针刺配合左归温经汤治疗多囊卵巢综合征所致不孕疗效观察

Observations on the Efficacy of Acupuncture plus Zuogui Wenjing Decoction for Infertility Due to Polycystic Ovarian Syndrome

目的观察针刺配合口服左归温经汤治疗肾虚血瘀证多囊卵巢综合征所致不孕的临床疗效。方法将210例肾虚血瘀证多囊卵巢综合征所致不孕患者随机分为A组、B组和C组,每组70例。A组采用针刺治疗,B组采用口服左归温经汤治疗,C组采用针刺配合口服左归温经汤治疗。观察3组治疗前后各项中医证候积分、血清生殖激素[促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)]水平、卵泡液氧化应激因子[谷氨酸半胱氨酸连接酶(Gcl-c)、谷胱甘肽过氧化物酶(GPx)、过氧化氢酶(CAT)、总抗氧化能力(TAC)]含量、卵巢多囊样指标[卵巢体积、子宫内膜厚度、卵泡膜的阻力指数(RI)、搏动指数(PI)]、内皮功能表达水平[纤溶酶原活性抑制物(PAI-1)、血管性血友病因子抗原(vWF:Ag)、血浆内皮素(ET)]的变化情况,并比较3组活产率。结果C组活产率为52.9%,明显高于A组的34.8%和B组的25.0%,差异均具有统计学意义(P<0.05)。3组治疗后各项中医证候积分、生殖激素水平、卵泡液氧化应激因子含量、卵巢多囊样指标及内皮功能表达水平与同组治疗前比较,差异均具有统计学意义(P<0.05)。C组治疗后各项中医证候积分、生殖激素水平、卵泡液氧化应激因子含量、卵巢多囊样指标及内皮功能表达水平与A组和B组比较,差异均具有统计学意义(P<0.05)。结论针刺配合口服左归温经汤治疗肾虚血瘀证多囊卵巢综合征所致不孕患者的活产率,其作用可能与改善卵巢多囊样指标及调节血清生殖激素、卵泡液氧化应激因子、内皮功能有关。

Objective To investigate the clinical efficacy of acupuncture plus Zuogui Wenjing Decoction for infertility due to polycystic ovarian syndrome with kidney deficiency and blood stasis.Methods Two hundred and ten patients with infertility due to polycystic ovarian syndrome with kidney deficiency and blood stasis were randomized to groups A,B and C,with 70 cases in each group.Group A received acupuncture;group B,oral administration of Zuogui Wenjing Decoction;group C,acupuncture plus oral administration of Zuogui Wenjing Decoction.The TCM syndrome item scores were recorded and serum reproductive hormones(luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T)and estradiol(E2))levels,factors for oxidative stress in follicular fluid(glutamate cysteine ligase catalytic subunit(GCLC),glutathione peroxidase(GPx),catalase(CAT)and total anti-oxidative capacity(TAC))contents,ovarian polycystic indicators(ovarian volume,endometrial thickness,follicular membrane resistance index(RI)and pulsation index(PI))and endothelial function expression levels(plasminogen activator inhibitor-1(PAI-1),von Willebrand factor antigen(vWF:Ag)and plasma endothelin(ET))were measured in the three groups before and after treatment.Live birth rates were compared between the three groups.Results The live birth rate was 52.9%in group C,which was significantly higher than 34.8%in group A and 31.3%in group B with statistically significant differences(P<0.05).The TCM syndrome item scores,reproductive hormones levels,factor for oxidative stress in follicular fluid contents,ovarian polycystic indicators and endothelial function expression levels had statistically significant differences in the three groups after treatment compared before(P<0.05).After treatment,the TCM syndrome item scores,reproductive hormones levels,factor for oxidative stress in follicular fluid contents,ovarian polycystic indicators and endothelial function expression levels had statistically significant differences between group C and group A or B(P<0.05).Conclusions Acupuncture plus oral administration of Zuogui Wenjing Decoction can increase the live birth rate in treating patients with infertility due to polycystic ovarian syndrome with kidney deficiency and blood stasis.Its action may be related to improving ovarian polycystic indicators and regulating serum reproductive hormones levels,factors for oxidative stress in follicular fluid and endothelial function.