本文關(guān)鍵詞： 經(jīng)皮穴位電刺激 焦慮、抑郁 AVP、OXT 體外受精-胚胎移植　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本臨床試驗(yàn)研究對(duì)患有焦慮、抑郁癥狀的擬行體外受精-胚胎移植技術(shù)(IVF-ET)助孕患者進(jìn)行經(jīng)皮穴位電刺激(transcutanclus electrical acupoint stimulation,TEAS)干預(yù),觀察經(jīng)皮穴位電刺激對(duì)患者焦慮、抑郁狀態(tài)和妊娠結(jié)局的影響,并嘗試闡述經(jīng)皮穴位電刺激可能干預(yù)焦慮、抑郁情緒的內(nèi)在機(jī)制。方法:將符合入組標(biāo)準(zhǔn)的患者隨機(jī)分成實(shí)驗(yàn)組60例,安慰組60例,空白對(duì)照組60例。實(shí)驗(yàn)組于降調(diào)節(jié)日開始給予每日1次經(jīng)皮穴位電刺激治療直至HCG日,并給予生活干預(yù)(囑咐患者合理作息,適當(dāng)運(yùn)動(dòng),放松心情);安慰組于降調(diào)節(jié)日開始給予每日1次的模擬經(jīng)皮穴位電刺激直至HCG日,并給予生活干預(yù);空白對(duì)照組僅給予生活干預(yù)。各組患者常規(guī)進(jìn)行控制性超促排卵治療,方案統(tǒng)一采用標(biāo)準(zhǔn)長方案。降調(diào)節(jié)日抽取三組患者血清抗利尿激素(AVP)和催產(chǎn)素(OXT)為干預(yù)前血清激素水平,同時(shí)進(jìn)行SAS/SDS評(píng)分作為干預(yù)前評(píng)分;HCG日抽取三組患者血清AVP、OXT為干預(yù)后血清激素水平,并再次對(duì)三組患者進(jìn)行SAS及SDS評(píng)分作為干預(yù)后評(píng)分。分析各組患者干預(yù)前后血清AVP、OXT變化以及焦慮、抑郁評(píng)分變化,并比較其獲卵數(shù)、受精率、優(yōu)質(zhì)胚胎率以及周期結(jié)局(周期取消率、生化妊娠率、臨床妊娠率)。結(jié)果:1、三組患者干預(yù)前在年齡、體重指數(shù)和不孕年限方面均無明顯差異(方差分析,P0.05)。2、三組患者治療前SAS、SDS評(píng)分組間比較無明顯差異(方差分析,P0.05);實(shí)驗(yàn)組和安慰組治療后SAS和SDS評(píng)分較治療前均下降,結(jié)果具有顯著性差異(配對(duì)樣本t檢驗(yàn),P0.05);對(duì)照組治療前后SAS和SDS評(píng)分無明顯變化(配對(duì)樣本t檢驗(yàn),P0.05);實(shí)驗(yàn)組在治療后SAS、SDS評(píng)分均低于安慰組,結(jié)果具有統(tǒng)計(jì)學(xué)差異(LSD檢驗(yàn),P0.05)。3、三組患者治療前血清AVP、OXT組間比較無明顯差異(方差分析,P0.05)。實(shí)驗(yàn)組治療后血清AVP水平降低,治療血清OXT水平升高,差異均有統(tǒng)計(jì)學(xué)意義(配對(duì)樣本t檢驗(yàn),P0.05);其余兩組治療前后血清AVP、OXT均無顯著差異(配對(duì)樣本t檢驗(yàn),P0.05)。4、三組患者獲卵數(shù)、受精率、優(yōu)質(zhì)胚胎率無顯著差異(方差分析,P0.05)。5、三組患者周期取消率無統(tǒng)計(jì)學(xué)差異(卡方檢驗(yàn),P0.05);實(shí)驗(yàn)組生化妊娠率、臨床妊娠率均高于安慰組和空白對(duì)照組,有統(tǒng)計(jì)學(xué)差異(卡方檢驗(yàn),P0.05)結(jié)論:經(jīng)皮穴位電刺激可以提高IVF-ET患者妊娠率,緩解其焦慮、抑郁狀態(tài),其可能作用機(jī)制是經(jīng)皮穴位電刺激可以升高血清OXT水平,降低血清AVP水平。
[Abstract]:Objective: this clinical trial study on patients with anxiety. IVF-ETT in patients with depressive symptoms undergoing percutaneous acupoint electrical stimulation (IVF-ETT). Transcutanclus electrical acupoint stimulation. To observe the effect of transcutaneous acupoint electrical stimulation on anxiety, depression and pregnancy outcome, and try to explain the possible intervention of transcutaneous acupoint electrical stimulation on anxiety. Methods: patients with depression were randomly divided into experimental group (n = 60) and comfort group (n = 60). 60 cases in the blank control group. The experimental group was treated with transcutaneous acupoint electrical stimulation once a day until HCG day on the day of descending adjustment, and the patients were given life intervention (telling them to take reasonable rest, exercise properly and relax their mood). In the comfort group, the simulated percutaneous electrical stimulation of acupoints was given once a day until the day of HCG, and the intervention of life was given on the day of descending adjustment. The blank control group was only given life intervention. The patients in each group were routinely treated with controlled hyperstimulation of ovulation. Standard long program was adopted in the scheme. The serum antidiuretic hormone (AVP) and oxytocin (oxytocin) were extracted from three groups of patients before intervention. At the same time, the SAS/SDS score was used as the pre-intervention score. On the day of HCG, three groups of patients' serum AVP- OXT were taken as the serum hormone level after intervention. Three groups of patients were again treated with SAS and SDS scores as post-intervention scores. The changes of serum AVPnOXT, anxiety and depression scores before and after intervention were analyzed, and the number of eggs obtained was compared. Fertilization rate, high quality embryo rate and cycle outcome (cycle cancellation rate, biochemical pregnancy rate, clinical pregnancy rate). There was no significant difference in body mass index (BMI) and infertile years (ANOVA, P0.05n. 2). There was no significant difference between the three groups before treatment (ANOVA, P0.05). The scores of SAS and SDS in the experimental group and the comfort group were significantly lower than those before the treatment. There were no significant changes in SAS and SDS scores before and after treatment in the control group (paired t-test P 0.05). The scores of SAS SDS in the experimental group were lower than those in the comfort group after treatment. The results were statistically different (P < 0.05). The serum AVP of the three groups before treatment was significantly lower than that in the control group (P < 0.05). There was no significant difference between the OXT groups (ANOVA, P0.05). After treatment, the serum AVP level in the experimental group was decreased, and the OXT level in the treated group was increased. The difference was statistically significant (paired sample t test, P 0.05); There was no significant difference in serum AVPnOXT between the other two groups before and after treatment (paired sample t-test, P0.05N. 4). There was no significant difference in the number of eggs, fertilization rate and high quality embryo rate in the three groups (ANOVA). There was no significant difference in the rate of cycle cancellation among the three groups (Chi-square test). The biochemical pregnancy rate and clinical pregnancy rate in the experimental group were higher than those in the comfort group and the blank control group, and there was statistical difference (chi-square test). Conclusion: Transcutaneous acupoint electrical stimulation can increase pregnancy rate and relieve anxiety and depression in patients with IVF-ET. The possible mechanism is that the level of serum OXT can be increased by percutaneous acupoint electrical stimulation. The serum AVP level was decreased.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.3

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