针药结合对肾虚痰湿型多囊卵巢综合征患者IVF-ET助孕结局的影响

Impact of Acupuncture Combined with Medicine on IVF-ET Fertility Outcomes of Polycystic Ovary Patients with Kidney Deficiency and Phlegm Dampness Syndrome

目的:观察针灸联合中药对多囊卵巢综合征(polycystic ovary syndrome, PCOS)肾虚痰湿证患者体外受精-胚胎移植(in vitro fertilization-embryo transfer, IVF-ET)助孕的影响。方法:200例肾虚痰湿型PCOS患者按照随机数字表法分为对照组、中药组、电针组和针药组。对照组给予单纯卵泡期长方案促排卵,中药组在对照组治疗基础上给予补肾化痰方,电针组在对照组治疗基础上给予电针干预,针药组在对照组治疗基础上给予补肾化痰方和电针干预。比较4组患者绒毛膜促性腺素(chorionic gonadotropic hormone, HCG)日雌二醇(estradiol, E)水平、获卵数、受精率、卵裂率、优质胚胎率、卵巢过度刺激综合征(ovarian hyperstimulation syndrome, OHSS)发生率、临床妊娠率、自然流产率、促性腺激素(gonadotropin, Gn)用量及用药时间。结果:(1) 4组患者治疗后HCG日E水平比较,差异无统计学意义(P>0.05)。(2)治疗后,4组患者的获卵数、受精率、卵裂率比较,差异无统计学意义(P>0.05);但电针组和针药组的优质胚胎率显著高于对照组和中药组,差异有统计学意义(P<0.05)。(3)治疗后,电针组和针药组的Gn用量和时间均小于对照组和中药组,差异有统计学意义(P<0.05)。(4)治疗后,针药组的临床妊娠率最高、OHSS发生率最低,与其他3组比较,差异均有统计学意义(P<0.05);中药组和针药组的自然流产率均低于对照组和电针组,差异有统计学意义(P<0.05)。结论:在PCOS患者IVF助孕的过程中,电针和中药联合使用能够提高患者的优质胚胎率、临床妊娠率,降低自然流产及OHSS的发生风险,同时能减少Gn用量及用药时间。

Objective: To observe the effect of acupuncture combined with traditional Chinese medicine on in vitro fertilization-embryo transfer(IVF-ET) fertility in patients with polycystic ovary syndrome(PCOS) with kidney deficiency and phlegm-dampness.Methods: 200 patients with PCOS due to kidney deficiency and phlegm-dampness were divided into control group, traditional Chinese medicine group, electroacupuncture group and acupuncture medicine group according to the random number table method.The control group was given the simple follicular phase long-term regimen for ovulation induction, the Chinese medicine group was given Bushen Huatan Formula on the basis of the treatment of the control group, the electroacupuncture group was given electroacupuncture intervention on the basis of the treatment of the control group, and the acupuncture-medicine group was given kidney-invigorating treatment on the basis of the treatment of the control group.Phlegm-resolving prescription and electro-acupuncture intervention.The daily estradiol(E) levels of chorionic gonadotropic hormone(HCG),the number of oocytes retrieved, the fertilization rate, the cleavage rate, the high-quality embryo rate, and the ovarian hyperstimulation syndrome(ovarian hyperstimulation syndrome) were compared among the four groups.Syndrome, OHSS) incidence, clinical pregnancy rate, spontaneous abortion rate, gonadotropin(gonadotropin, Gn) dosage and medication time.Results:(1)There was no significant difference in the Elevels of HCG in the four groups after treatment(P>0.05).(2)After treatment, there was no significant difference in the number of oocytes retrieved, fertilization rate and cleavage rate among the four groups(P>0.05);however, the high-quality embryo rates in the electroacupuncture and acupuncture groups were significantly higher than those in the control group and traditional Chinese medicine.group, the difference was statistically significant(P<0.05).(3)After treatment, the dosage and time of Gn in the electroacupuncture group and the acupuncture-medicine group were lower than those in the control group and the traditional Chinese medicine group, and the difference was statistically significant(P<0.05).(4)After treatment, the clinical pregnancy rate of the acupuncture-medicine group was the highest, and the incidence of OHSS was the lowest, and the differences were statistically significant compared with the other three groups(P<0.05).group and electroacupuncture group, the difference was statistically significant(P<0.05).Conclusion: In the process of IVF assisted pregnancy in PCOS patients, the combined use of electroacupuncture and traditional Chinese medicine can improve the patients′ high-quality embryo rate and clinical pregnancy rate, reduce the risk of spontaneous abortion and OHSS,and reduce Gn dosage and medication time.