水火既济针法联合西药治疗排卵障碍性不孕症的疗效观察及对血清VEGF、CTGF、HGF水平的影响

Efficacy Observation of Shui Huo Ji Ji Needling Combined with Western Medication for Anovulatory Infertility and Its Effects on Serum VEGF,CTGF,and HGF Levels

目的观察水火既济针法联合西药治疗排卵障碍性不孕症的临床疗效及对血清肝细胞生长因子(HGF)、血管内皮细胞生长因子(VEGF)及结缔组织生长因子(CTGF)的影响。方法将98例排卵障碍性不孕症患者随机分为对照组(51例)和观察组(47例)。对照组给予克罗米芬口服治疗,观察组在对照组治疗基础上联合水火既济针法治疗。观察治疗前后中医证候积分、血清性激素[孕酮(P)、雌二醇(E2)、黄体生成素(LH)和卵泡刺激素(FSH)]、HGF、VEGF和CTGF水平以及子宫内膜容受性变化,并比较两组临床疗效。结果治疗后,观察组总有效率高于对照组(P<0.05)。两组治疗后中医证候积分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清P、E2和LH水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);血清FSH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清VEGF和HGF水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清CTGF水平低于治疗前(P<0.05);观察组与对照组比较,差异无统计学意义(P>0.05)。观察组治疗后A型子宫内膜比例明显高于对照组(P<0.05)。结论水火既济针法联合西药能够提高排卵障碍性不孕患者临床疗效,改善其内分泌紊乱状态及性激素水平,提高子宫内膜容受性。

Objective To observe the clinical efficacy of Shui Huo Ji Ji(coordinating the heart and the kidney)needling plus Western medication in treating anovulatory infertility and its effects on patient’s serum levels of hepatocyte growth factor(HGF),vascular endothelial growth factor(VEGF),and connective tissue growth factor(CTGF).Method Ninety-eight patients with anovulatory infertility were randomized into a control group(51 cases)and an observation group(47 cases).The control group received oral Clomiphene citrate,and the observation group received additional Shui Huo Ji Ji acupuncture treatment.Before and after the treatment,the traditional Chinese medicine(TCM)symptom score,serum levels of sex hormones[progesterone(P),estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],HGF,VEGF,and CTGF,and endometrial receptivity were observed.The clinical efficacy was compared between the two groups.Result After the treatment,the total effective rate was higher in the observation group than in the control group(P<0.05).The TCM symptom score dropped after the intervention in both groups and was lower in the observation group than in the control group,showing statistical significance(P<0.05).The serum levels of P,E2,and LH elevated after the treatment in the two groups and were significantly higher in the observation group than in the control group(P<0.05);the serum FSH level declined in both groups after the treatment and was lower in the observation group than in the control group,presenting statistical significance(P<0.05).The post-treatment serum VEGF and HGF levels were lower than the baseline in both groups(P<0.05),and the observation group was lower than the control group with statistical significance(P<0.05).After the treatment,the serum CTGF level decreased in the two groups(P<0.05),while the between-group difference was not statistically significant(P>0.05).The proportion of type A endometrium in the observation group was markedly higher than that in the control group after the treatment(P<0.05).Conclusion Shui Huo Ji Ji needling method plus Western medication can enhance the clinical efficacy,improve endocrine disorders and sex hormone levels,and increase endometrial receptivity in treating anovulatory infertility.