摘要
目的探讨中医药干预对卵巢储备功能下降(DOR)女性体外受精胚胎移植(IVF-ET)助孕结局的影响。方法选取2019年1月至2021年10月在我院行IVF助孕的20~42岁DOR女性212例,随机分为中药组、电针组、中药联合电针组及对照组各60个取卵周期。分别在入周前行中药或电针或针药联合或脱氢表雄酮加辅酶Q10干预3个月,比较四组患者干预前后抗苗勒氏管激素(AMH)、基础性激素、窦卵泡数(AFC)、焦虑和抑郁评分、促性腺激素(Gn)用量、获卵数、成熟卵子数(MII)、正常受精(2PN)数、可移植胚胎数、临床妊娠率、活产率和流产率等。结果四组干预前AMH、基础性激素、AFC、焦虑抑郁评分、人绒毛膜促性腺激素(HCG)日E2、内膜厚度、获卵数、MII卵数、妊娠率、活产率、流产率比较,差异无统计学意义(P>0.05)。干预后,中药组AMH、AFC、Gn使用量及天数均显著高于电针组和对照组(P<0.05);干预后,中药组和针药联合组基础促卵泡素(b-FSH)显著低于对照组(P<0.05);中药组、电针组、中药联合电针组焦虑抑郁评分均低于干预前(P<0.05);针药联合组的2PN数和可移植胚胎数高于电针组和对照组(P<0.05)。结论DOR患者IVF入周前行补肾活血疏肝健脾中医药及电针治疗均可以改善患者焦虑抑郁评分,联合服用中药比单纯电针治疗效果更好,能够改善DOR患者卵巢功能,增加获卵数、MII卵数、2PN数和可移植胚胎数,提高IVF-ET妊娠率及提升活产率的趋势。
Objectives To investigate the effect of Traditional Chinese Medicine intervention on the outcomeofin vitro fertilization and embryo transfer(IVF-ET)in women with diminished ovarian reserve(DOR).Methods Total of 212 DOR women aged 20~42 years who underwent IVF in our hospital from January 2019 to October 2021 were randomly divided into Chinese Medicine group,electroacupuncture group,Chinese Medicine combined with electroacupuncture group,and control group,with 60 cycles in each group.The patients were treated with TCM or electroacupuncture or acupuncture combined with TCM or dehydroepiandrosterone(DHEA)plus coenzyme Q10 for 3 months respectively before IVF.The anti-mullerian hormone(AMH),basic sex hormone,antral follicle number(AFC),anxiety and depression score,gonadotropin(Gn)dosage,number of oocytesretrieved,number of metaphase II(MII)oocytes,number of normal fertilization(2PN),number of transplantable embryos,clinical pregnancy rate,live birth rate,and abortion rate were compared among the four groups before and after intervention.Results There were no significant differences in AMH,basic sex hormones,AFC,anxiety and depression scores,Estradiol(E2)on human chorionic gonadotropin(HCG)injection day,endometrial thickness,number of retrieved oocytes,pregnancy rate,number of MII oocytes,live birth rate and abortion rate among the four groups(P>0.05).After intervention,the AMH level,AFC,the days and dosage of Gn,in TCM group were significantly higher than those in electroacupuncture group and control group(P<0.05).After intervention,basic follicle stimulating hormone(b-FSH)in TCM group and acupuncture combinedwithTCM group was significantly lower than that in control group(P<0.05).The anxiety and depression scores of the 3 groups except the control group were significantly lower than those before intervention(P<0.05).The number of 2PN,the number of transplantable embryos,and in the combined group were significantly higher than those in the electroacupuncture group and the control group(P<0.05).Conclusions Both TCM an
作者
李冬兰
梁瑞宁
刘淑娟
LI Donglan;LIANG Ruining;LIU Shujuan(Department of Reproduction,Affiliated Hospital of Nanchang Institute of Medical Science/Reproductive Hospital of Jiangxi University of Traditional Chinese Medicine;Department of Gynecology,The Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330000 Jiangxi,China)
出处
《现代诊断与治疗》
CAS
2023年第7期949-953,共5页
Modern Diagnosis and Treatment
基金
江西省中医药科研课题(项目编号2019A361)。
关键词
卵巢储备功能下降
体外受精胚胎移植
中药
电针
Diminished ovarian reserve
In vitro fertilization embryo transfer
Traditional Chinese Medicine
Electroacupuncture
