针刺结合中药调周法内外同治肾虚血瘀型未破裂卵泡黄素化综合征临床研究

目的:探究针刺结合中药调周法内外同治对肾虚血瘀型未破裂卵泡黄素化综合征(LUFS)患者血流动力学及抗苗勒氏管激素(AMH)、抑制素B(IHNB)的影响。方法:选择肾虚血瘀型LUFS患者40例,随机将患者均分为西药组(口服枸橼酸氯米芬+注射hCG)、中药联合组(中药调周+针刺),每组20例。两组患者进行为期3个疗程的治疗,1个月经周期为1个疗程。记录比较两组治疗前后HPS评分、肾气虚症候积分、宫内膜超声评分、AMH水平和IHNB水平,治疗总有效率,治疗后的排卵状况以及血流动力学状况。结果:治疗前两组HPS评分比较无统计学差异(P>0.05); 治疗后两组HPS评分明显上升(P<0.05),且治疗后中药结合组的HPS评分更高(P<0.05)。治疗前后两组组间肾气虚症候积分相比,中药联合组积分更低,中药联合组排卵率更高(P<0.05)。两组患者单个周期排卵个数比较差异有统计学意义(P<0.05),两组间卵泡直径大小比较无统计学差异(P>0.05)。治疗前后比较两组AMH水平均上升(P<0.05),但组间相比,中药联合组AMH水平更高(P<0.05)。两组组间相比IHNB水平治疗前后无明显变化(P>0.05)。治疗后两组组间比较,中药联合组PSV水平更高,RI、PI水平更低(P<0.05)。结论:对肾虚血瘀型LUFS患者应用中药调周法、针刺联合内外同治,有助于改善患者血流动力学,降低AMH水平,提升治疗效果,改变排卵状况。

Study on treating luteinized unruptured follicle syndrome of kidney deficiency and blood stasis type by acupuncture combined with Chinese medicine regulating cycle method

Objective:To explore the effect of acupuncture combined with traditional Chinese medicine on hemodynamics and anti Mullerian hormone(AMH)in patients with luteinized unruptured follicle syndrome(LUFS)in the AMH and inhibin B(IHNB).Methods:40 patients with kidney deficiency and blood stasis type LUFS were randomly divided into western medicine group(Clomiphene citrate orally + hCG),Chinese medicine combination group(TCM week adjustment + acupuncture),20 cases in each group.The total effective rate,ovulation and hemodynamic status were recorded and compared before and after treatment,including HPS score,renal Qi deficiency syndrome score,endometrial ultrasound score,AMH level and IHNB level.Results:There was no significant difference in HPS score between the two groups before treatment(P>0.05); After treatment,the HPS score of the two groups had a significant upward trend(P<0.05),and the HPS score of the traditional Chinese medicine combined group was higher(P<0.05).In the aspect of syndrome integral of kidney qi deficiency,compared with the two groups before and after treatment,the integral of traditional Chinese medicine combined group was lower.Compared with the western medicine group,the ovulation rate of the Chinese medicine combined group was higher(86.7% vs 63.3%),the difference was significant(P<0.05).Compared with western medicine group and traditional Chinese medicine group,ovulation rate was higher(76.67% vs 50.00%),the difference was significant(P<0.05).There was significant difference in the number of ovulation in a single cycle between the two groups(P<0.05),and there was no significant difference in the diameter of follicles between the two groups(P>0.05).Compared with before and after treatment,the AMH level of the two groups decreased and increased(P<0.05),but the AMH level of the combined group was lower and higher(P<0.05).There was no significant difference in IHNB level between the two groups before and after treatment(P>0.05).After treatment,the PSV level was higher,RI and PI level was lower in the combined group(all P<0.05).Conclusion:It is of positive clinical significance to apply the method of regulating the circulation of traditional Chinese medicine and acupuncture combined with internal and external treatment in LUFS patients with kidney deficiency and blood stasis,which is helpful to improve the hemodynamics of patients,decrease the level of AMH,improve the therapeutic effect and change ovulation.