补肾疏肝法改善卵泡膜血流提高IVF-ET胚胎着床率的初步探究.pdfVIP

提 要 目的：通过研究针刺补肾舒肝法对接受体外授精-胚胎移植患者卵泡膜血流阻力 指数的影响及其与胚胎种植率的关系，探讨补肾舒肝法改善胚胎种植率的机理。 方法：将60例因输卵管因素行体外授精-胚胎移植的女性患者，随机分为两组： 针刺组（30例）和空白对照组（30例），观察HCG日卵泡膜血流阻力指数及胚胎种植 率,同时观察治疗前后两组之间的肾虚肝郁证候改善情况，治疗前后SAS,SDS评分变 化，两组取卵数，优卵率，卵裂率，受精率，成胚率，优胚率，临床妊娠率；对卵泡 膜血流阻力指数与患者一般资料，IVF-ET各项指标之间分别进行相关性检验。 结果：（1）与空白对照组相比，针刺治疗组的肾虚肝郁证候，SAS，SDS的评分 数值改善程度，卵裂率，优卵率，受精率，优质胚胎率及胚胎着床率均显著提高；临 床妊娠率高于空白对照组，但无统计学差异；取卵个数、受精率无显著性差异。 （2）针刺治疗组患者HCG日卵泡膜血流阻力指数（RI）明显低于空白对照组， 有显著性差异。 （3）卵泡膜血流阻力指数与SAS，SDS的评分数值成依赖性正相关，与优卵率， 卵裂率，成胚率，优胚率，胚胎着床率呈明显 负性相关，与患者年龄、病程、孕产 史、及取卵数、受精率无显著性相关。 结论：针刺补肾疏肝法提高胚胎着床率有良好的疗效，其机理可能与调节女性患 者慢性应激状态，降低交感神经系统兴奋性，减少血管收缩，改善卵泡膜血运，从而 提高卵子质量有关。 关键词 针刺；体外授精-胚胎移植；胚胎种植率；卵泡膜血流阻力指数； The Initial Study of Bushen -Shugan Therapy to Improve the Embryo implantation rate of Invitro Fertilization and Embryo Transfer by Ameliorating Resistance index of Theca blood Speciality: Gynecology of TCM Author: Guo Qiong Tutor: Pof. Lian Fan Abstract Objective: Through the research method of the Bushen -Shugan Therapy infertility patients were done in vitro fertilization (IVF) Resistance index of Theca blood impacts and fuses with the Embryo implantation, this paper discusses the relationship between the Bushen -ShuganTherapy and Embryo implantation the influencing mechanism. Methods: Clinical Study: Sixty infertile patients with tubal obstruction undergoing IVF-ET were divided into two groups at random, 30 cases in the test group treated with acupuncture and western medicine, and 30 cases in the control group treated only by western medicine. The differences of improvement of kidney deficiency and liver depressed syndrome, Guide resistance index of theca blood impacts and the embryo implantation, scores of SAS,SDS,accounts of har