毓麟珠方联合调和阴阳针刺法对波塞冬第四分组行IVF-ET卵巢储备功能下降患者妊娠结局的临床观察

Clinical Observation of Yulinzhu(毓麟珠)Decoction Combined with Yin(阴)-Yang(阳)Acupuncture in Treatment of Pregnancy Outcome of Patients with Decreased Ovarian Reserve Function in the Fourth Group of Poseidon Treated with IVF-ET

目的:探讨毓麟珠方联合调和阴阳针刺法治疗波塞冬第四分组卵巢储备功能下降患者体外受精-胚胎移植(Invitro fertilization and embryo transfer,IVF-ET)妊娠结局临床观察。方法:选择于华中科技大学同济医学院附属武汉中西医结合医院就诊的欲行IVF-ET的波塞冬第四分组卵巢储备功能下降患者62例,根据随机数字表法分为观察组与对照组各31例,两组均给予地屈孕酮片治疗,对照组给予调和阴阳针刺法,观察组在对照组基础上给予毓麟珠方治疗,观察两组治疗前后临床疗效、中医证候评分、血清细胞因子[即细胞间黏附分子-1(ICAM-1)、环氧合酶-2(COX-2)]浓度水平、血清生殖激素水平;B超观察基础窦卵泡数、卵巢动脉收缩期峰值流速、卵巢动脉舒张末期流速,促排情况(Gn天数、Gn剂量、获卵数、MII卵数、获卵率、MII卵率)、评价IVF-ET结局指标(胚胎种植率、临床妊娠率、活产率)及安全性。结果:观察组治疗后总有效率为90.32%,显著高于对照组的64.52%(P<0.05);与治疗前比较,治疗后两组中医证候评分、血清促卵泡激素(FSH)、血清ICAM-1、COX-2含量降低(P<0.05);治疗后观察组中医证候评分、血清FSH、HG活力、血清ICAM-1、COX-2含量低于对照组(P<0.05);治疗后观察组血清LH水平低于对照组(P<0.05);与治疗前比较,治疗后两组基础窦卵泡数、卵巢动脉收缩期峰值流速、卵巢动脉舒张末期流速明显升高(P<0.05);治疗后观察组基础窦卵泡数、卵巢动脉收缩期峰值流速、卵巢动脉舒张末期流速高于对照组(P<0.05);观察组促排后的获卵数、获卵率、MII卵数、MII卵率均高于对照组(P<0.05)。结论:毓麟珠方联合调和阴阳针刺法治疗波塞冬第四分组卵巢储备功能下降患者临床疗效显著。

Objective:To investigate the clinical observation of Yulinzhu(毓麟珠)Decoction combined with Yin(阴)-Yang(阳)acupuncture in the treatment of invitro fertilization and embryo transfer(IVF-ET)patients with decreased ovarian reserve function in the fourth group of Poseidon.Methods:A total of 62 patients with decreased ovarian reserve function who wanted to receive IVF-ET in the fourth group of Poseidon were selected from Wuhan Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.According to the random number table method,they were divided into the observation group and the control group,with 31 patients in each group.Both groups were treated with dydrogesterone tablets.The control group was treated with mixed Yin-Yang acupuncture,and the observation group was treated with Yulinzhu Decoction on the basis of the control group.The clinical effect,TCM syndrome score,intercellular cell adhesion molecule-1(ICAM-1)concentration level,cyclooxygenase-2(COX-2)concentration level,serum reproductive hormone level,B-ultrasound results(number of basal sinus follicles,peak systolic flow velocity,and end-diastolic flow velocity of an ovarian artery),ovulation induction(Gn days,Gn dose,ovulation number,MII ovulation number,ovulation rate,and MII ovulation rate),outcome indexes of IVF-ET(embryo implantation rate,clinical pregnancy rate,and live birth rate),and safety evaluation were observed before and after treatment.Results:The total effective rate of the observation group is 90.32%,which is significantly higher than 64.52%in the control group(P<0.05).After treatment,TCM syndrome scores,serum levels of follicle-stimulating hormone(FSH),ICAM-1,and COX-2 in both groups are decreased(P<0.05).The TCM syndrome score,serum FSH,serum ICAM-1,and COX-2 levels in the observation group are lower than those in the control group(P<0.05).In addition,serum luteinizing hormone(LH)level in the observation group is decreased(P<0.05).The serum LH level in the observation group is lower than that in the control group(P<0.05).The number of basal sinus follicles,peak systolic flow velocity,and end-diastolic flow velocity of the ovarian artery are increased in both groups after treatment(P<0.05).The number of basal sinus follicles,peak systolic flow velocity,and end-diastolic flow velocity of the ovarian artery in the observation group are higher than those in the control group(P<0.05).Ovulation number,ovulation rate,MII ovulation number,and MII ovulation rate in the observation group are higher than those in the control group(P<0.05).Conclusion:Yulinzhu Decoction combined with Yin-Yang acupuncture in the treatment of patients with decreased ovarian reserve function in the fourth group of Poseidon has significant clinical effects.