Pang Cong-Hui, Guo Dan-Yang, Wang Qi, Wang Ke-Hua, Lian Fang
The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, 250011, China.
Department of Reproduction and Genetics, Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250011, China.
Chin J Integr Med. 2025 Aug 20. doi: 10.1007/s11655-025-4216-z.
To explore the effects of electroacupuncture (EA) on pregnancy outcomes after assisted reproduction and mitochondrial function of granulosa cells (GCs) in patients with polycystic ovary syndrome (PCOS) and phlegm-dampness syndrome.
In this randomized controlled trial, 90 infertile women with PCOS and phlegm-dampness syndrome were recruited between August 2022 and December 2022. Patients were randomly assigned to the EA and control groups using a random sequence of codes in the order of enrolment, with 45 in in each group. Both groups underwent the ovarian stimulation protocol. The patients in the EA group received EA therapy including Zhongwan (CV 12), Qihai (CV 6), bilateral Xuehai (SP 10), Sanyinjiao (SP 6), Yinlingquan (SP 9), Tianshu (ST 25), Zusanli (ST 36), and Fenglong (ST 40), and the patients in the control group was treated with pseudo-acupuncture. The intervention was 25 min twice a week for a total of 6 times until the trigger day after menstruation had ended in the cycle before oocyte retrieval. The primary outcomes were clinical pregnancy rate (CPR) and the number of high-quality embryos. The secondary outcomes were (1) pregnancy-related indicators, including fresh embryo transfer rate (ETR), ovarian hyperstimulation syndrome (OHSS) rate, early pregnancy loss rate (ePLR), ectopic pregnancy rate, live birth rate (LBR), and cumulative CPR; (2) mitochondrial autophagy and mitochondrial membrane potential (MMP) in GCs; and (3) scoring for Chinese medicine syndrome. Adverse events to assess clinical safety were also monitored.
The cumulative CPR was significantly higher in the EA group (42/45, 93.3%) than in the control group (38/45, 84.4%, P=0.036). The number of high-quality embryos and fresh ETR in the EA group were higher than those in the control group (3.80±1.65 vs. 2.44±1.34, P<0.001; 46.7% vs 24.4%, P=0.028). Ectopic pregnancies were not observed in either group. There were no significant differences in the fresh CPR, OHSS rate, ePLR or LBR between the two groups (P>0.05). Compared with the control group, the EA group showed lower expression levels of miR-146a-5p mRNA and P62 protein in GCs and higher levels of MMP and the LC3-II/LC3-I protein ratio (all P<0.01). The phlegm-dampness syndrome scores of the EA group were significantly lower than those of the control group (P<0.01).
EA significantly improved pregnancy outcomes in patients with PCOS and phlegm dampness syndrome. Mechanistically, this effect may be related to EA in decreasing miR-146a-5p mRNA expression, promoting mitochondrial autophagy in GCs, and improving mitochondrial function, which may contribute to improved oocyte quality. (Trial registration No. ChiCTR2200062915).
探讨电针（EA）对多囊卵巢综合征（PCOS）痰湿证患者辅助生殖后妊娠结局及颗粒细胞（GCs）线粒体功能的影响。
在这项随机对照试验中，于2022年8月至2022年12月招募了90例PCOS痰湿证不孕女性。按照入组顺序使用随机编码序列将患者随机分为EA组和对照组，每组45例。两组均接受卵巢刺激方案。EA组患者接受电针治疗，穴位包括中脘（CV 12）、气海（CV 6）、双侧血海（SP 10）、三阴交（SP 6）、阴陵泉（SP 9）、天枢（ST 25）、足三里（ST 36）和丰隆（ST 40），对照组患者接受假针刺治疗。干预为每周两次，每次25分钟，共6次，直至取卵周期月经结束后的扳机日。主要结局为临床妊娠率（CPR）和优质胚胎数。次要结局为：（1）妊娠相关指标，包括新鲜胚胎移植率（ETR）、卵巢过度刺激综合征（OHSS）发生率、早期妊娠丢失率（ePLR）、异位妊娠率、活产率（LBR）和累积CPR；（2）GCs中的线粒体自噬和线粒体膜电位（MMP）；（3）中医证候评分。还监测了评估临床安全性的不良事件。
EA组的累积CPR显著高于对照组（42/45，93.3% 比 38/45，84.4%，P = 0.036）。EA组的优质胚胎数和新鲜ETR高于对照组（3.80±1.65 比 2.44±1.34，P < 0.001；46.7% 比 24.4%，P = 0.028）。两组均未观察到异位妊娠。两组间新鲜CPR、OHSS发生率、ePLR或LBR无显著差异（P > 0.05）。与对照组相比，EA组GCs中miR-146a-5p mRNA和P62蛋白表达水平较低，MMP及LC3-II/LC3-I蛋白比值较高（均P < 0.01）。EA组的痰湿证评分显著低于对照组（P < 0.01）。
电针显著改善了PCOS痰湿证患者的妊娠结局。机制上，这种作用可能与电针降低miR-146a-5p mRNA表达、促进GCs线粒体自噬及改善线粒体功能有关，这可能有助于提高卵母细胞质量。（试验注册号：ChiCTR2200062915）
