摘要
目的观察针刺冲任脉腧穴对卵巢储备功能下降(DOR)患者卵巢反应性的改善效果。方法按1∶1中心区组随机分配,采用随机数字表法将104例DOR患者分为针刺组与药物组各52例。针刺组针刺石关、肓俞、四满、大赫、气冲、气海、关元、列缺、照海、内关、公孙,每次留针30min,隔日治疗,每周3次,连续12周。药物组于月经第5日起口服戊酸雌二醇片,1 mg/次,每日1次,口服,连续21 d,月经第16日起加地屈孕酮片,10 mg/次,每日2次,口服,连续10 d,两药于月经第26日同时停药,连续治疗3个月经周期。观察2组临床疗效,比较2组治疗前后窦卵泡计数(AFC)、左右侧卵巢体积、促卵泡素(FSH)、FSH/黄体生成素(LH)、雌二醇、抗米勒管激素(AMH)及中医证候积分。结果针刺组脱落中止7例、药物组脱落中止10例。针刺组总有效率为97.78%(44/45),药物组为88.10%(37/42),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,针刺组治疗后AFC 2~10 mm、AFC 8~10 mm、AMH明显升高(P<0.05),药物组AFC2~10mm明显升高(P<0.05),2组双侧卵巢体积均明显增加(P<0.05),FSH、FSH/LH、中医证候积分均明显降低(P<0.05);2组治疗后比较,针刺组AFC2~10mm、AFC8~10mm、双侧卵巢体积、AMH高于药物组(P<0.05),中医证候积分低于药物组(P<0.05)。结论针刺冲任脉腧穴可改善DOR患者AFC、卵巢体积、FSH、FSH/LH、AMH、中医证候积分、临床有效率,效果优于激素替代疗法,可提高患者生存质量。
Objective To observe the improving effects of acupuncture on the acupoints of Chong and Conception Vessels on ovarian reactivity in patients with diminished ovarian reserve(DOR).Methods Totally 104 patients with DOR were divided into acupuncture group and drug group with 52 patients in each group by random number table method according to 1∶1 central area group.In the acupuncture group,Shiguan,Huangshu,Siman,Dahe,Qichong,Qihai,Guanyuan,Lieque,Zhaohai,Neiguan and Gongsun were treated with needles for 30 min each time,and were treated on alternate days,3 times a week for 12 weeks.The drug group was given estradiol valerate tablets,1 mg/time,once a day,orally for 21 consecutive days from the 5th day of menstruation,and dydrogesterone tablets,10 mg/time,orally twice a day from the 16th day of menstruation for 10 consecutive days.The two drugs were stopped at the same time on the 26th day of menstruation,and the treatment lasted for 3 consecutive menstrual cycles.The clinical efficacy of both groups was observed.The antral follicle count(AFC),the left and right ovarian volume,follicle-stimulating hormone(FSH),FSH/luteinizing hormone(LH),estradiol,anti-Müllerian hormone(AMH),and TCM symptom scores of the two groups were observed before and after treatment.Results There were 7 cases lost in acupuncture group and 10 cases lost in drug group.The total effective rate of acupuncture group was 97.78%(44/45),which was better than that of drug group 88.10%(37/42),with statistical significance(P<0.05).Compared before treatment,AFC 2–10 mm,AFC 8–10 mm,and AMH in the acupuncture significantly increased(P<0.05),AFC 2–10 mm significantly increased in the drug group(P<0.05),bilateral ovarian volume in both groups significantly increased(P<0.05),and FSH,FSH/LH and TCM symptom scores significantly decreased in both groups after treatment(P<0.05);after treatment,AFC 2–10 mm,AFC 8–10 mm,bilateral ovarian volume and AMH in acupuncture group were higher than those in drug group(P<0.05),and the TCM symptom scores of acupuncture group was lower than that of drug group(P<0.05).Conclusion Acupuncture on the acupoints of Chong and Conception Vessels can improve AFC,ovarian volume,FSH,FSH/LH,AMH,TCM symptom scores and clinical effective rate in patients with DOR.The effect is better than hormone replacement therapy,which can improve the quality of life of patients.
作者
杨丽鹍
王宁
陈新宇
张佳佳
张丽娜
宋鹏
徐首静
赵吉平
YANG Likun;WANG Ning;CHEN Xinyu;ZHANG Jiajia;ZHANG Lina;SONG Peng;XU Shoujing;ZHAO Jiping(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2023年第11期167-172,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
北京市通州区科技计划项目(KJ2019CX008)
国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX201506)。
关键词
卵巢储备功能下降
针刺
冲任脉
腧穴
卵巢反应性
diminished ovarian reserve
acupuncture
Chong and Conception Vessels
acupoints
ovarian reactivity
