Centre for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW, 2751, Australia.
BMC Complement Altern Med. 2012 Jul 7;12:88. doi: 10.1186/1472-6882-12-88.
Assisted reproductive technologies (ART) are increasingly utilised for resolving difficulties conceiving. These technologies are expensive to both the public purse and the individual consumers. Acupuncture is widely used as an adjunct to ART with indications that it may assist reducing the time to conception and increasing live birth rates. Heterogeneity is high between treatment protocols. The aim of this study was to examine what fertility acupuncturists consider key components of best practice acupuncture during an ART cycle, and to establish an acupuncture protocol by consensus.
Fifteen international acupuncturists with extensive experience treating women during ART interventions participated in 3 rounds of Delphi questionnaires. The first round focused on identifying the parameters of acupuncture treatment as adjunct to ART, the second round evaluated statements derived from the earlier round, and the third evaluated specific parameters for a proposed trial protocol. Consensus was defined as greater than 80% agreement.
Significant agreement was achieved on the parameters of best practice acupuncture, including an acupuncture protocol suitable for future research. Study participants confirmed the importance of needling aspects relating to the dose of acupuncture, the therapeutic relationship, tailoring treatment to the individual, and the role of co-interventions. From two rounds of the Delphi a consensus was achieved on seven treatment parameters for the design of the acupuncture treatment to be used in a clinical trial of acupuncture as an adjunct to ART. The treatment protocol includes the use of the traditional Chinese medicine acupuncture, use of manual acupuncture, a first treatment administered between day 6-8 of the stimulated ART cycle which is individualised to the participant, two treatments will be administered on the day of embryo transfer, and will include points SP8, SP10, LR3, ST29, CV4, and post transfer include: GV20, KD3, ST36, SP6, and PC6. Auricular points Shenmen and Zigong will be used. Practitioner intent or yi will be addressed in the treatment protocol.
Despite a lack of homogeneity in the research and clinical literature on ART and acupuncture, a consensus amongst experts on key components of a best practice treatment protocol was possible. Such consensus offers guidance for further research.
辅助生殖技术（ART）越来越多地被用于解决受孕困难的问题。这些技术既昂贵又耗费个人消费者的财力。针灸作为 ART 的辅助手段被广泛应用，其适应证表明它可能有助于缩短受孕时间并提高活产率。不同治疗方案之间的异质性很高。本研究旨在探讨在 ART 周期中，生育针灸师认为最佳实践针灸的关键组成部分，并通过共识制定针灸方案。
15 名具有丰富治疗 ART 干预女性经验的国际针灸师参与了 3 轮 Delphi 问卷调查。第一轮重点是确定作为 ART 辅助治疗的针灸参数，第二轮评估第一轮得出的陈述，第三轮评估拟议试验方案的具体参数。共识定义为超过 80%的同意。
在最佳实践针灸的参数上达成了显著的一致，包括适合未来研究的针灸方案。研究参与者确认了针刺方面的重要性，包括针刺剂量、治疗关系、根据个体定制治疗方案以及联合干预的作用。通过两轮 Delphi，就针灸作为 ART 辅助治疗的临床试验设计达成了七个治疗参数的共识。治疗方案包括使用传统中医针灸、使用手动针灸、在刺激的 ART 周期的第 6-8 天进行个体化首次治疗、胚胎移植当天进行两次治疗，并包括 SP8、SP10、LR3、ST29、CV4 和转移后包括：GV20、KD3、ST36、SP6 和 PC6。将使用耳穴神门和子宫。治疗方案将涉及到医生意图或意念。
尽管在 ART 和针灸的研究和临床文献中缺乏同质性，但专家之间就最佳实践治疗方案的关键组成部分达成了共识。这种共识为进一步的研究提供了指导。
