温针灸对肾阳虚薄型子宫内膜患者子宫内膜容受性的影响
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摘要
目的观察温针灸对肾阳虚薄型子宫内膜患者子宫内膜容受性的临床疗效。方法将60例不孕症薄型子宫内膜患者随机分为对照组30例和治疗组30例。对照组给予口服戊酸雌二醇片治疗,治疗组在对照组基础上给予温针灸治疗。比较两组治疗前后子宫内膜厚度、子宫内膜形态及子宫内膜血流搏动指数(PI)、血流阻力指数(RI)和肾阳虚症状体征积分变化,并比较两组临床妊娠率。结果两组治疗后子宫内膜厚度较同组治疗前均有不同程度的改善(P<0.05),两组治疗后子宫内膜厚度比较差异无统计学意义(P>0.05)。治疗组治疗后子宫内膜分型中A型比例较治疗前增加(P<0.01);与对照组比较,差异有统计学意义(P<0.05)。治疗组治疗后子宫内膜血流PI、RI均低于对照组,差异具有统计学意义(P<0.05)。治疗组临床妊娠率为33.3%,对照组临床妊娠率20.0%,两组比较差异有统计学意义(P<0.05)。两组治疗后肾阳虚症状体征积分较同组治疗前降低(P<0.05),治疗组低于对照组(P<0.05)。结论温针灸治疗能改善肾阳虚薄型子宫内膜患者子宫内膜容受性,提高临床妊娠率。
Objective To observe the clinical efficacy of warm needling in intervening endometrial receptivity in kidney-yang deficiency patients with thin endometrium. Method Sixty infertile patients with thin endometrium were randomized into a control group of 30 cases and a treatment group of 30 cases. The control group was intervened by oral administration of estradiol valerate tablets, and the treatment group was additionally given warm needling. The endometrium thickness, endometrial morphological appearance, endometrial blood flow resistance index(RI) and pulse index(PI), and kidney-yang deficiency symptom and sign score of the two groups were compared before and after treatment. The clinical pregnancy rates of the two groups were also compared. Result After treatment, the endometrium thickness was improved to different degrees in the two groups(P<0.05), while there was no betweengroup difference in the endometrium thickness after treatment(P>0.05). In the treatment group, the number of type A endometrium increased after treatment(P<0.01), and was significantly different from that in the control group(P<0.05). After treatment, the endometrial blood flow PI and RI in the treatment group were significantly lower than those in the control group(P<0.05). The clinical pregnancy rate was 33.3% in the treatment group, versus 20.0% in the control group, and the between-group difference was statistically significant(P<0.05). The kidney-yang deficiency symptom and sign score dropped after treatment in both groups(P<0.05), and the treatment group was lower than the control group(P<0.05). Conclusion Warm needling can improve the endometrial receptivity in kidney-yang deficiency patients with thin endometrium, and it can increase the clinical pregnancy rate.
Objective To observe the clinical efficacy of warm needling in intervening endometrial receptivity in kidney-yang deficiency patients with thin endometrium. Method Sixty infertile patients with thin endometrium were randomized into a control group of 30 cases and a treatment group of 30 cases. The control group was intervened by oral administration of estradiol valerate tablets, and the treatment group was additionally given warm needling. The endometrium thickness, endometrial morphological appearance, endometrial blood flow resistance index(RI) and pulse index(PI), and kidney-yang deficiency symptom and sign score of the two groups were compared before and after treatment. The clinical pregnancy rates of the two groups were also compared. Result After treatment, the endometrium thickness was improved to different degrees in the two groups(P<0.05), while there was no betweengroup difference in the endometrium thickness after treatment(P>0.05). In the treatment group, the number of type A endometrium increased after treatment(P<0.01), and was significantly different from that in the control group(P<0.05). After treatment, the endometrial blood flow PI and RI in the treatment group were significantly lower than those in the control group(P<0.05). The clinical pregnancy rate was 33.3% in the treatment group, versus 20.0% in the control group, and the between-group difference was statistically significant(P<0.05). The kidney-yang deficiency symptom and sign score dropped after treatment in both groups(P<0.05), and the treatment group was lower than the control group(P<0.05). Conclusion Warm needling can improve the endometrial receptivity in kidney-yang deficiency patients with thin endometrium, and it can increase the clinical pregnancy rate.
引文
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[3]乐杰.妇产科学[M].第7版,北京:人民卫生出版社,2008:415.
[4]杨永琴,尤昭玲,游卉,等.尤昭玲对不孕病症中医治疗及试孕方案经验[J].中华中医药杂志,2016,35(11):4559-4562.
[5]郭玉琪,刘义,丁玉莲,等.小剂量阿司匹林促排卵过程中对子宫内膜发育的研究[J].中国实用妇科与产科杂志,2006,22(10):750-753.
[6]俞凌,王淑芳,叶明侠,等.薄型子宫内膜治疗新进展[J].国际生殖健康/计划生育杂志,2016,35(2):165-169.
[7]许娟,唐淮云,汤丽莎,等.温经祛瘀方对子宫内膜病变不孕患者IVF-ET周期子宫内膜形态变化及妊娠的影响[J].山东医药,2015,55(5):19-21.
[8]张蔚苓,常淑华.补肾活血周期治疗联合西药对官腔粘连术后子宫内膜影响的临床研究[J].中华中医药学刊,2016,21(5):1169-1172.