Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure

YOU Xiu-mi; ZHANG Jun-xin; YANG Juan; LIN Qiu-ping; LIN Jie; QIU Jia-hui; GAO Huan-huan; XU Jin-bang

doi:10.13702/j.1000-0607.20230084

您当前的位置：

首页 >

文章列表页 >

Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure

更新时间：2023-09-18

- Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure
- Acupuncture Research Vol. 48, Issue 9, Pages: 939-945(2023)
- 作者机构：
  
  1.福建省妇幼保健院，福建医科大学妇儿临床医学院，福州 350001
  2.福建中医药大学，福州 350122
- 作者简介：
- 基金信息：
- DOI：10.13702/j.1000-0607.20230084
  CLC： R245.31
- Received：08 February 2023，
  
  Revised：07 April 2023，
  
  Published：25 September 2023
- 稿件说明：
移动端阅览
游秀密,张俊新,杨娟等.针刺对反复种植失败血栓前状态不孕患者妊娠结局影响的临床研究[J].针刺研究,2023,48(09):939-945.

YOU Xiu-mi,ZHANG Jun-xin,YANG Juan,et al.Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure[J].Acupuncture Research,2023,48(09):939-945.
游秀密,张俊新,杨娟等.针刺对反复种植失败血栓前状态不孕患者妊娠结局影响的临床研究[J].针刺研究,2023,48(09):939-945. DOI： 10.13702/j.1000-0607.20230084.

YOU Xiu-mi,ZHANG Jun-xin,YANG Juan,et al.Clinical study on the effect of acupuncture on pregnancy outcome in patients with prethrombotic infertility after repeated implantation failure[J].Acupuncture Research,2023,48(09):939-945. DOI： 10.13702/j.1000-0607.20230084.

摘要

目的

观察针刺联合西药对肾虚血瘀型反复种植失败（RIF）血栓前状态不孕患者妊娠结局的影响。

方法

将70例拟行冻融胚胎移植的肾虚血瘀型反复种植失败血栓前状态患者随机分为对照组35例，治疗组35例。对照组予人工周期冻融胚胎移植基础治疗和口服阿司匹林肠溶片25 mg/片，一次1片，每日2次，连续治疗3个月经周期。治疗组在对照组的基础上加用针刺治疗，每次30 min，一周3次，连续治疗3个月经周期。比较两组患者临床妊娠率、胚胎种植率、活产率；于治疗前及移植前1 d，比较两组患者肾虚血瘀症状评分；于治疗前及移植前1 d采用多普勒超声检测患者子宫螺旋动脉血流搏动指数（PI值）、阻力指数（RI值），于移植前1 d比较两组子宫内膜厚度；检测患者血浆D-二聚体、血清同型半胱氨酸（Hcy）及血栓素B2（TXB2）含量。

结果

治疗组临床妊娠率、胚胎种植率、活产率均高于对照组（

0.05）。治疗后两组的肾虚血瘀型症状评分、血浆D-二聚体含量、血清Hcy和TXB2含量、PI和RI值均较治疗前降低（

0.05），且治疗组低于对照组（

0.05）。治疗过程中对照组7例患者在一定程度上出现胃脘胀痛、纳差、便秘、欲呕等胃肠的不适反应，而治疗组仅2例出现上述不适反应。

结论

针刺能在西药治疗基础上降低肾虚血瘀型血栓前状态RIF患者的血清TXB2含量而改善血管内皮功能，提高子宫内膜容受性，可缓解患者的肾虚血瘀症状，减少药物不良反应，最终改善患者妊娠结局，提高胚胎种植率。

Abstract

Objective

To observe the effect of acupuncture combined with medication on the pregnancy outcome of kidney deficiency and blood stasis type recurrent implantation failure （RIF） in prethrombotic infertility patients.

Methods

A total of 70 RIF patients of kidney deficiency and blood stasis type who were to undergo freeze-thaw embryo transplantation were randomly divided into control and treatment groups， with 35 cases in each group. Patients in the control group were given the basic treatment of artificial periodic freeze-thaw embryo transfer and oral aspirin enteric-coated tablet， 25 mg each time， twice a day， for 3 consecutive menstrual cycles. Patients in the treatment group were treated with acupuncture on the basis of the control group， 30 min each time， 3 times a week， for 3 consecutive menstrual cycles. The clinical pregnancy rate， embryo implantation rate and live birth rate of the two groups were compared. Before treatment and 1 day before transplantation， the scores of kidney deficiency and blood stasis symptom were compared. The blood flow pulse index （PI） and resistance index （RI） of the uterus spiral artery were detected by Doppler ultrasound before treatment and 1 day before transplantation. The endometrial thickness was detected 1 day before transplantation. The contents of plasma D-dimer， serum homocysteine （Hcy） and serum thromboxane B2 （TXB2） were detected.

Results

The clinical pregnancy rate， embryo implantation rate and live birth rate in the treatment group were higher than those in the control group （

0.05）. After treatment， the scores of kidney deficiency and blood stasis symptom， the levels of plasma D-dimer， serum Hcy and TXB2 ，the PI and RI value in both groups were decreased （

0.05） compared with those before treatment， and the indexes in the treatment group were decreased （

0.05） more than those in the control group. There was no significant difference in endometrial thickness between the two groups. In the course of treatments， 7 patients in the control group underwent gastric distension pain， poor appetite， constipation， nausea and other gastrointestinal reactions， while only 2 patients in the treatment group had the above discomfort reactions.

Conclusion

On the basis of medication， acupuncture can reduce the serum TXB2 content in RIF patients in prethrombotic state， improve vascular endothelial function， enhance endometrial tolerance， alleviate the symptoms of kidney deficiency and blood stasis， reduce drug adverse reactions， and ultimately improve the pregnancy outcome and increase the rate of embryo implantation.

关键词

Keywords

references

FRANASIAK J M ， ALECSANDRU D ， FORMAN E J ， et al . A review of the pathophysiology of recurrent implantation failure ［J］. Fertil Steril ， 2021 ， 116 （ 6 ）： 1436 - 1448 .

MA J Y ， GAO W Y ， LI D . Recurrent implantation failure： a comprehensive summary from etiology to treatment ［J］. Front Endocrinol ， 2023 ， 13 ： 1061766 .

CRACIUNAS L ， GALLOS I ， CHU J ， et al . Conventional and modern markers of endometrial receptivity： a systematic review and meta-analysis ［J］. Hum Reprod Update ， 2019 ， 25 （ 2 ）： 202 - 223 .

LIU H ， HUANG X B ， MOR G ， et al . Epigenetic modifications working in the decidualization and endometrial receptivity ［J］. Cell Mol Life Sci ， 2020 ， 77 （ 11 ）： 2091 - 2101 .

谭小方，丁家怡 . 血栓前状态在胚胎反复种植失败中的研究进展［J］. 中国妇幼健康研究， 2019 ， 30 （ 6 ）： 744 - 748 .

TAN X F ， DING J Y . Advances in the study of prethrombotic state in repeated implantation failure （in Chinese）［J］. Chinese Journal of Woman and Child Health Research ， 2019 ， 30 （ 6 ）： 744 - 748 .

赵娜，陆启滨 . 陆启滨教授诊治复发性流产血栓前状态的临证经验［J］. 现代中西医结合杂志， 2019 ， 28 （ 17 ）： 1870 - 1873 .

ZHAO N ， LU Q B . Professor Lu Qibin’s clinical experience in diagnosis and treatment of prethrombotic state of recurrent abortion （in Chinese）［J］. Modern Journal of Integrated Traditional Chinese and Western Medicine ， 2019 ， 28 （ 17 ）： 1870 - 1873 .

李孟邻，郑淑珍，王浩然，等 . “通元针法”改善反复种植失败妊娠结局51例［J］. 中国针灸， 2022 ， 42 （ 2 ）： 155 - 156 .

LI M L ， ZHENG S Z ， WANG H R ， et al . Tongyuan acupuncture for improving therapeutic outcomes of 51 recurrent implantation failure patients （in Chinese）［J］. Chinese Acupuncture & Moxibustion ， 2022 ， 42 （ 2 ）： 155 - 156 .

钟秀芳，宗道宽，迟令侃等 . 电针对体外受精-胚胎移植肾精亏虚型卵巢低反应患者妊娠结局的影响［J］. 针刺研究， 2023 ， 48 （ 4 ）： 392 - 398 .

ZHONG X F ， ZONG D K ， CHI L K ， et al . Effects of electroacupuncture on pregnancy outcome in poor ovarian response patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer （in Chinese）［J］. Acupuncture Research ， 2023 ， 48 （ 4 ）： 392 - 398 .

COUGHLAN C ， LEDGER W ， WANG Q ， et al . Recurrent implantation failure： definition and management ［J］. Reprod Biomed Online ， 2014 ， 28 （ 1 ）： 14 - 38 .

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 .

ZHENG X Y . Guiding principles for clinical research of new Chinese medicine： trial implementation （in Chinese）［M］. Beijing ： China Medical Science Press ， 2002 .

黄兰，陈赛琼 . “ 调冲任、固肾元”针刺法配合益宫养泡汤治疗小卵泡排卵不孕症疗效及对下丘脑-垂体-卵巢轴功能的影响［J］. 现代中西医结合杂志， 2021 ， 30 （ 2 ）： 160 - 163， 203 .

HUANG L ， CHEN S Q . Curative effect of acupuncture for coordinating Chong-Ren and strengthening kidney combined with Yigong Yangpao Decoction on small follicular ovulation infertility and its effect on the function of the hypothalamus-pituitary-ovarian axis （in Chinese）［J］. Modern Journal of Integrated Traditional Chinese and Western Medicine ， 2021 ， 30 （ 2 ）： 160 - 163， 203 .

钱婧 . 基于“冲为血海”的分期针灸疗法改善IVF-ET血栓前状态的临床研究［D］. 昆明：云南中医药大学， 2019 .

QIAN J . Clinical research of staged acupuncture treatment based on the theory of Chong channel being sea of blood with pre-thrombotic state patients in IVF-ET （in Chinese）［D］. Kunming ： Yunnan University of Traditional Chinese Medicine ， 2019 .

薛红梅，李月梅，陈雨婷，等 . “通元针法”分期施治对薄型子宫内膜反复种植失败患者妊娠结局的影响［J］. 中国针灸， 2021 ， 41 （ 12 ）： 1338 - 1342 .

XUE H M ， LI Y M ， CHEN Y T ， et al . Effect of staging treatment of Tongyuan acupuncture on pregnancy outcome in patients with recurrent implantation failure of thin endometrium type （in Chinese）［J］. Chinese Acupuncture & Moxibustion ， 2021 ， 41 （ 12 ）： 1338 - 1342 .

WESTERGAARD L G ， MAO Q H ， KROGSLUND M ， et al . Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women： a prospective， randomized trial ［J］. Fertil Steril ， 2006 ， 85 （ 5 ）： 1341 - 1346 .

辛思源，杨志新，郭建恩，等 . 电针“三阴交-悬钟”对类痛经模型大鼠血浆血栓素B 2 （TXB 2 ）、六酮前列腺素F 1α （6-keto-PGF 1α ）的影响［J］. 科技风， 2020 （ 29 ）： 186 - 187 .

XIN S Y ， YANG Z X ， GUO J E ， et al . Effects of electroacupuncture at “Sanyinjiao-Xuanzhong” on plasma thromboxane B 2 （TXB 2 ） and hexaketoprostaglandin F 1α （6-keto-PGF 1α ） in dysmenorrhea-like rats （in Chinese）［J］. Technology Wind ， 2020 （ 29 ）： 186 - 187 .

Views

下载量

CNKI被引量

Alert me when the article has been cited

提交

Tools

Publicity Resources

Research progress on the mechanism of acupuncture based on microbiota-gut-brain axis

Research progress on the effect of α-synuclein in acupuncture treatment for Parkinson’s disease

Advances of researches on acupuncture treatment of Parkinson’s disease by regulating mitochondrial function

Clinical observation on the effect of visual occlusion on pain sensation and pain emotion in patients with scapulohumeral periarthritis treated with acupuncture

Related Author

XING Min

QIAO Li-na

WAN Hong-ye

YANG Yong-sheng

SHEN Yi-wei

WANG Shun

BAI Yan

WANG Yu-lin

Related Institution

Institute of Acupuncture and Moxibustion， China Academy of Chinese Medical Sciences

The Second Clinical Medical School， Heilongjiang University of Traditional Chinese Medicine

Heilongjiang Academy of Traditional Chinese Medicine

College of Acupuncture-Moxibustion and Tuina，Shandong University of Traditional Chinese Medicine

College of Clinical Medicine，Jining Medical University

Postal code：100700
Tel：010-64089344,84014607 Email：zcyjbjb@vip.163.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备05017590号-8 京公网安备11010802020460号
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰