温针灸治疗甲状腺自身抗体阳性不明原因不孕症临床研究

Clinical Research of Warm Acupuncture in the Treatment of Unexplained Infertility with ATA Positive

目的:研究甲状腺自身抗体(ATA)阳性与不明原因不孕症之间的关系,初步探讨温针灸治疗对ATA阳性不明原因不孕症的临床疗效。方法:分别检测不明原因不孕症非妊娠妇女192例(研究组),有正常妊娠史非妊娠健康妇女112例(对照组)的ATA水平[包括抗甲状腺过氧化物酶抗体(TPO-Ab)、抗甲状腺球蛋白抗体(TG-Ab)];对不明原因不孕症患者中ATA阳性的患者进行分组,25例不做任何治疗,30例进行温针灸治疗,并比较治疗前后的ATA水平,随访2组妊娠情况。结果:不明原因不孕症患者TG-Ab阳性率为18.2%,TPO-Ab阳性率为27.1%,ATA阳性率为30.2%,均显著高于对照组的抗体阳性率(5.4%、8%、10.7%)(P<0.01);温针灸治疗组治疗后2种甲状腺自身抗体水平均明显低于治疗前(P<0.01);治疗组妊娠率为16.7%,未治疗组妊娠率为8%,2者比较无明显差异(P>0.05)。结论:TG-Ab和TPO-Ab阳性是导致不明原因不孕症的可能原因之一;温针灸治疗能有效降低ATA水平,值得临床推广应用。

Objective： To study the relationship between thyroid autoantibodies（ATA） positive and unexplained infertility, and to explore the clinical efficacy of warm acupuncture moxibustion on ATA positive unexplained infertility.Methods： 192 non-pregnant women with unexplained infertility（research group）, ATA levels in 112 non-pregnant women with normal pregnancy history（control group）（including anti-thyroid peroxidase antibody（TPO-Ab） and antithyroglobulin antibody（TG-Ab）]. ATA-positive patients in the group of unexplained infertility were grouped, 25 patients were treated without any treatment, 30 patients were treated with warm acupuncture, and ATA levels before and after treatment were compared. The pregnancy status of the two groups was followed. Results： The positive rate of TGAb in unexplained infertility patients was 18.2%, the positive rate of TPO-Ab was 27.1%, and the positive rate of ATA was 30.2%, which was significantly higher than that of the control group（5.4%, 8%）. 10.7%）（P〈0.01）. The autoantibody levels of the two thyroid glands in the warm acupuncture and moxibustion treatment group were significantly lower than those before treatment（P〈0.01）. The pregnancy rate was 16.7% in the treatment group and 8% in the untreated group. There was no significant difference between the two groups（P〉0.05）. Conclusion： Positive TG-Ab and TPO-Ab are one of the possible causes of unexplained infertility. Warm acupuncture and moxibustion treatment can effectively reduce ATA levels and is worthy of clinical application.