从子宫内膜蠕动角度探针药结合对肾阴虚患者子宫内膜容受性的影响

发布时间：2018-08-07 08:32

【摘要】：目的:1.诠释肾主生殖的科学内涵,印证针刺联合滋肾清热中药的临床疗效。2.依据子宫内膜蠕动波频率的相关指标,探讨针刺联合滋肾清热中药提高子宫内膜容受性的干预机制。方法:选择肾阴虚型行冻融胚胎移植(FET)的患者70例,应用针刺联合滋肾清热中药治疗者35例(治疗组),应用伪针联合安慰剂者35例(对照组),通过观察治疗前后患者的肾阴虚证候评分,FET日子宫内膜蠕动波频率(UPF)、内膜下血流及容积、前列腺素F2α(PGF2α)的含量、血清中E2/P的比值以及临床妊娠率,从子宫内膜蠕动波频率角度探讨针药结合对FET周期子宫内膜容受性的影响及对肾阴虚患者的症状改善作用。结果:1.治疗组UPF低于对照组(P0.05);两组患者FET日UPF值总体分布不同,治疗组A组(≤2.0次/min)、B组(2.1~3.0次/min)的人数百分比明显大于对照组,而对照组C组(3.0次/min)的人数百分比明显大于治疗组(P0.05);妊娠率A组明显高于B组和C组,C组最低。2.对照组E2/P的比值、PGF2α的值高于治疗组(P0.05)。3.治疗组VI、FI、VFI和V的值明显大于对照组。4.治疗后治疗组患者肾阴虚症状得到明显改善,临床妊娠率治疗组高于对照组(P0.05)。结论:1.子宫内膜蠕动频率增加是肾阴虚患者胚胎着床失败的原因之一,FET日较低的子宫内膜蠕动频率预示较好的临床妊娠率。2.针刺联合滋肾清热中药可通过降低PGF2α的含量,调节下丘脑-垂体-卵巢轴(HPO轴),改善子宫内膜血流状态来降低子宫内膜蠕动波频率,进而促进胚胎顺利着床,改善妊娠结局。3.针刺联合滋肾清热中药能明显改善肾阴虚型FET患者的肾阴虚状态,适度降低子宫内膜蠕动的频率,提高子宫内膜对胚胎的接受能力,从而获得较好的临床妊娠率。4.以“肾主生殖”为理论向导,从中医滋肾清热角度阐明肾阴虚患者子宫内膜蠕动加快的原因,进一步诠释了“肾主生殖”的科学内涵。
[Abstract]:Purpose 1. Explain the scientific connotation of kidney and reproduction, confirm the clinical curative effect of acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat. According to the related indexes of peristaltic wave frequency of endometrium, the intervention mechanism of acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat to improve endometrial receptivity was discussed. Methods: seventy (FET) patients with kidney yin deficiency were selected for freeze-thawing embryo transfer. 35 cases (treatment group) were treated with acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat (treatment group) and 35 cases (control group) were treated with pseudo-acupuncture combined with placebo (control group). The frequency of peristalsis of endometrium on the day of (UPF), was evaluated by observing the score of syndrome of kidney yin deficiency before and after treatment. Submembranous blood flow and volume, The content of prostaglandin F _ 2 伪 (PGF2 伪), the ratio of E _ 2 / P in serum and the clinical pregnancy rate, the effect of combination of acupuncture and medicine on the endometrial receptivity of FET cycle and the improvement of symptoms in patients with kidney yin deficiency were discussed from the point of view of peristaltic wave frequency of endometrium. The result is 1: 1. The UPF of the treatment group was lower than that of the control group (P0.05), the total distribution of FET day UPF value was different between the two groups, and the percentage of the patients in group A (鈮，

本文编号：2169473