[针刺对反复种植失败后血栓前状态不孕症患者妊娠结局影响的临床研究]
[Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure].
作者信息
You Xiu-Mi, Zhang Jun-Xin, Yang Juan, Lin Qiu-Ping, Lin Jie, Qiu Jia-Hui, Gao Huan-Huan, Xu Jin-Bang
机构信息
Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China; Fujian University of Traditional Chinese Medicine, Fuzhou 350122.
Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China.
出版信息
Zhen Ci Yan Jiu. 2023 Sep 25;48(9):939-45. doi: 10.13702/j.1000-0607.20230084.
OBJECTIVE
To observe the effect of acupuncture combined with medication on the pregnancy outcome of kidney deficiency and blood stasis type recurrent implantation failure (RIF) in prethrombotic infertility patients.
METHODS
A total of 70 RIF patients of kidney deficiency and blood stasis type who were to undergo freeze-thaw embryo transplantation were randomly divided into control and treatment groups, with 35 cases in each group. Patients in the control group were given the basic treatment of artificial periodic freeze-thaw embryo transfer and oral aspirin enteric-coated tablet, 25 mg each time, twice a day, for 3 consecutive menstrual cycles. Patients in the treatment group were treated with acupuncture on the basis of the control group, 30 min each time, 3 times a week, for 3 consecutive menstrual cycles. The clinical pregnancy rate, embryo implantation rate and live birth rate of the two groups were compared. Before treatment and 1 day before transplantation, the scores of kidney deficiency and blood stasis symptom were compared. The blood flow pulse index (PI) and resistance index (RI) of the uterus spiral artery were detected by Doppler ultrasound before treatment and 1 day before transplantation. The endometrial thickness was detected 1 day before transplantation. The contents of plasma D-dimer, serum homocysteine (Hcy) and serum thromboxane B2 (TXB2) were detected.
RESULTS
The clinical pregnancy rate, embryo implantation rate and live birth rate in the treatment group were higher than those in the control group (<0.05). After treatment, the scores of kidney deficiency and blood stasis symptom, the levels of plasma D-dimer, serum Hcy and TXB2, the PI and RI value in both groups were decreased (<0.05) compared with those before treatment, and the indexes in the treatment group were decreased (<0.05) more than those in the control group. There was no significant difference in endometrial thickness between the two groups. In the course of treatments, 7 patients in the control group underwent gastric distension pain, poor appetite, constipation, nausea and other gastrointestinal reactions, while only 2 patients in the treatment group had the above discomfort reactions.
CONCLUSION
On the basis of medication, acupuncture can reduce the serum TXB2 content in RIF patients in prethrombotic state, improve vascular endothelial function, enhance endometrial tolerance, alleviate the symptoms of kidney deficiency and blood stasis, reduce drug adverse reactions, and ultimately improve the pregnancy outcome and increase the rate of embryo implantation.
目的
观察针刺联合药物治疗对血栓前状态不孕患者肾虚血瘀型反复种植失败(RIF)妊娠结局的影响。
方法
将70例拟行冻融胚胎移植的肾虚血瘀型RIF患者随机分为对照组和治疗组,每组35例。对照组给予人工周期冻融胚胎移植基础治疗及口服阿司匹林肠溶片,每次25mg,每日2次,连续3个月经周期。治疗组在对照组基础上加用针刺治疗,每次30分钟,每周3次,连续3个月经周期。比较两组的临床妊娠率、胚胎着床率及活产率。治疗前及移植前1天,比较两组肾虚血瘀症状评分。治疗前及移植前1天,采用多普勒超声检测子宫螺旋动脉血流脉冲指数(PI)及阻力指数(RI)。移植前1天检测子宫内膜厚度。检测血浆D-二聚体、血清同型半胱氨酸(Hcy)及血清血栓素B2(TXB2)含量。
结果
治疗组临床妊娠率、胚胎着床率及活产率均高于对照组(P<0.05)。治疗后,两组肾虚血瘀症状评分、血浆D-二聚体、血清Hcy及TXB2水平、PI及RI值均较治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。两组子宫内膜厚度比较差异无统计学意义。治疗过程中,对照组7例患者出现胃胀、食欲差、便秘、恶心等胃肠道反应,治疗组仅2例患者出现上述不适反应。
结论
在药物治疗基础上,针刺可降低血栓前状态RIF患者血清TXB2含量,改善血管内皮功能,增强子宫内膜容受性,缓解肾虚血瘀症状,减少药物不良反应,最终改善妊娠结局,提高胚胎着床率。