热敏灸联合人工周期治疗脾肾阳虚型卵巢早衰的临床观察

Clinical Observation of Heat-sensitive Moxibustion Combined with Artificial Cycle for Premature Ovarian Failure of Spleen-kidney Yang Deficiency Pattern

目的观察热敏灸联合人工周期疗法治疗脾肾阳虚型卵巢早衰的临床疗效。方法将74例脾肾阳虚型卵巢早衰患者随机分为对照组和观察组,每组37例。对照组予人工周期疗法,观察组在对照组治疗基础上予热敏灸治疗。观察两组临床疗效,并比较两组治疗前后的子宫内膜厚度、窦卵泡数量、卵巢平均体积、性激素[雌激素(E2)和卵泡刺激素(FSH)]水平及血清前纤维蛋白1(PFN1)、血管内皮生长因子(VEGF)水平的变化。结果治疗后,观察组总有效率明显高于对照组(P<0.05)。两组治疗后子宫内膜厚度、窦卵泡数量、卵巢平均体积均优于治疗前(P<0.05),且观察组治疗后的子宫内膜厚度、窦卵泡数量、卵巢平均体积均优于对照组(P<0.05)。治疗后,两组血清E2和FSH水平均较治疗前改善(P<0.05),且观察组血清E2和FSH水平优于对照组(P<0.05)。治疗后,对照组血清PFN1和VEGF水平较治疗前无明显变化(P>0.05),而观察组血清PFN1和VEGF水平较治疗前明显改善(P<0.05),且观察组治疗后血清PFN1和VEGF水平优于对照组(P<0.05)。结论热敏灸联合人工周期治疗脾肾阳虚型卵巢早衰的临床疗效优于单一人工周期治疗,且能改善子宫内膜厚度、窦卵泡数量及卵巢体积,调整性激素水平,可能与其改善血清PFN1和VEGF水平相关。

Objective To observe the clinical efficacy of heat-sensitive moxibustion plus artificial cycle therapy in treating premature ovarian failure(POF)of spleen-kidney yang deficiency pattern.Method Seventy-four POF patients of spleen-kidney yang deficiency pattern were randomized into a control group and an observation group,with 37 cases in each group.The control group was given artificial cycle therapy while the observation group was given additional heat-sensitive moxibustion.Clinical efficacy was observed in the two groups.Endometrial thickness,antral follicle count(AFC),average ovary volume,sex hormone levels[estrodiol(E2)and follicle-stimulating hormone(FSH)]and serum profilin 1(PFN1)and vascular endothelial growth factor(VEGF)levels were compared before and after treatment.Result After treatment,the total effective rate was markedly higher in the observation group than in the control group(P<0.05).Endometrial thickness,AFC,and average ovary volume were improved after treatment in both groups(P<0.05),and were better in the observation group than in the control group(P<0.05).After intervention,the serum E2 and FSH levels showed improvements in both groups(P<0.05),and were better in the observation group than in the control group(P<0.05).The levels of serum PFN1 and VEGF didn’t show significant changes after treatment in the control group(P>0.05),while the serum PFN1 and VEGF levels showed significant improvements in the observation group after intervention(P<0.05)and were better than those in the control group(P<0.05).Conclusion Heat-sensitive moxibustion plus artificial cycle can produce more significant clinical efficacy than artificial cycle alone in treating POF of spleen-kidney yang deficiency pattern,and it can improve endometrial thickness,AFC and ovary volume and regulate sex hormone levels,which may be due to its regulation of serum PFN1 and VEGF levels.