针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响：一项临床随机试验

Jia-man WU; Yan NING; Yang-yang YE; Yu-lei LIU; Meng TANG; Shan HU; Yuan-yuan ZHUO

doi:10.1007/s11655-022-3498-z

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针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响：一项临床随机试验

Clinical Experience | Updated：2022-07-20

- 针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响：一项临床随机试验
- Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing in vitro Fertilization-Embryo Transfer:A Randomized Clinical Trial
- Chinese Journal of Integrative Medicine 2022年28卷第8期页码：736-742
- Affiliations：
  
  1.Department of Traditional Chinese Medicine, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong Province (518028),China
  2.First College of Clinical Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou(510405), China
  3.Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital,Shenzhen, Guangdong Province (518033), China
- Author bio：
  
  Prof. ZHUO Yuan-yuan, E-mail:qinyuan64@163.com
- Funds：
  
  the Sanming Project of Medicine in Shenzhen(SZSM201612046);the Guangdong Provincial Administration of Traditional Chinese Medicine(20181229);the Guangdong Provincial Administration of Traditional Chinese Medicine(20201294)
- DOI：10.1007/s11655-022-3498-z
  中图分类号：
- 纸质出版日期：2022-08，
  
  网络出版日期：2022-04-13，
  
  录用日期：2020-10-15
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Jia-man WU, Yan NING, Yang-yang YE, 等. 针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响：一项临床随机试验[J]. Chinese Journal of Integrative Medicine, 2022,28(8):736-742.

Jia-man WU, Yan NING, Yang-yang YE, et al. Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing in vitro Fertilization-Embryo Transfer:A Randomized Clinical Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(8):736-742.
Jia-man WU, Yan NING, Yang-yang YE, 等. 针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响：一项临床随机试验[J]. Chinese Journal of Integrative Medicine, 2022,28(8):736-742. DOI： 10.1007/s11655-022-3498-z.

Jia-man WU, Yan NING, Yang-yang YE, et al. Effects of Acupuncture on Endometrium and Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome Undergoing in vitro Fertilization-Embryo Transfer:A Randomized Clinical Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(8):736-742. DOI： 10.1007/s11655-022-3498-z.

摘要

目的:

观察针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响.

研究方法:

用SPSS软件随机数字表将83名患者随机分为观察组 (40例) 和实验组 (43例) . 两组患者均将GnRH激动剂长方案作为常规治疗

观察组患者每隔一天针刺两组不同的穴位各30分钟. 第一组针刺关元 (CV4) 、气海 (CV6) 、中极 (CV3) 及双侧子宫穴 (EX-CA1)

第二组针刺命门 (GV4) 、腰阳关 (GV3) 、双侧肾俞 (BL23) 及次髎穴 (BL32)

两组针刺穴位交替进行. 整个针刺治疗过程从促排卵时开始持续到移植日当天

总共3个周期

而实验组未给予针刺治疗. 观察两组患者的Gn剂量和Gn刺激时长

子宫内膜厚度和类型 (A

人绒毛膜促性腺激素 (HCG) 注射日当天的雌二醇 (E2) 和孕酮 (P) 水平

临床妊娠率及胎儿活产率. 记录实验过程中的不良反应

随访全部患者体外受精—胚胎移植后14天的妊娠率及孕后的胎儿活产率

试验中所有的针刺不良反应均已记录.

结果:

观察组的Gn剂量和Gn刺激时长低于实验组 (

0.01) ; 观察组中A型子宫内膜比例高于实验组 (

0.05) ; 与实验组相比

观察组在HCG注射日当天E2和P的水平降低

临床妊娠率更高 (

0.05)

本实验过程中无明显不良反应.

结论:

针刺可以增加A型子宫内膜占比

控制HCG注射日E2和P值水平

改善行体外受精—胚胎移植多囊卵巢不孕患者的妊娠率.

Abstract

Objective:

To observe the effect of acupuncture on endometrium and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) infertility undergoing in vitro fertilization-embryo transfer (IVF-ET).

Methods:

Eighty-three patients were randomly assigned to observation group (40 cases) and control group (43 cases) according to the random numbers generated by SPSS software. The patients of the two groups received GnRH agonist long protocol as a routine treatment. In the observation group

acupuncture was given at two acupoint groups for 30 min once every other day. Group 1 included Guanyuan (CV 4)

Qihai (CV 6)

Zhongji (CV 3)

bilateral acupoints Zigong (EX-CA1). Group 2 included Mingmen (GV 4)

Yaoyangguan (GV 3)

bilateral Shenshu (BL 23) and Ciliao (BL 32). The two groups of acupoints were used alternately. The whole needling process was performed at the time of ovulation induction until the transplantation day and consisted of 3 courses

while the control group did not receive acupuncture interventions. The Gn dosage and Gn stimulation time

endometrial thickness and type (A

and C)

serum oestradiol (E2) and progesterone (P) levels on the day of injection of human chorionic gonadotropin (hCG)

clinical pregnancy rate

as well as live birth rate were observed. Adverse reactions were also be recorded. All patients were followed up for the pregnant rate 14 days after IVF-ET and live birth rate after pregnancy. All adverse reactions (AEs) of acupuncture were recorded during the trial.

Results:

The Gn dosage and Gn stimulation time in the observation group were lower in the observation group than in the control group (

0.01). The proportion of type A endometrium in the observation group were higher than that in the control group (

0.05). The serum E

and P levels on the day of hCG injection was lower and the clinical pregnancy rate was higher in the observation group compared to those in the control group (

0.05). There was no serious AEs during this trial.

Conclusion:

Acupuncture can improve the proportion of type A endometrium

regulate the levels of serum E

and P on the day of hCG injection

and improve the pregnancy rate in patients with PCOS infertility undergoing IVF-ET.

关键词

Keywords

acupuncturein vitro fertilization-embryo transferpolycystic ovarian syndromeendometrium

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