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针刺联合克罗米芬治疗多囊卵巢综合征所致不孕症:一项随机对照试验

[Infertility in polycystic ovary syndrome treated with acupuncture and clomiphene: a randomized controlled trial].

作者信息

Jiang Duosheng, Zhang Yingchun, Wu Xianqun, Wu Song

出版信息

Zhongguo Zhen Jiu. 2015 Feb;35(2):114-8.

PMID:25854013
Abstract

OBJECTIVE

To explore the best therapy for infertility caused by polycystic ovary syndrome (PCOS).

METHODS

One hundred and twenty patients were randomized into three groups, a clomi-phene group (group A), an acupuncture-moxibustion + Chinese medicine group (group B) and a clomiphene + acupuncture-moxibustion+ Chinese medicine group (group C), 40 cases in each one. In the group A, since the 5th day of menstruation, clomiphene was prescribed for oral administration. In the group B, on the 5th day of menstruation, warm needling therapy was applied at Zhongji (CV 3), Guanyuan (CV 4), Guilai (ST 29), etc. Additionally, the Chinese herbal medication for tonifying the kidney and activating blood circulation was provided. In the group C, the therapy as the group B was combined on the basis of the treatment as the group A. The treatment lasted continuously for 3 menstrual cycles. The endometrial thickness, endometrial type and cervical mucus score on human chorionic gon adotropin (HCG) day, and ovulatory cycle rate, clinical pregnancy rate and abortion rate after treatment were observed in the patients of the three groups.

RESULTS

  1. HCG day cervical mucus score, endometrial thickness and endometrial morphology (A type rate): the results in the group C were better than those in the group A (all P<0.01); the results in the group B were better than those in the group A (all P<0.05). The difference in the endometrial thickness was not significant in comparison between the group C and the group B (P>0.05). The cervical mucus score and endometrial morphology (A type rate) in the group C were better than those in the group B (both P<0.05). 2) The ovulatory cycle rates in the group A and group (C were higher than that in the group B (both P<0.05), the pregnancy rate in the group C was higher than that in the other groups (both P<0.05), and the early abortion rate in the group C was lower than that in the group A and group B (both P<0.01). 3) Follicle diameter from 18 mm to 20 mm and endometrial thickness: the differences were not significant between the normal pregnancy patients and the early abortion patients (both P>0.05). The endometrial morphology A type rate in the normal pregnancy patients was higher than that in the early abortion patients (P<0.05).

CONCLUSION

The combined therapy of acupuncture, herbal medicine and clomiphene improves the pregnancy rate and reduces early abortion rate by effectively improving HCG day cervical mucus, endometrial thickness and morphology. The efficacy is apparently superior to the simple medication with clomiphene and the combined application of acupuncture and herbal medicine.

摘要

目的

探讨多囊卵巢综合征(PCOS)所致不孕症的最佳治疗方法。

方法

将120例患者随机分为三组,即氯米芬组(A组)、针灸加中药组(B组)和氯米芬加针灸加中药组(C组),每组40例。A组自月经第5天起口服氯米芬。B组在月经第5天,于中极(CV 3)、关元(CV 4)、归来(ST 29)等穴位行温针治疗。此外,给予补肾活血的中药。C组在A组治疗基础上联合B组治疗方法。连续治疗3个月经周期。观察三组患者人绒毛膜促性腺激素(HCG)日的子宫内膜厚度、内膜类型及宫颈黏液评分,以及治疗后的排卵周期率、临床妊娠率和流产率。

结果

1)HCG日宫颈黏液评分、子宫内膜厚度及内膜形态(A型率):C组结果优于A组(均P<0.01);B组结果优于A组(均P<0.05)。C组与B组比较,子宫内膜厚度差异无统计学意义(P>0.05)。C组宫颈黏液评分及内膜形态(A型率)优于B组(均P<0.05)。2)A组和C组的排卵周期率高于B组(均P<0.05),C组妊娠率高于其他两组(均P<0.05),C组早期流产率低于A组和B组(均P<0.01)。3)卵泡直径18 mm至20 mm及子宫内膜厚度:正常妊娠患者与早期流产患者之间差异无统计学意义(均P>0.05)。正常妊娠患者的子宫内膜形态A型率高于早期流产患者(P<0.05)。

结论

针灸、中药与氯米芬联合治疗通过有效改善HCG日宫颈黏液、子宫内膜厚度及形态,提高了妊娠率并降低了早期流产率。其疗效明显优于单纯氯米芬用药及针灸与中药联合应用。

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