【摘要】 目的 观察针刺联合补肾健脾方治疗卵巢储备功能减退(diminished ovarian reserve, DOR)的临床疗效。方法 纳入脾肾两虚型DOR患者120例,按随机数字表法分为针刺组(40例)、中药组(40例)和针药联合组(40例)。针刺组单纯行针刺治疗,中药组单纯口服补肾健脾方,针药联合组采用针刺联合补肾健脾方治疗。观察3组治疗前后血清抗苗勒管激素(anti-Müllerian hormone, AMH)、促卵泡生成素(follicle-stimulating hormone, FSH)、黄体生成素(luteinizing hormone, LH)、雌二醇(estradiol, E2)以及FSH/LH水平的变化,观察3组治疗前后症状和证候评分以及窦卵泡数(antral follicle count, AFC)的变化,比较3组临床疗效。结果针药联合组、中药组和针刺组总有效率分别为90.0%、62.5%和60.0%;中药组和针刺组总有效率比较,差异无统计学意义(P=0.05);针药联合组总有效率高于其余两组,差异具有统计学意义(P<0.05)。治疗后,3组血清AMH水平和AFC均较治疗前提高(P<0.05),针药联合组血清AMH水平和AFC高于中药组和针刺组(P<0.05)。治疗后,3组症状和证候评分均较治疗前降低(P<0.05),针药联合组症状和证候评分低于其余两组(P<0.05)。治疗后,3组FSH水平均降低(P<0.05),E2水平均提高(P<0.05);针药联合组FSH和E2水平均优于其余两组(P<0.05);针药联合组LH水平低于针刺组(P<0.05),针药联合组FSH/LH水平低于中药组(P<0.05)。结论 针刺联合补肾健脾方治疗可改善DOR患者的卵巢功能,提高卵泡数量及质量,缓解症状,调节性激素水平,疗效优于单纯补肾健脾方治疗和单纯针刺治疗。更多还原

【Abstract】 Objective To observe the clinical efficacy of acupuncture plus Bu Shen Jian Pi formula in treating diminished ovarian reserve(DOR). Method A total of 120 patients with DOR of dual deficiency of the spleen and kidney pattern were recruited and divided into an acupuncture group(40 cases), a Chinese medication group(40 cases),and a combined acupuncture-medication group(40 cases) using the random number table method. The acupuncture group only received acupuncture treatment, the Chinese medication group received Bu Shen Jian Pi formula via oral administration, and the combined acupuncture-medication group was offered acupuncture plus Bu Shen Jian Pi formula.Before and after the treatment, the three groups were observed for changes in the serum levels of anti-Müllerian hormone(AMH), follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), and FSH/LH. Changes in the symptom and sign score and antral follicle count(AFC) were also observed. The clinical efficacy was compared among the three groups. Result The total effective rate was 90.0%, 62.5%, and 60.0% in the combined acupuncture-medication group, Chinese medication group, and acupuncture group, respectively; there was no significant difference in comparing the total effective rate between the Chinese medication and acupuncture groups(P=0.05), and the combined acupuncture-medication group was significantly higher than the other two groups in comparing the total effective rate(P<0.05). After the intervention, the serum AMH level and AFC increased in all three groups(P<0.05) and were higher in the combined acupuncture-medication group than in the Chinese medication and acupuncture groups(P<0.05). The symptom and sign score dropped after the treatment in the three groups(P<0.05)and was lower in the combined acupuncture-medication group than in the other two groups(P<0.05). After the treatment, all three groups showed a decreased FSH level(P<0.05) and an increased E2 level(P<0.05), and the combined acupuncture-medication group was superior to the other two groups in comparing the levels of FSH and E2(P<0.05); the LH level was lower in the combined acupuncture-medication group than in the acupuncture group(P<0.05), and the FSH/LH level was lower in the combined acupuncture-medication group than in the Chinese medication group(P<0.05). Conclusion Acupuncture plus Bu Shen Jian Pi formula can improve ovarian function in DOR patients, enhancing the follicle number and quality, alleviating symptoms, and regulating sex hormone levels. This combined method can produce more significant efficacy than the two methods used separately.更多还原