针灸对IVF-ET反复种植失败患者子宫内膜血流及胞饮突表达的影响

发布时间：2018-04-14 15:07

本文选题：针灸 + 体外受精-胚胎移植(IVF-ET)　；参考：《生殖与避孕》2015年03期

【摘要】：目的:探讨针灸对体外受精-胚胎移植(IVF-ET)反复种植失败(RIF)患者子宫内膜容受性的影响及其作用机制。方法:将IVF-ET胚胎质量好但RIF的40例患者随机分为试验组及对照组,每组20例。试验组于月经第7日开始运用艾条灸神阙穴,针刺穴位关元、气海、子宫、血海等至排卵后第7日止,此为1个疗程,共行3个疗程。对照组于相同时间运用安慰针灸针治疗。观察治疗前、后排卵第7日的子宫内膜厚度、类型、子宫内膜血流指数[搏动指数(PI)及阻力指数(RI)],并用扫描电子显微镜观察患者子宫内膜表面胞饮突情况。结果:治疗前所有IVF-ET反复失败患者发育的胞饮突少,不同步,发育完全的胞饮突少见,试验组治疗后的患者子宫内膜胞饮突表达丰富,发育完全,与治疗前比差异有统计学意义,对照组治疗前、后变化差异无统计学意义。试验组治疗3个疗程后,排卵后第7日A型内膜比例高于对照组,差异有统计学意义(P0.05),子宫内膜血流参数PI、RI低于对照组,差异均有统计学意义(P0.01或P0.05),试验组与对照组治疗后的排卵第7日子宫内膜厚度差异无统计学意义(P0.05)。结论:针灸可以改善IVF-ET胚胎质量好,但RIF患者的子宫内膜形态,降低子宫内膜的血流阻力,改善血供,提高患者子宫内膜胞饮突的表达,从而提高子宫内膜容受性,有利于胚胎种植。
[Abstract]:Objective: To investigate the effect of acupuncture on in vitro fertilization embryo transfer (IVF-ET) repeated implantation failure (RIF) patients with endometrial receptivity and its mechanism. Methods: IVF-ET embryos good quality but 40 of RIF patients were randomly divided into experimental group and control group, 20 cases in each group. The experimental group began to use the seventh day of menstruation Moxa Moxibustion, acupoint Guanyuan, Qihai, uterus, blood and seventh days after ovulation, the total of 1 courses, 3 courses. The control group at the same time using the comfort acupuncture needle treatment. Before treatment, the endometrial thickness, seventh days after ovulation, endometrial blood flow [index pulsatility index (PI) and resistance index (RI), and to observe the patients with endometrial pinopode surface by scanning electron microscope. Results: all patients before treatment IVF-ET repeated failure of development of pinopode less, not synchronous, fully developed pinopodes rare test The expression of rich group after treatment in patients with endometrial pinopode growth, compared with that before treatment, there was significant difference in control group before treatment, there was no significant difference. After the change in experimental group after 3 courses of treatment, seventh days after ovulation type A endometrial ratio is higher than the control group, the difference was statistically significant (P0.05), endometrial blood flow parameters PI, RI lower than the control group, the differences were statistically significant (P0.01 or P0.05), the experimental group and the control of ovulation on endometrial thickness difference of seventh groups after treatment had no statistical significance (P0.05). Conclusion: acupuncture can improve the IVF-ET quality of embryos, but the endometrial morphology in patients with RIF, reduce the endometrial blood flow resistance, improve blood supply, improve the expression in patients with endometrial pinopode, so as to improve the endometrial receptivity for embryo implantation.

【作者单位】：青岛海慈医疗集团妇一科;烟台毓璜顶医院生殖医学科;
【基金】：2013~2014年度山东省中医药科技发展计划项目,项目编号:2013-275
【分类号】：R714.8

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