针药联合治疗对高龄肾虚型备孕妇女的影响

Effect of Combination of Acupunture and Drug on Advanced Maternal Age Kidney Deficiency Women in Preparing for Pregnancy

【目的】观察针药联合治疗对肾虚型高龄备孕妇女临床症状、妊娠率及生活质量的影响。【方法】将50例肾虚型的高龄备孕妇女随机分为观察组和对照组,每组各25例。对照组给予复合维生素片+叶酸片口服,观察组在对照组治疗的基础上,给予复方左归胶囊口服联合腹针治疗,连续治疗3个月。治疗3个月后,观察2组患者治疗前后肾虚积分与月经积分的变化情况,比较2组患者治疗前后健康状况调查问卷(SF-36)各项评分的变化情况并对SF-36评分进行Logistic回归分析以评估干预效果。记录2组患者第3、6个月期间宫内妊娠、异位妊娠人次,并计算怀孕率。【结果】(1)治疗后,观察组患者的月经积分、肾虚积分均明显改善,与同组治疗前比较,差异有统计学意义(P<0.05),且观察组在改善月经积分、肾虚积分方面均明显优于对照组,差异有统计学意义(P<0.05)。2组患者月经积分、肾虚积分治疗前后差值比较,观察组明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的SF-36各项指标评分及总分均较治疗前明显改善(P<0.05),且观察组在改善SF-36各项指标评分及总分方面均明显优于对照组,差异有统计学意义(P<0.05)。2组患者总体健康GH、活力VT、心理健康MH、生理健康PH(总)、心理健康MH(总)以及总分治疗前后差值比较,差异均有统计学意义(P<0.05)。(3)观察组怀孕率为48.0%(12/25),对照组为16.0%(4/25)。观察组怀孕率高于对照组,差异有统计学意义(P<0.05)。(4)Logistic回归分析显示:生理功能PF评分和心理健康MH评分能显著影响干预后怀孕率。且生理功能PF评分与怀孕呈负相关,PF评分越高,则患者怀孕的概率越低。生理功能PF评分高怀孕的概率是生理功能PF评分低患者的0.777倍。心理健康MH评分与怀孕呈正相关,MH评分越高,则患者怀孕的概率越大。心理健康MH评分高怀孕的概率是心理健康MH评分低患者的1.443倍。【结论】针药联合治疗高龄肾虚型备孕妇女,能够有效地改善高龄肾虚妇女的生理及心理状况,改善肾虚症状并提升妊娠率,从而提高患者生活质量,疗效显著。

Objective To observe the effect of combination of acupunture and drug on clinical symptoms,pregnancy rate and quality of life in advanced maternal age kidney deficiency women in preparing for pregnancy.Methods Fifty cases of advanced maternal age kidney deficiency women in preparing for pregnancy were randomly divided into observation group and control group,25 cases in each group. The two groups received oral use of complex vitamin tablets and folic acid tablets, and additionally, the treatment group received oral use of compound Zuogui Capsules combined with abdominal acupuncture,the treatment lasting 3 months. After 3 months of treatment,the changes in kidney deficiency symptom score and menstruation symptom score were observed in the two groups before and after treatment,changes in 36-item short form health survey questionnaire(SF-36)score were compared in the two groups before and after treatment and then given Logistic regression analysis to evaluate the intervention effect. The occurrence of uterine pregnancy and ectopic gestation during 3,6 months was recorded in the two groups,and the pregnancy rate was calculated. Results(1)After treatment,the menstruation symptom score and kidney deficiency symptom score were improved in the observation group(P<0.05 as compared with those of the same group before treatment),and the improvement in menstruation symptom score and kidney deficiency symptom score of the observation group was superior to that of the control group(P<0.05). The difference values for menstruation symptom score and kidney deficiency symptom score before and after treatment in the observation group were superior to that in the control group(P<0.05).(2)After treatment,the score of each item of SF-36 and total score were improved in the observation group(P<0.05 as compared with those before treatment),and the improvement in score of each item of SF-36 and total score of the observation group was superior to that of the control group(P<0.05). The difference values for general health score, vitality score,mentality health score,total physical health score,total mentality health score and total score before and after treatment in the observation group was superior to those in the control group(P<0.05).(3)The pregnancy rate was48.0%(12/25)in the observation group,and was 16.0%(4/25)in the control group. The pregnancy rate in the observation group was higher than that in control group,the difference being significant(P<0.05).(4)Logistic regression analysis results showed that physical function score and mentality health score had effect on pregnancy rate after intervention. Physical function score was negatively correlated with pregnancy rate, and the higher physical function score was, the lower pregnancy rate was. The probability of pregnancy with high physical function score was 0.777 times that of lower physical function score. Mentality health score was positively correlated with pregnancy rate,and the higher mentality health score was,the greater probability of pregnancy was. The probability of mentality with high physical function score was 1.443 times that of lower mentality function score.Conclusion Combination of acupuncture and drug is effective for the treatment of advanced maternal age kidney deficiency women in preparing for pregnancy, and has effects on improving the physiological and psychological status of the patients,improving kidney deficiency symptoms and increasing the pregnancy rate,promoting life of quality.