电针治疗卵巢早衰疗效观察
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摘要
目的：观察电针治疗卵巢早衰方法的近期疗效。
方法：纳入符合标准的23名患者,设对照组即西药雌孕激素序贯疗法配合中药口服(安慰剂胶囊)及观察组采用电针治疗配合中药口服(安慰剂胶囊),取穴：天枢(双),中髎(双),两穴方隔日交替针刺,得气后连接电针仪,频率20Hz,连续波形,电流强度1-4毫安,留针20min。第1-2周每周治疗4次,第3-4周每周治疗2次,以后每周治疗1次,三个月为一疗程。通过组间疗前、疗后比较,观察月经情况、兼症情况及激素水平FSH、LH,E2的改变情况。
结果：观察组13例患者中(其中2例患者脱落),10例患者行经,1例无月经。10例行经患者中,9例恢复规律月经,其中6例经量正常(6/10,60%),3例经量较少(3/10,30%)；1例间断行经,经量较少(1/10,10%)；11例患者雌二醇疗后基线较前增加54.32±46.03,卵泡刺激素疗后基线较前下降47.45±43.32,促黄体生成素疗后基线较前下降19.93±16.96。对照组10例患者中,5例患者行径,其中1例恢复规律月经,经期正常,经量正常(1/10,10%)；3例恢复规律月经,经量较少(3/10,30%)；1例间断行经,经期正常,经量正常(1/10,10%)；5例月经周期、经期无规律(5/10,50%)。10例患者雌二醇疗后基线较前增加29.86±39.75,卵泡刺激素疗后基线较前下降30.45±32.81,促黄体生成素基线疗后基线较前下降8.73±28.36。观察组与对照组治疗比较,无显著差异(P>0.05)。
结论：电针治疗可短期内改善卵巢早衰患者月经情况及兼症情况,可提高雌二醇水平,并降低卵泡刺激素和促黄体生成素水平。
Objective:Observe the short term efficacy of the method of treatment, electro-acupuncture, on premature ovarian failure.
Methods:23patients conform to the standard were brought into the subject, the study group was treated with electro-acupuncture and the Chinese patent medicine (placebo capsule), while the control group was treated with Hormone replacement therapy and the Chinese patent medicine (placebo capsule). Acupoints:Tianshu (double), Zhongliao (double), the two acupoints were used alternately every other day, connect electro-acupuncture device after the acupoints sensation respond, set the frequency of20Hz, a continuous waveform, current intensity of1-4mA, keep the needle for20min.4times per week in the first two weeks,2times per week in the second weeks, then1times per week, the course of treatment is3months. the change of menstruation, accompanied symptoms and the hormone levels of FSH, LH, E2were observed before and after treatment.
Results:In the13patients of the study group (including two without treatment),10patients had menses,while1patients didn't.6patients resumed regular menstrual period with normal Menstrual quantity (6/10,60%);3patients of the10resumed regular menstrual period with less Menstrual quantity (3/10,30%),1patient resumed intermittent menstrual period with less Menstrual quantity (1/10,10%); after treatment the estradiol baseline of11patients increased by54.32±46.03,the follicle stimulating hormone baseline decreased by47.45±43.32, and the luteinizing hormone baseline decreased by19.93±16.96. In the10patients of the control group,5patients had menses,while5patients didn't.1patients resumed regular menstrual period with normal Menstrual quantity (1/10,10%);3patients resumed regular menstrual period with less Menstrual quantity (3/10,30%),1patient resumed intermittent menstrual period with normal Menstrual quantity (1/10,10%); after treatment the estradiol baseline of10patients increased by29.86±39.75, the follicle stimulating hormone baseline decreased by30.45±32.81, and the luteinizing hormone baseline decreased by8.73±28.36. there was no significant difference between the two groups(P>0.05)
Conclusion:electro-acupunctur (EA)can improve the menstruation and the accompanied symptoms, increase the level of estradiol.and decrease the level of follicle-stimulating hormone and luteinizing hormone of the patients with POF in short term.
方法：纳入符合标准的23名患者,设对照组即西药雌孕激素序贯疗法配合中药口服(安慰剂胶囊)及观察组采用电针治疗配合中药口服(安慰剂胶囊),取穴：天枢(双),中髎(双),两穴方隔日交替针刺,得气后连接电针仪,频率20Hz,连续波形,电流强度1-4毫安,留针20min。第1-2周每周治疗4次,第3-4周每周治疗2次,以后每周治疗1次,三个月为一疗程。通过组间疗前、疗后比较,观察月经情况、兼症情况及激素水平FSH、LH,E2的改变情况。
结果：观察组13例患者中(其中2例患者脱落),10例患者行经,1例无月经。10例行经患者中,9例恢复规律月经,其中6例经量正常(6/10,60%),3例经量较少(3/10,30%)；1例间断行经,经量较少(1/10,10%)；11例患者雌二醇疗后基线较前增加54.32±46.03,卵泡刺激素疗后基线较前下降47.45±43.32,促黄体生成素疗后基线较前下降19.93±16.96。对照组10例患者中,5例患者行径,其中1例恢复规律月经,经期正常,经量正常(1/10,10%)；3例恢复规律月经,经量较少(3/10,30%)；1例间断行经,经期正常,经量正常(1/10,10%)；5例月经周期、经期无规律(5/10,50%)。10例患者雌二醇疗后基线较前增加29.86±39.75,卵泡刺激素疗后基线较前下降30.45±32.81,促黄体生成素基线疗后基线较前下降8.73±28.36。观察组与对照组治疗比较,无显著差异(P>0.05)。
结论：电针治疗可短期内改善卵巢早衰患者月经情况及兼症情况,可提高雌二醇水平,并降低卵泡刺激素和促黄体生成素水平。
Objective:Observe the short term efficacy of the method of treatment, electro-acupuncture, on premature ovarian failure.
Methods:23patients conform to the standard were brought into the subject, the study group was treated with electro-acupuncture and the Chinese patent medicine (placebo capsule), while the control group was treated with Hormone replacement therapy and the Chinese patent medicine (placebo capsule). Acupoints:Tianshu (double), Zhongliao (double), the two acupoints were used alternately every other day, connect electro-acupuncture device after the acupoints sensation respond, set the frequency of20Hz, a continuous waveform, current intensity of1-4mA, keep the needle for20min.4times per week in the first two weeks,2times per week in the second weeks, then1times per week, the course of treatment is3months. the change of menstruation, accompanied symptoms and the hormone levels of FSH, LH, E2were observed before and after treatment.
Results:In the13patients of the study group (including two without treatment),10patients had menses,while1patients didn't.6patients resumed regular menstrual period with normal Menstrual quantity (6/10,60%);3patients of the10resumed regular menstrual period with less Menstrual quantity (3/10,30%),1patient resumed intermittent menstrual period with less Menstrual quantity (1/10,10%); after treatment the estradiol baseline of11patients increased by54.32±46.03,the follicle stimulating hormone baseline decreased by47.45±43.32, and the luteinizing hormone baseline decreased by19.93±16.96. In the10patients of the control group,5patients had menses,while5patients didn't.1patients resumed regular menstrual period with normal Menstrual quantity (1/10,10%);3patients resumed regular menstrual period with less Menstrual quantity (3/10,30%),1patient resumed intermittent menstrual period with normal Menstrual quantity (1/10,10%); after treatment the estradiol baseline of10patients increased by29.86±39.75, the follicle stimulating hormone baseline decreased by30.45±32.81, and the luteinizing hormone baseline decreased by8.73±28.36. there was no significant difference between the two groups(P>0.05)
Conclusion:electro-acupunctur (EA)can improve the menstruation and the accompanied symptoms, increase the level of estradiol.and decrease the level of follicle-stimulating hormone and luteinizing hormone of the patients with POF in short term.
引文
[1].Laml T,Sehulz-LobmeyrI, ObrucaA,etal.Premature ovarian failure etiology and prospects[J].GynecolEndocrinol,2000,14(4):292—302.
[2]杨亚洲,等.卵巢早衰的病因学研究进展.实用妇产科杂志,2001,17(6)：328-330.
[3]Van Kasteren YM, Schoemaker J.Premature ovarian failure a systematic review on t herapeutic interventions to restore ovarian function and achieve pregnancy [J].Hum Repr od Update,1999,5(5):483-389.
[4]Brown CJ,Lafreniere RG, PowersVE,etal.Localization of the Xinactivation centre on the human X chromosome in Xq13.Nature,1991,349:82-84.
[5]黄邱朝,等.卵巢功能早衰患者抗卵巢抗体及细胞免疫功能的测定.中华妇产科杂志,1996,31：603-605.
[6]De Baere E,Dixon MJ, Small KW, etal. Spectrum of FOX12 genemutations in blepharophimosis-ptosis-epicanthusinverses(BPES)familiesdem-onstratesagenotype-pheno type correlation[J].Hum Mol Gene,2001,15(10):1591-1600.
[7]肖苇,等.关于卵巢早衰的诊断与治疗研究进展.黑龙江医学,2010,2(34)：107-108.
[8]Blumenfeld Z.Ovarian rescue/protection from chemotherapeutic a-gents.J soc Gynecol Investig,2001,(8):50-54.
[9]BinesJ,OleskeDM,CobleighMA.Ovari-anfunctionin prem-enopausalwomen treated with ad-juvant chemotherapy for breascancer[J].JClinOnco,1996,(14):1718-1721.
[10]金晓华,朱艳红.卵巢早衰的病因研究.医学理论与实践,2011,24(3)：268-269.
[111.Laml T,Sehulz-Lobmeyr I,Obruca A,et al. Premature ovarianfailure:etiology and prospects[J]. Gynecol Endocrinol,2000,14(4):292—302.
[12].滕秀春.柴松岩编制治疗卵巢早衰经验.中国中医药信息杂志,2011,11(18)：92-93.
[13].刘慧敏.李翠萍教授以补肾调周法防治卵巢早衰经验.广西中医药,2011,8(34)：31-32.
[14].张蕾,曲秀芬.曲秀芬教授治疗卵巢早衰经验拾萃.吉林中医药,2009,7(29)：565-566.
[15].吴燕平.裘笑梅治疗闭经经验举要.浙江中医杂志,1999,34(1)：6.
[16].徐珉等.中医补肾法对高龄不孕妇女的卵巢储备功能的调控[J].广州中医药大学学报,2004,21(4)：267-271.
[17].秦薇等.中药人工周期治疗卵巢功能早衰45例.国医论坛,2004,19(1)：30.
[18].钟雪梅,代嘉莉,李宗恒.补肾养经汤合人工周期法治疗卵巢早衰38例临床观察[J].江苏中医药,2005,26(8)：21-22.
[19].许学兵,等.表里经之俞募穴埋线治疗卵巢早衰33例.中国民间疗法,2008(3)：12-13.
[20].刘红姣,等.肝脾肾之俞募穴埋线治疗卵巢早衰66例临床观察.世界中医药,2008,3(2)：97-98.
[21].沙桂娥,等.针灸治疗卵巢早衰76例临床研究[J].中国针灸,1999,19(4)：199-201.
[22].沙桂娥,等.针灸治疗卵巢早衰不孕症84例的临床研究[J].针灸临床杂志,1998,14(6)：16-18.
[23].马仁海,等.针灸治疗卵巢功能低落56例临床观察[J].中国针灸,1997,17(7)：395-396.
[24].杨晓虹,赖晓梅,黄祖波.针灸治疗卵巢早衰60例临床观察.四川中医,2008,26(5)106-107.
[25].何文扬.针刺治疗卵巢早衰症15例.中国针灸,2000,20(7)：399.
[26].浦蕴星.针灸治疗闭经疗效分析[J].上海针灸杂志,1994,13(6)：257-258.
[27].邢红梅,王蕊,杨华.自拟补肾健脾方配合艾灸治疗卵巢早衰的临床研究.疑难病杂志,2008,7(2)101-102.
[28].蒋贵林,王转丽,刘晓燕.归肾丸合热敏灸治疗卵巢早衰32例.江西中医药,2007,38(12),45.
[1].弓翠萍,郝天宇.卵巢早衰的病因学研究进展.2010,31(3)：284-287.
[2].林守清.激素补充治疗临床应用指南[J].实用妇产科杂志,2004,20(3)：136-137.
[3].史云,张玉珍.补肾健脾调肝活血法治疗卵巢功能早衰临床观察[J].中医药学刊,2006,24(6)：1174-1176.
[4].曹默基,邵基.天枢穴在妇科病治疗中的配伍应用.针灸临床杂志,2000,16(9)：38-39.
[2]杨亚洲,等.卵巢早衰的病因学研究进展.实用妇产科杂志,2001,17(6)：328-330.
[3]Van Kasteren YM, Schoemaker J.Premature ovarian failure a systematic review on t herapeutic interventions to restore ovarian function and achieve pregnancy [J].Hum Repr od Update,1999,5(5):483-389.
[4]Brown CJ,Lafreniere RG, PowersVE,etal.Localization of the Xinactivation centre on the human X chromosome in Xq13.Nature,1991,349:82-84.
[5]黄邱朝,等.卵巢功能早衰患者抗卵巢抗体及细胞免疫功能的测定.中华妇产科杂志,1996,31：603-605.
[6]De Baere E,Dixon MJ, Small KW, etal. Spectrum of FOX12 genemutations in blepharophimosis-ptosis-epicanthusinverses(BPES)familiesdem-onstratesagenotype-pheno type correlation[J].Hum Mol Gene,2001,15(10):1591-1600.
[7]肖苇,等.关于卵巢早衰的诊断与治疗研究进展.黑龙江医学,2010,2(34)：107-108.
[8]Blumenfeld Z.Ovarian rescue/protection from chemotherapeutic a-gents.J soc Gynecol Investig,2001,(8):50-54.
[9]BinesJ,OleskeDM,CobleighMA.Ovari-anfunctionin prem-enopausalwomen treated with ad-juvant chemotherapy for breascancer[J].JClinOnco,1996,(14):1718-1721.
[10]金晓华,朱艳红.卵巢早衰的病因研究.医学理论与实践,2011,24(3)：268-269.
[111.Laml T,Sehulz-Lobmeyr I,Obruca A,et al. Premature ovarianfailure:etiology and prospects[J]. Gynecol Endocrinol,2000,14(4):292—302.
[12].滕秀春.柴松岩编制治疗卵巢早衰经验.中国中医药信息杂志,2011,11(18)：92-93.
[13].刘慧敏.李翠萍教授以补肾调周法防治卵巢早衰经验.广西中医药,2011,8(34)：31-32.
[14].张蕾,曲秀芬.曲秀芬教授治疗卵巢早衰经验拾萃.吉林中医药,2009,7(29)：565-566.
[15].吴燕平.裘笑梅治疗闭经经验举要.浙江中医杂志,1999,34(1)：6.
[16].徐珉等.中医补肾法对高龄不孕妇女的卵巢储备功能的调控[J].广州中医药大学学报,2004,21(4)：267-271.
[17].秦薇等.中药人工周期治疗卵巢功能早衰45例.国医论坛,2004,19(1)：30.
[18].钟雪梅,代嘉莉,李宗恒.补肾养经汤合人工周期法治疗卵巢早衰38例临床观察[J].江苏中医药,2005,26(8)：21-22.
[19].许学兵,等.表里经之俞募穴埋线治疗卵巢早衰33例.中国民间疗法,2008(3)：12-13.
[20].刘红姣,等.肝脾肾之俞募穴埋线治疗卵巢早衰66例临床观察.世界中医药,2008,3(2)：97-98.
[21].沙桂娥,等.针灸治疗卵巢早衰76例临床研究[J].中国针灸,1999,19(4)：199-201.
[22].沙桂娥,等.针灸治疗卵巢早衰不孕症84例的临床研究[J].针灸临床杂志,1998,14(6)：16-18.
[23].马仁海,等.针灸治疗卵巢功能低落56例临床观察[J].中国针灸,1997,17(7)：395-396.
[24].杨晓虹,赖晓梅,黄祖波.针灸治疗卵巢早衰60例临床观察.四川中医,2008,26(5)106-107.
[25].何文扬.针刺治疗卵巢早衰症15例.中国针灸,2000,20(7)：399.
[26].浦蕴星.针灸治疗闭经疗效分析[J].上海针灸杂志,1994,13(6)：257-258.
[27].邢红梅,王蕊,杨华.自拟补肾健脾方配合艾灸治疗卵巢早衰的临床研究.疑难病杂志,2008,7(2)101-102.
[28].蒋贵林,王转丽,刘晓燕.归肾丸合热敏灸治疗卵巢早衰32例.江西中医药,2007,38(12),45.
[1].弓翠萍,郝天宇.卵巢早衰的病因学研究进展.2010,31(3)：284-287.
[2].林守清.激素补充治疗临床应用指南[J].实用妇产科杂志,2004,20(3)：136-137.
[3].史云,张玉珍.补肾健脾调肝活血法治疗卵巢功能早衰临床观察[J].中医药学刊,2006,24(6)：1174-1176.
[4].曹默基,邵基.天枢穴在妇科病治疗中的配伍应用.针灸临床杂志,2000,16(9)：38-39.