文章摘要
林爱莲,陈浩波,李雅静,等.补肾活血中药联合耳穴压豆干预肾虚血瘀型胚胎移植不孕症患者的临床研究[J].浙江中医药大学学报,2020,44(6):537-541, 553.
补肾活血中药联合耳穴压豆干预肾虚血瘀型胚胎移植不孕症患者的临床研究
Clinical Study of Traditional Chinese Medicine for Tonifying Kidney and Activating Blood Circulation Combined with Auricular Point Pressing Bean to Intervene Embryo Transfer Infertility Patients with Kidney Deficiency and Blood Stasis Type
DOI:10.16466/j.issn1005-5509.2020.06.008
中文关键词: 不孕症  胚胎移植  肾虚血瘀  补肾活血  临床妊娠率  治未病  耳穴压豆  中医药
英文关键词: infertility  embryo transfer  kidney deficiency and blood stasis  tonifying kidney and activating blood circulation  clinical pregnancy rate  pre-disease treatment  auricular point pressing beans  traditional Chinese medicine
基金项目:浙江省中医药科技计划项目(2014ZA105)
作者单位
林爱莲 温州市中西医结合医院 浙江温州 325000 
陈浩波 温州市中西医结合医院 浙江温州 325000 
李雅静 温州市中西医结合医院 浙江温州 325000 
王玮 温州市中西医结合医院 浙江温州 325000 
谢一红 温州市中西医结合医院 浙江温州 325000 
陈墨 温州市中西医结合医院 浙江温州 325000 
林婧 温州市中西医结合医院 浙江温州 325000 
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中文摘要:
      [目的]在中医治未病理论的指导下,探讨补肾活血中药联合耳穴压豆对肾虚血瘀型胚胎移植不孕症患者子宫动脉血流动力学和子宫内膜的干预作用。[方法]选择2018年1月至2019年1月的胚胎移植不孕症患者,经辨证分型后选取肾虚血瘀型病例90例,随机分成A组(补肾活血中药联合耳穴压豆治疗组)、B组(补肾活血中药组)及C组(耳穴压豆组)共3组,每组30例。3组患者均使用长方案超促排卵,治疗从月经周期第3天开始,至胚胎移植后第5周结束。同时,A组另予补肾活血中药、耳穴压豆治疗,B组另予单纯补肾活血中药治疗,C组予耳穴压豆治疗。观察并比较各组子宫内膜厚度、子宫动脉血流搏动指数(pulsatility index,PI)、双侧收缩期峰值流速/舒张末期流速(systolic/diastolic ratio value,S/D)、生化妊娠率、临床妊娠率等指标。[结果]与C组比较,A组和B组生化妊娠率、临床妊娠率方面均优于C组,差异均有统计学意义(P<0.05)。与C组比较,A组和B组内膜厚度显著增加,子宫动脉血流PI、双侧S/D显著降低,差异均有统计学意义(P<0.05);与B组比较,A组子宫动脉血流PI显著降低,而生化妊娠率、临床妊娠率方面均优于B组,差异均有统计学意义(P<0.05)。[结论]补肾活血中药联合耳穴压豆治疗可以改善肾虚血瘀型胚胎移植患者的子宫内膜厚度、子宫动脉血流阻力,提高临床妊娠率,且较单纯使用中药或耳穴压豆效果更佳。
英文摘要:
      [Objective] To investigate the effect of Chinese medieine tonifying kidney and activating blood circulation combined with auricular point pressing beans on the blood flow mechanics of uterine artery and endometrium in patients with infertility caused by kidney deficiency and blood stasis in embryo transplantation under the guidance of traditional Chinese medicine(TCM) theory of pre-disease treatment.[Methods] Infertile embryo transfer patients from January 2018 to January 2019 were selected. After syndrome differentiation, 90 cases of kidney deficiency and blood stasis were randomly divided into 3 groups: Group A, group B and group C. All patients in the three groups were treated with a long regimen of hyperovulation, starting from the 3rd day of the menstrual cycle and ending in the 5th week after embryo transfer. At the same time, group A was also treated with TCM of tonifying kidney and activating blood circulation and auricular point bean pressing, while group B was treated with simple TCM of tonifying kidney and activating blood circulation, group C was given auricular point bean pressing. The total scores of TCM kidney deficiency and blood stasis, endometrial thickness, uterine arterial pulsatility index (PI) and systolic/diastolic ratio value (S/D), biochemical pregnancy rate, clinical pregnancy rate and other indicators were observed and compared in each group.[Results]In group A and group B,the biochemical and clinical pregnancy rates were higher than those in group C, with statistically significant differences (P<0.05).Compared with group C, the endometrial thickness of group A was significantly increased, and PI of uterine arterial and S/D were significantly decreased, with statistically significant differences(P<0.05).Compared with group B, the PI of uterine arterial was significantly reduced in group A, and the biochemical and clinical pregnancy rates were higher than those of group B, with statistically significant differences(P<0.05).[Conclusion] The therapy of tonifying kidney and activating blood circulation with TCM combined with auricular point pressing bean can improve the endometrium thickness and blood flow resistance of uterine artery in embryo transplantation patients with kidney deficiency and blood stasis, and the effect was better than simple use of TCM or auricular point pressing beans.
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