腹针联合西药治疗对排卵障碍性不孕症患者妊娠结局的影响

Impact of abdominal acupuncture combined with Western medication on the pregnancy outcome in patients with anovulatory infertility

目的观察腹针联合口服枸橼酸氯米芬和戊酸雌二醇片治疗对排卵障碍性不孕症患者妊娠结局的影响。方法将60例排卵障碍性不孕症患者随机分为药物组和联合组,每组30例。药物组采用口服枸橼酸氯米芬和戊酸雌二醇片治疗,联合组在对照组药物治疗基础上联合腹针治疗。比较两组排卵率、未破裂卵泡黄素化综合征发生率、妊娠率和流产率。用经阴道彩色多普勒超声测量两组治疗前后的排卵期子宫内膜厚度和子宫动脉阻力指数,观察内膜容受性。结果治疗后,药物组周期排卵率为78.0%,妊娠率为20.0%,流产率为33.3%,未破裂卵泡黄素化综合征发生率为16.0%;联合组周期排卵率达87.8%,妊娠率为53.3%,流产率为0.0%,未破裂卵泡黄素化综合征发生率为4.0%;两组排卵率比较,差异无统计学意义(P>0.05);两组妊娠率和流产率比较,差异有统计学意义(P<0.05)。联合组人绒毛膜促性腺激素注射日子宫内膜厚度及A型子宫内膜比例明显高于药物组(P<0.05),子宫动脉阻力指数明显低于药物组(P<0.05)。结论在口服枸橼酸氯米芬和戊酸雌二醇片治疗基础上,腹针可提高排卵障碍性不孕症患者的妊娠率,降低流产率,可能与其能降低未破裂卵泡黄素化综合征发生率、促进卵泡排出及改善枸橼酸氯米芬对子宫内膜容受性抑制有关。

Objective To observe the impact of abdominal acupuncture combined with oral administration of Clomifene citrate and Estradiol valerate tablets on the pregnancy outcome in patients with anovulatory infertility.Method Sixty patients with anovulatory infertility were randomly allocated to a medication group and an integrated group,with 30 cases in each group.The medication group was treated with oral Clomifene citrate and Estradiol valerate tablets,and the integrated group received additional abdominal acupuncture treatment.The two groups were compared regarding ovulation rate,the incidence of luteinized unruptured follicle syndrome,pregnancy rate,and miscarriage rate.The transvaginal color Doppler ultrasound was used to measure endometrial thickness and uterine artery resistance index and observe endometrial receptivity.Result After treatment,the periodic ovulation rate was 78.0%,the pregnancy rate was 20.0%,the miscarriage rate was 33.3%,and the incidence of luteinized unruptured follicle syndrome was 16.0%in the medication group;in the integrated group,the periodic ovulation rate was 87.8%,the pregnancy rate was 53.3%,the miscarriage rate was 0.0%,and the luteinized unruptured follicle syndrome incidence was 4.0%.There was no significant difference in the ovulation rate between the two groups(P>0.05);the between-group differences in the pregnancy rate and miscarriage rate were statistically significant(P<0.05).The endometrial thickness and type A endometrium ratio on the day of injecting human chorionic gonadotropin were notably higher in the integrated group than in the medication group(P<0.05),and the uterine artery resistance index was significantly smaller in the integrated group than in the medication group(P<0.05).Conclusion Based on oral administration of Clomifene citrate and Estradiol valerate tablets,abdominal acupuncture can increase pregnancy rate and lower miscarriage rate in treating anovulatory infertile patients,which may be because it can reduce the luteinized unruptured follicle syndrome incidence,encourage ovulation,and counter the inhibition of endometrial receptivity brought by Clomifene citrate.