分期针刺任督经穴治疗早发性卵巢功能不全的临床观察

Clinical observation of staging acupuncture at the meridian point of Conception Vessel and Governor Vessel in the treatment of premature ovarian insufficiency

目的观察分期针刺任督经穴治疗早发性卵巢功能不全(POI)的临床疗效。方法选取2021年6月至2022年12月就诊于上海市静安区中医医院的104例POI患者作为研究对象,按照完全随访化方法分为分期组、任脉组、督脉组、西药组,各26例。比较各组患者治疗前后血清性激素水平、窦卵泡计数(AFC),以及治疗和随访过程中共5个访视点的Kupperman(K)表和月经不调症状分级量化(MDQ)表评分。结果治疗后,四组血清卵泡刺激素(FSH)水平下降,雌二醇(E_(2))水平上升(P<0.05);西药组、督脉组和分期组AFC升高(P<0.01),分期组AFC改善优于任脉组(P<0.05)。西药组K表和MDQ表评分在治疗期间下降(P<0.01);随访期间K表不再下降(P>0.05),MDQ表上升(P<0.01)。任脉组K表评分在1MC和随访期间下降(P<0.05),MDQ表评分在3MC下降(P<0.01)。督脉组K表和MDQ表评分在3MC下降(P<0.01);随访期间MDQ表评分下降(P<0.05)。分期组K表评分在每个访视点均下降(P<0.05),MDQ表评分在3MC和随访期间下降(P<0.01)。结论分期针刺任督经穴治疗POI的临床疗效显著。

Objective To observe the clinical efficacy of staging acupuncture at the meridian point of Conception Vessel and Governor Vessel in the treatment of premature ovarian insufficiency(POI).Methods A total of 104 patients with POI admitted to Shanghai Jing′an District Hospital of Traditional Chinese Medicine from June 2021 to December 2022 were selected as the study objects.According to the complete follow-up method,they were divided into staging group,Conception Vessel group,Governor Vessel group,and western medicine group,with 26 cases each.Serum sex hormone levels,antral follicle count(AFC)before and after treatment,Kupperman(K)scale and menstrual distress questionnaire(MDQ)scale scores of 5 sites during treatment and follow-up were compared in all groups.Results Follicle stimulating hormone(FSH)decreased and E_(2) increased in four groups after treatment(P<0.05);AFC was increased in western medicine group,Governor Vessel group and staging group(P<0.01).The improvement of AFC in staging group was higher than that in Conception Vessel group(P<0.05).The scores of K scale and MDQ scale in western medicine group decreased during treatment(P<0.01),but no longer decreased(P>0.05)and the MDQ scale increased(P<0.01)during follow-up period.In the Conception Vessel group,the K scale score decreased at 1MC and during follow-up period(P<0.05),the MDQ scale score decreased at 3MC(P<0.01).The K scale and MDQ scale scores in Governor Vessel group decreased at 3MC(P<0.01),and the MDQ scale scores decreased during follow-up period(P<0.05).In staging group,the K scale score decreased at each visit point(P<0.05),and the MDQ scale score decreased at 3MC and during follow-up period(P<0.01).Conclusions The staging acupuncture at the meridian point of Conception Vessel and Governor Vessel in the treatment of POI has remarkable clinical effect.