针灸序贯疗法预处理配合药物治疗小卵泡排卵疗效观察

Efficacy Observation of Preintervention with Acupuncture-moxibustion Sequential Treatment Combined with Medication for Small Follicle Ovulation

目的观察针灸序贯疗法预处理配合药物治疗小卵泡排卵(OSF)的临床疗效。方法将80例OSF患者按治疗方法的不同分为治疗组和对照组,每组40例。对照组采用促排卵治疗(口服枸橼酸氯米芬片配合肌肉注射注射用尿促性素),治疗组在促排卵治疗前2个月采用针灸序贯疗法进行预处理。观察两组治疗后促性腺激素(Gn)使用天数、Gn总量及人绒毛膜促性腺激素(hCG)注射日血清雌二醇(E2)值、卵泡发育情况、子宫内膜平均厚度,比较两组获卵率、受精率、优质胚胎率、卵巢过度刺激综合征(OHSS)发生率及临床疗效。结果治疗组治疗后hCG注射日血清E2值和最大卵泡平均直径(MFD)、MFD≥18 mm且≤23 mm卵泡个数及子宫内膜平均厚度与对照组比较差异均有统计学意义(P<0.05)。治疗组治疗后优质胚胎率和总有效率分别为84.2%和90.0%,对照组分别为40.0%和72.5%,两组比较差异均具有统计学意义(P<0.05)。结论针灸序贯疗法预处理能够提高OSF患者对促排药物的反应,为卵泡的生长发育创造良好的内环境,与促排卵药物具有较好的协同作用。

Objective To observe the clinical efficacy of preintervention with acupuncture-moxibustion sequential treatment plus medication in treating small follicle ovulation.Method Eighty patients with small follicle ovulation were divided into a treatment group and a control group according to the intervention methods,with 40 cases in each group.The control group received ovulation induction treatment(oral administration of Clomifene citrate tablets plus muscular injection of Menotrophin injection),while the treatment group received preintervention with acupuncture-moxibustion sequential treatment since 2 months before ovulation induction treatment.After treatment,the number of gonadotropins(Gn)days and total Gn amount were observed in the two groups,as well as the serum estradiol(E2)value,follicle development and mean endometrial thickness on the day of receiving human chorionic gonadotropin(hCG).The oocyte retrieval rate,fertilization rate,high-quality embryo rate,ovarian hyperstimulation syndrome(OHSS)rate and clinical efficacy were compared between the two groups.Result After treatment on the hCG injection day,the serum E2 value,maximum mean follicle diameter(MFD),the number of follicles with MFD≥18 mm and≤23 mm and mean endometrial thickness in the treatment group were significantly different from those in the control group(P<0.05).The high-quality embryo rate was 84.2%and the total effective rate was 90.0%in the treatment group after intervention,versus 40.0%and 72.5%in the control group,and the between-group differences were statistically significant(P<0.05).Conclusion Preintervention with acupuncture-moxibustion sequential treatment can enhance the response of patients ovulated with small follicles to the ovulation induction medications,provide a good internal environment for follicle development,and work synergistically with ovulation induction medications.