不同针刺方法治疗排卵障碍性不孕症的正交优化研究

Study on Orthogonal Optimization of Different Acupuncture Methods in Treatment of Anovulatory Infertility

目的:探讨体针、头皮针、施加因素(电针、温针灸)对排卵障碍性不孕症疗效影响的主持因素,并优化其治疗方案。方法:将收集的80例排卵障碍性不孕症患者作为研究对象进行正交设计试验研究,将其随机分为8组,每组10例。头皮针(焦式)取足运感区(双侧)、生殖区(双侧)。体针取关元穴、气海穴、中极穴、命门穴、子宫穴(双侧)、卵巢穴(双侧)、足三里穴(双侧)、肾俞穴(双侧)、三阴交穴(双侧)。电针取足运感区(双侧)、生殖区(双侧)和关元、中极、卵巢穴(双侧)。温针灸取关元、中极、卵巢穴(双侧)、足三里(双侧)、三阴交(双侧)、太溪(双侧)。通过研究3因素2水平对各组治疗前后排卵期最大卵泡直径(FD)及此时子宫内膜厚度(Em)的差异筛选最优方案。结果:各组治疗后FD、Em比较表明不同因素水平的组合对FD、Em的影响不同,均有显著改善(P <0. 01);施加因素(电针、温针灸)为FD、Em的显著影响因素(P <0. 05);正交试验表明,最优方案为A1B1C1,即体针、头皮针、电针。结论:体针、头皮针、施加因素对排卵障碍性不孕症疗效影响的主次关系为:施加因素>体针>头皮针;最优组合治疗方案为A1B1C1,即体针、头皮针、电针。

Objective:To explore the main factors influencing the curative effect of body acupuncture,scalp acupuncture and applied factors(electro-acupuncture,warm acupuncture)on ovulation disorder infertility and optimize the treatment plan.Methods:Eighty cases of infertility due to ovulation disorder were selected as the subjects for orthogonal design experiment,and randomly divided into 8 groups,10 cases in each group.Scalp needles group(coke type)selected affected area(bilateral)and the reproductive area(bilateral).Body acupuncture group selected Guanyuan(RN4),Qihai(RN6),Zhongji(RN3),uterine point,ovary point,Mingmen(DU4),Zusanli(ST36,bilateral),Shenshu(BL23,bilateral)and Sanyinjiao(SP6,bilateral),Electro-acupuncture group selected foot movement area(bilateral),reproductive area(bilateral)or Guanyuan(RN4),Qihai(RN6),Zusanli(ST36,bilateral),Sanyinjiao(SP36,bilateral).Warm needle moxibustion took Guanyuan(RN4),Qihai(RN6),Zusanli(ST36,bilateral)and Sanyinjiao(SP36,bilateral).By studying the difference of maximum follicular diameter(FD)and endometrial thickness(Em)before and after treatment,the optimal scheme was selected.Results:The comparison of FD and Em in each group showed that the combination of different factors had different effects on FD and Em(P<0.01),the application of factors(electro-acupuncture,warm acupuncture)was the significant influence factor of FD and Em(P<0.05).The orthogonal test showed that the optimal scheme was A1 B1 C2,i.e.body acupuncture,scalp acupuncture,warm acupuncture and moxibustion.Conclusion:The primary and secondary relationships of body acupuncture,scalp acupuncture and application factors on the efficacy of ovulation disorder infertility are as follows:application factor>body acupuncture>scalp acupuncture.The optimal combination of treatment is A1B1C2,namely body acupuncture,scalp acupuncture and warm acupuncture.