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电针对多囊卵巢综合征患者体外受精-胚胎移植中卵细胞质量及妊娠的影响(英文)
引用本文:崔薇,李静,孙伟,闻姬. 电针对多囊卵巢综合征患者体外受精-胚胎移植中卵细胞质量及妊娠的影响(英文)[J]. 世界针灸杂志, 2012, 22(1): 23-29. DOI: 10.1016/S1003-5257(12)60005-1
作者姓名:崔薇  李静  孙伟  闻姬
作者单位:崔薇 (山东中医药大学第二附属医院生殖医学科,济南250001,中国) ; 李静 (山东中医药大学第二附属医院生殖医学科,济南250001,中国) ; 孙伟 (山东中医药大学第二附属医院生殖医学科,济南250001,中国) ; 闻姬 (山东中医药大学第二附属医院生殖医学科,济南250001,中国) ;
基金项目:Supported,by,Natural,Science,Fund,Project,of,Shandong,Province
摘    要:目的:观察多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)过程中给予电针干预对卵细胞质量及妊娠结局的影响,并探讨其作用机制。方法:将接受IVF-ET的PCOS患者66例随机分为观察组(34例)、对照组(32例),两组均给予达英-35及促性腺激素释放激素激动剂长方案超促排卵,观察组加用电针干预,穴取关元、中极、三阴交、子宫、太溪。比较两组妊娠结局及取卵日血清、卵泡液中干细胞因子(SCF)水平。结果:两组治疗后肾虚症状评分均明显降低,且观察组较对照组改善明显(P0.01);观察组较对照组受精率[(76.25±20.33)% vs(66.34±15.44)%]、卵裂率[(98.66±3.70)% vs(94.47±9.45)%]、优质胚胎率[(60.20±22.20)% vs(50.55±16.15)%]均明显提高(均P0.05);观察组临床妊娠率为46.67%(14/30)高于对照组的37.93%(11/29),但差异无统计学意义(P0.05)。取卵日血清、卵泡液SCF水平明显高于对照组(均P0.05)。结论:电针对接受IVF-ET的PCOS患者的妊娠结局具有积极作用,可改善中医肾虚症状,提高临床妊娠率。其机制为通过提高SCF水平从整体上调节机体内分泌和卵巢局部微环境,改善卵细胞的质量。

关 键 词:多囊卵巢综合征  电针  体外受精-胚胎移植  干细胞因子  随机对照试验

Effect of electroacupuncture on oocyte quality and pregnancy of patients with PCOS undergoing in vitro fertilization and embryo transfer
Wei CUI,Jing LI,Wei SUN,Ji WEN. Effect of electroacupuncture on oocyte quality and pregnancy of patients with PCOS undergoing in vitro fertilization and embryo transfer[J]. World Journal of Acupuncture-Moxibustion, 2012, 22(1): 23-29. DOI: 10.1016/S1003-5257(12)60005-1
Authors:Wei CUI  Jing LI  Wei SUN  Ji WEN
Affiliation:Reproductive Medicine Department, The Second Hospital Affiliated to Shandong University of TCM, Jinan 250001, china
Abstract:ObjectiveTo observe the impacts of electroacupuncture (EA) on oocyte quality and pregnant outcome for the patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET) and explore its potential mechanism.MethodsSixty-six patients with PCOS and undergoing IVF-ET were divided into two groups randomly, including an observation group (34 cases) and a control group (32 cases). Ethinylestradiol and cyproterone acetate tablets and gonadotropin-releasing hormone agonist were administered for long-program superovulation in either group. In the observation group, the intervention of EA was applied to Guānyuán (
></figure> CV 4), Zhōngjí (<figure class=></figure> CV 3), Sānyīnjiāo (<figure class=></figure> SP 6), Zîgōng (<figure class=></figure> EX-CA 1) and Tàixi (<figure class=></figure> Kl 3) additionally for 30 min, once daily, 1 menstrual cycle before controlled ovarian hyperstimulation (COH) and during COH. The pregnant outcome, evaluation of kidney deficiency syndrome, blood hormone level on the day of human chorionic gonadotropin injection and the concentrations of stem cell factor (SCF) in the serum and follicular fluid on the day of oocyte collection were compared between the two groups.<b>Results</b>The score of kidney deficiency symptoms was reduced remarkably after treatment in either group and the improvement in the observation group was superior to that in the control group (<em>P</em><0.01). The fertilization rate [(76.25 ± 20.33)% vs (66.34 ± 15.44)%], cleavage rate [(98.66 ± 3.70)% vs (94.47 ± 9.45)%] and the rate of high-quality embryos [(60.20 ± 22.20)% vs (50.55 ± 16.15)%] in the observation group were all superior to those in the control group separately (all <em>P</em><0.05). Clinical pregnancy rate (46.67%, 14/30) in the observation group was higher than that (37.93%, 11/29) in the control group, but without statistical difference (<em>P</em>>0.05). SCF concentrations in the serum and follicular fluid on the day of oocyte collection in the observation group were higher obviously than those in the control group (both <em>P</em><0.05).<b>Conclusion</b>Electroacupuncture plays an active role in the pregnant outcomes of PCOS patients undergoing IVF-ET and it can relieve the symptoms of kidney deficiency in terms of TCM and improve clinical pregnant rate. The mechanism is relevant to the overall adjustment of organic endocrinal system and the local micro-environment of ovary and the improvement of oocyte quality through the up-regulation of SCF concentration.</td>
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