针刺治疗高龄妇女卵巢储备功能下降的临床观察
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摘要
目的观察不同频次"调任通督针刺法"治疗高龄妇女卵巢储备功能下降的临床疗效并探讨其作用机制。方法将42例高龄妇女卵巢储备功能下降患者随机分为高频次治疗组(n=21)和低频次治疗组(n=21),28天为1个疗程,治疗3个疗程后随访3个月,观察比较患者的临床症状评分、抗缪勒氏管激素(AMH)、排卵期内膜厚度、基础血清雌二醇(E_2)、促卵泡生成素(FSH)、促黄体生成素(LH)及FSH/LH比值、妊娠情况、月经改善情况主要疗效指标。结果治疗后两组临床症状评分、排卵期内膜厚度、FSH、E_2水平及FSH/LH比值较治疗前均明显改善(P<0.05);且高频次治疗组在内膜增厚、临床症状评分、E_2、FSH、月经改善方面优于低频次治疗组(P<0.05)。结论 "调任通督针刺法"对于高龄妇女卵巢储备功能下降具有一定的临床疗效,且每周治疗3次具有更佳的疗效,其机制可能是通过改善下丘脑-垂体-卵巢轴内分泌功能来实现的。
Objective To observe the clinical effect of different frequency of "regulating conception-governor vessel" acupuncture on the diminished ovarian reserve(DOR)in aged women and to explore its mechanism.Methods Patients were randomly divided into the high-frequency treatment group(n=21) and the low-frequency treatment group(n=21). The whole treatment consists three consecutive course of treatment(28 days for each course), followed by 3 months' follow-up. The main outcome measures were the clinical symptom score, anti-mullerian hormone(AMH), endometrium thickness in the ovulatory period, basal serum hormone levels(E_2, FSH, LH, FSH/LH), menstrual improvement and pregnancy status. Results After 3 months' treatment, the clinical symptom score, endometrium thickness in the ovulatory period and the levels of FSH, E_2 and FSH/LH in both groups were significantly improved after treatment(P<0.05). Moreover, the high-frequency treatment group was superior to the low-frequency treatment group in improving the clinical symptom score, the endometrium thickness, level of E_2 and FSH, as well as the menstruation(P<0.05). Conclusion The "regulating conception-governor vessel " acupuncture method has certain effect on the DOR in aged women, especially 3 times one week, and the mechanism may be achieved by improving the endocrine function of the hypothalamic-pituitary-ovarian axis.
Objective To observe the clinical effect of different frequency of "regulating conception-governor vessel" acupuncture on the diminished ovarian reserve(DOR)in aged women and to explore its mechanism.Methods Patients were randomly divided into the high-frequency treatment group(n=21) and the low-frequency treatment group(n=21). The whole treatment consists three consecutive course of treatment(28 days for each course), followed by 3 months' follow-up. The main outcome measures were the clinical symptom score, anti-mullerian hormone(AMH), endometrium thickness in the ovulatory period, basal serum hormone levels(E_2, FSH, LH, FSH/LH), menstrual improvement and pregnancy status. Results After 3 months' treatment, the clinical symptom score, endometrium thickness in the ovulatory period and the levels of FSH, E_2 and FSH/LH in both groups were significantly improved after treatment(P<0.05). Moreover, the high-frequency treatment group was superior to the low-frequency treatment group in improving the clinical symptom score, the endometrium thickness, level of E_2 and FSH, as well as the menstruation(P<0.05). Conclusion The "regulating conception-governor vessel " acupuncture method has certain effect on the DOR in aged women, especially 3 times one week, and the mechanism may be achieved by improving the endocrine function of the hypothalamic-pituitary-ovarian axis.
引文
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[9] 卓缘圆,吴家满,林婉珊,等.“调任通督针刺法”治疗多囊卵巢综合征不孕症的临床疗效观察[J].中国针灸,2016,36(12):1237.
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[11] 徐虹云.针刺治疗肾虚血瘀型卵巢储备功能下降的临床研究[D].黑龙江中医药大学硕士学位论文,2016.
[12] 朱丽娟,徐义勇,黄丽娟.针刺联合补肾调周法对高龄不孕妇女卵巢储备功能影响的临床研究[J].内蒙古中医药,2016,35(10):62.
[13] 王黎明,张永臣,贾红玲.近10年来针灸治疗卵巢早衰机制研究进展[J].上海针灸杂志,2017,36(3):361.
[2] 林湫莹.卵巢储备功能下降的中西医研究进展及中医用药规律探讨[D].北京中医药大学硕士学位论文,2016.
[3] Diagnostic evaluation of the infertile female:a committee opinion[J].Fertil Steril,2015,103(6):e44.
[4] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[5] 张玉珍.中医妇科学,第2版[M].北京:中国中医药出版社,2007:69.
[6] 万凌屹,丁彩飞,俞佳.补肾活血方治疗肾虚血瘀型卵巢储备功能下降临床观察[J].中华中医药学刊,2018,36(2):432.
[7] 杨青萍,黄筱金.卵巢储备功能与生育力减退影响因素的研究进展[J].医学综述,2016,22(11):2158.
[8] 陈鹏典,杨卓欣,黎杰运,等.任督脉与孕育的相关性探析[J].中国民族民间医药,2016,25(13):49.
[9] 卓缘圆,吴家满,林婉珊,等.“调任通督针刺法”治疗多囊卵巢综合征不孕症的临床疗效观察[J].中国针灸,2016,36(12):1237.
[10] 李晓彤.调经促孕针刺法对卵巢储备功能下降影响的临床探索性研究[D].中国中医科学院硕士学位论文,2017.
[11] 徐虹云.针刺治疗肾虚血瘀型卵巢储备功能下降的临床研究[D].黑龙江中医药大学硕士学位论文,2016.
[12] 朱丽娟,徐义勇,黄丽娟.针刺联合补肾调周法对高龄不孕妇女卵巢储备功能影响的临床研究[J].内蒙古中医药,2016,35(10):62.
[13] 王黎明,张永臣,贾红玲.近10年来针灸治疗卵巢早衰机制研究进展[J].上海针灸杂志,2017,36(3):361.