Xue Hong-Mei, Li Yue-Mei, Chen Yu-Ting, Li Cui, Zhang Ying, Jin Ping, Li Meng-Lin, Lin Yun
First Clinical College of Guangzhou University of CM, Guangzhou 510499, Guangdong Province, China.
Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guangzhou University of CM, Guangzhou 510405, Guangdong Province.
Zhongguo Zhen Jiu. 2021 Dec 12;41(12):1338-42. doi: 10.13703/j.0255-2930.20210105-k0001.
To compare the effect of acupuncture combined with medication and medication alone on pregnancy outcome in patients with recurrent implantation failure (RIF) of thin endometrium type.
A total of 74 patients with RIF of thin endometrium type undergoing freeze-thaw embryo transfer were randomly divided into an observation group (37 cases) and a control group (37 cases). The patients in the control group were treated with freeze-thaw embryo transfer in hormone replacement cycle, and the estradiol valerate tablets were taken orally from the fifth day of menstruation, 2 mg per day. On the basis of the control group, the observation group was additionally treated with acupuncture at Baihui (GV 20), Dazhui (GV 14), Qihai (CV 6), Guanyuan (CV 4), etc., combined with other acupoints based on syndrome differentiation and menstrual stage, once every other day. Both groups were treated for 3 menstrual cycles. The clinical pregnancy rate and embryo implantation rate of the two groups were observed after transplantation; the endometrial thickness and type, resistance index (RI) and pulsatility index (PI) of endometrial blood flow were measured before treatment and one day before transplantation, and adverse reactions was recorded.
The clinical pregnancy rate was 37.8% (14/37) in the observation group, which was higher than 16.2% (6/37) in the control group (<0.05). There was no significant difference in embryo implantation rate between the two groups (>0.05). One day before transplantation, the endometrial thickness and the proportion of type A in endometrial classification in the two groups were increased compared with those before treatment (<0.01), and those in the observation group were higher than the control group (<0.01, <0.05). The PI and RI of endometrial blood flow in the two groups were lower than those before treatment (<0.01), and those in the observation group were lower than the control group (<0.01, <0.05). During the treatment, 6 patients in the control group had discomfort such as breast distending pain, stomach pain, dizziness and nausea, and there were no adverse reaction in the observation group.
On the basis of conventional medication, acupuncture could increase the endometrial thickness, improve endometrial receptivity, improve pregnancy outcome and reduce adverse reactions in patients with RIF of thin endometrial type.
比较针刺联合药物与单纯药物治疗对薄型子宫内膜复发性种植失败（RIF）患者妊娠结局的影响。
将74例接受冻融胚胎移植的薄型子宫内膜RIF患者随机分为观察组（37例）和对照组（37例）。对照组采用激素替代周期冻融胚胎移植，月经第5天开始口服戊酸雌二醇片，每日2mg。观察组在对照组基础上，加用针刺百会（GV20）、大椎（GV14）、气海（CV6）、关元（CV4）等，并根据辨证和月经周期加用其他穴位，隔日1次。两组均治疗3个月经周期。观察两组移植后的临床妊娠率和胚胎着床率；测量治疗前及移植前1天的子宫内膜厚度、类型、子宫内膜血流阻力指数（RI）和搏动指数（PI），并记录不良反应。
观察组临床妊娠率为37.8%（14/37），高于对照组的16.2%（6/37）（P<0.05）。两组胚胎着床率比较，差异无统计学意义（P>0.05）。移植前1天，两组子宫内膜厚度及子宫内膜分类中A型比例均较治疗前增加（P<0.01），且观察组高于对照组（P<0.01，P<0.05）。两组子宫内膜血流PI和RI均低于治疗前（P<0.01），且观察组低于对照组（P<0.01，P<0.05）。治疗期间，对照组6例患者出现乳房胀痛、胃痛、头晕、恶心等不适，观察组未出现不良反应。
在常规药物治疗基础上，针刺可增加薄型子宫内膜RIF患者的子宫内膜厚度，提高子宫内膜容受性，改善妊娠结局，并减少不良反应。
