while the dosage and administration duration of Gn were significantly lower in the EA group than in the medication group （P〈0.05）. A positive correlation was found between the high quality embryo rate and the SCF level in both follicular fluid and serum （ P〈0.01 ）. No significant differences were found between the two groups in the number of retrieved oocytes, fertilization rate,cleavage rate, clinical pregnancy rate, OHSS incidence rate, cycle cancellation rate, early abortion rate, serum LH, E2 and P contents （P〈0.05）. Conclusion EA can improve the high quality embryo rate, which may be related to its effect in increasing serum and follicular fluid SOF levels.