温针灸对肾阳虚型高龄患者试管婴儿成功率及对患者月经和子宫内膜厚度的影响

A Randomized Controlled Study on the Success Rate of Warm Acupuncture on Tube Baby in Elderly Patients with Kidney-Yang Deficiency and its Effect on Menstruation and Endometrial Level

目的:探讨温针灸对肾阳虚型高龄患者试管婴儿成功率、月经和子宫内膜水平的影响。方法:选取2015年1月至2016年12月三亚市人民医院收治的高龄不孕不育症患者68例作为研究对象,随机分为对照组和观察组,每组34例。对照组采用Gn-RH-/PSH-r/HMG/HCG超排卵长方案进行体外受精-胚胎移植(IVF-ET)治疗,观察组在上述治疗的基础上联合温针灸进行治疗,连续治疗3个月,待子宫内膜水平稳定后进行胚胎移植。比较2组治疗前后肾阳虚症状积分及月经情况积分变化,治疗前后检测并比较2组子宫内膜改善情况及性激素水平,观察治疗后2组临床疗效及妊娠结局。结果:治疗后观察组和对照组的治疗有效率分别为90.32%、50.00%,观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后2组肾阳虚症状积分及月经情况积分明显降低,且观察组低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后观察组子宫内膜厚度明显增高,子宫内膜A型患者比例及血清E 2和P水平明显升高,且均高于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床妊娠率明显高于对照组(P<0.05),2组生化妊娠及早孕流产率,差异无统计学意义(P>0.05)。结论:温针灸可明显提高肾阳虚型高龄患者试管婴儿临床妊娠成功率,可能与改善患者肾阳虚体征,调节患者月经情况及子宫内膜厚度有关。

Objective:To investigate the effects of warm acupuncture on the success rate of tube baby,menstruation and endometrial level in elderly patients with kidney-yang deficiency.Methods:A total of 68 cases of elderly infertility patients in Sanya Municipal People′s Hospital from Jan.2015 to Dec.2016 were selected and randomly divided into an observation group and a control group,with 34 cases in each group.The control group was treated with Gn-RH-/PSH-r/HMG/HCG superovulation program for in vitro fertilization and embryo transfer(IVF-ET);and the observation group combined with warm acupuncture for treatment on the basis of the control group,and continuously treated for 3 months.The 2 groups were performed embryo transfer after the level of endometrium was stabilized.The scores of kidney-yang deficiency syndrome and the change of menstrual status before and after treatment were compared between the 2 groups.The endometrium improvement and sex hormone levels were detected and compared between the 2 groups before and after treatment.The clinical efficacy and outcome of pregnancy of the 2 groups were observed after the treatment.Results:After treatment,the total effective rate of the observation group and the control group were 90.32%,50.00%respectively,and the total efficiency of the observation group was significantly higher than that of the control group(P<0.01).After treatment,the scores of kidney-yang deficiency syndrome and menstruation in the 2 groups were obviously decreased than before treatment,and the observation group was lower than those of the control group(P<0.01).Compared with before treatment,the endometrial thickness,the proportion of endometrial type A and serum E 2 and P levels increased significantly in the observation group,and which were higher than those in the control group(P<0.01).After treatment,the clinical pregnancy rate in the observation group was significantly higher than that in the control group(P<0.05),and there was no significant difference between the 2 groups in biochemical pregnancy rate and early pregnancy miscarriage rate(P>0.05).Conclusion:Warm acupuncture can improve the success rate of clinical pregnancy in elderly patients with kidney-yang deficiency.It may be related to the improvement of the symptoms of kidney-yang deficiency,the regulation of menstruation and the endometrial level.