1. 上海中医药大学附属曙光医院生殖医学中心,上海,201203
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蔡靓, 李丽, 赵以琳, 等. 健脾补肾针刺法对PCOS不孕症患者IVF-ET促排卵及子宫内膜容受性的影响[J]. 上海中医药杂志, 2020,54(11):48-52.
CAI Liang, LI Li, ZHAO Yilin, et al. Effects of acupuncture method of strengthing spleen and invigorating kidney on ovulation and endometrial receptivity of infertile patients with PCOS in IVF-ET [J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(11):48-52.
蔡靓, 李丽, 赵以琳, 等. 健脾补肾针刺法对PCOS不孕症患者IVF-ET促排卵及子宫内膜容受性的影响[J]. 上海中医药杂志, 2020,54(11):48-52. DOI: 10.16305/j.1007-1334.2020.1909077.
CAI Liang, LI Li, ZHAO Yilin, et al. Effects of acupuncture method of strengthing spleen and invigorating kidney on ovulation and endometrial receptivity of infertile patients with PCOS in IVF-ET [J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(11):48-52. DOI: 10.16305/j.1007-1334.2020.1909077.
目的:探讨健脾补肾针刺法对行体外受精(IVF)-胚胎移植(ET)的多囊卵巢综合征(PCOS)不孕症患者促排卵及子宫内膜容受性的影响。 方法:纳入82例行IVF-ET的PCOS不孕症患者,随机分为对照组(42例)和治疗组(40例)。所有患者均给予西药拮抗剂促排方案,治疗组患者在此基础上予健脾补肾针刺法治疗。比较两组患者的获卵数量、受精卵子数及优质胚胎率,检测并比较两组患者的扳机日黄体生成素(LH)、雌二醇(E,2,)、孕酮(P)水平,于扳机日检测患者的子宫内膜厚度及血流分布情况,比较两组患者在周期中的促性腺激素(Gn)使用剂量及鲜胚移植数、人绒毛膜促性腺激素(HCG)阳性率、临床妊娠率。 结果:①两组患者的获卵数及受精卵子数比较,差异无统计学意义(P,>,0.05);治疗组患者的优质胚胎率高于对照组(P,<,0.05)。②扳机日治疗组患者的E,2,、P水平明显高于对照组(P,<,0.05)。③扳机日两组患者的子宫内膜厚度比较,差异无统计学意义(P,>,0.05);治疗组患者的子宫内膜血流分布阳性情况显著优于对照组(P,<,0.05)。④治疗期间,治疗组患者的Gn用量较对照组明显减少(P,<,0.05)。⑤两组患者的HCG阳性率、临床妊娠率比较,差异均无统计学意义(P,>,0.05)。 结论:健脾补肾针刺法联合西药拮抗剂促排方案可改善行IVF-ET的PCOS不孕症患者的子宫内膜容受性和内分泌激素水平,提高优质胚胎率,减少Gn用量。
Objective:To explore the effect of acupuncture method of strengthing spleen and invigorating kidney on ovulation and endometrial receptivity of infertile patients with PCOS undergoing in vitro fertilization(IVF)-embryo transfer(ET). MethodsEighty-two infertile patients with PCOS who undergoing IVF-ET were selected and randomly divided into the control group(42 cases)and the treatment group(40 cases). All the patients were treated with western medicine antagonist ovulation regimen,and the patients in the treatment group were treated with the acupuncture method of strengthing spleen and invigorating kidney based on obove. The number of retrieved oocytes and oosperms and the rate of high-quality embryos were compared. The levels of luteinizing hormone(LH),estradiol(E,2,)and progesterone(P)on the day of human chorionic gonadotropin(HCG)injection were detected and compared. The endometrial thickness and blood flow were tested on the day of HCG injection. The dosage of gonadotropin(Gn)in the cycle,the number of fresh embryo transfer,the HCG positive rate and the clinical pregnancy rate were compared. Results:①There were no statistically significant differences on the number of retrieved oocytes and oosperms between the two groups(P,>,0.05). The rate of high-quality embryos in the treatment group was higher than that in the control group(P,<,0.05). ②The levels of E,2, and P on the day of HCG injection in the treatment group were higher than those in the control group(P,<,0.05). ③There was no statistically significant difference on the endometrial thickness on the day of HCG injection between the two groups(P,>,0.05). The endometrial blood flow positive distribution in the treatment group was superior to the control group(P,<,0.05). ④In the course of treatment,the dosage of Gn in the treatment group was less than that in the control group(P,<,0.05). ⑤There were no statistically 〖JP+significant differences on the HCG positive rate and the clinical pregnancy rate between the two groups(P,>,0.05). Conclusion:The acupuncture method of strengthing spleen and invigorating kidney combined with western medicine antagonist ovulation regimen can improve the endometrial receptivity and sex hormone levels,enhance the high-quality embryos rate,and reduce the dosage of Gn in infertile patients with PCOS undergoing IVF-ET.
不孕症多囊卵巢综合征体外受精-胚胎移植针刺拮抗剂方案
infertilitypolycystic ovarian syndromein vitro fertilization-embryo transferacupunctureantagonist therapeutic regimen
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