【摘要】：目的:1.詮釋腎主生殖的科學(xué)內(nèi)涵,印證針刺聯(lián)合滋腎清熱中藥的臨床療效。2.依據(jù)子宮內(nèi)膜蠕動(dòng)波頻率的相關(guān)指標(biāo),探討針刺聯(lián)合滋腎清熱中藥提高子宮內(nèi)膜容受性的干預(yù)機(jī)制。方法:選擇腎陰虛型行凍融胚胎移植(FET)的患者70例,應(yīng)用針刺聯(lián)合滋腎清熱中藥治療者35例(治療組),應(yīng)用偽針聯(lián)合安慰劑者35例(對(duì)照組),通過(guò)觀察治療前后患者的腎陰虛證候評(píng)分,FET日子宮內(nèi)膜蠕動(dòng)波頻率(UPF)、內(nèi)膜下血流及容積、前列腺素F2α(PGF2α)的含量、血清中E2/P的比值以及臨床妊娠率,從子宮內(nèi)膜蠕動(dòng)波頻率角度探討針?biāo)幗Y(jié)合對(duì)FET周期子宮內(nèi)膜容受性的影響及對(duì)腎陰虛患者的癥狀改善作用。結(jié)果:1.治療組UPF低于對(duì)照組(P0.05);兩組患者FET日UPF值總體分布不同,治療組A組(≤2.0次/min)、B組(2.1~3.0次/min)的人數(shù)百分比明顯大于對(duì)照組,而對(duì)照組C組(3.0次/min)的人數(shù)百分比明顯大于治療組(P0.05);妊娠率A組明顯高于B組和C組,C組最低。2.對(duì)照組E2/P的比值、PGF2α的值高于治療組(P0.05)。3.治療組VI、FI、VFI和V的值明顯大于對(duì)照組。4.治療后治療組患者腎陰虛癥狀得到明顯改善,臨床妊娠率治療組高于對(duì)照組(P0.05)。結(jié)論:1.子宮內(nèi)膜蠕動(dòng)頻率增加是腎陰虛患者胚胎著床失敗的原因之一,FET日較低的子宮內(nèi)膜蠕動(dòng)頻率預(yù)示較好的臨床妊娠率。2.針刺聯(lián)合滋腎清熱中藥可通過(guò)降低PGF2α的含量,調(diào)節(jié)下丘腦-垂體-卵巢軸(HPO軸),改善子宮內(nèi)膜血流狀態(tài)來(lái)降低子宮內(nèi)膜蠕動(dòng)波頻率,進(jìn)而促進(jìn)胚胎順利著床,改善妊娠結(jié)局。3.針刺聯(lián)合滋腎清熱中藥能明顯改善腎陰虛型FET患者的腎陰虛狀態(tài),適度降低子宮內(nèi)膜蠕動(dòng)的頻率,提高子宮內(nèi)膜對(duì)胚胎的接受能力,從而獲得較好的臨床妊娠率。4.以“腎主生殖”為理論向?qū)?從中醫(yī)滋腎清熱角度闡明腎陰虛患者子宮內(nèi)膜蠕動(dòng)加快的原因,進(jìn)一步詮釋了“腎主生殖”的科學(xué)內(nèi)涵。
[Abstract]:Purpose 1. Explain the scientific connotation of kidney and reproduction, confirm the clinical curative effect of acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat. According to the related indexes of peristaltic wave frequency of endometrium, the intervention mechanism of acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat to improve endometrial receptivity was discussed. Methods: seventy (FET) patients with kidney yin deficiency were selected for freeze-thawing embryo transfer. 35 cases (treatment group) were treated with acupuncture combined with traditional Chinese medicine for nourishing kidney and clearing away heat (treatment group) and 35 cases (control group) were treated with pseudo-acupuncture combined with placebo (control group). The frequency of peristalsis of endometrium on the day of (UPF), was evaluated by observing the score of syndrome of kidney yin deficiency before and after treatment. Submembranous blood flow and volume, The content of prostaglandin F _ 2 偽 (PGF2 偽), the ratio of E _ 2 / P in serum and the clinical pregnancy rate, the effect of combination of acupuncture and medicine on the endometrial receptivity of FET cycle and the improvement of symptoms in patients with kidney yin deficiency were discussed from the point of view of peristaltic wave frequency of endometrium. The result is 1: 1. The UPF of the treatment group was lower than that of the control group (P0.05), the total distribution of FET day UPF value was different between the two groups, and the percentage of the patients in group A (鈮，

本文編號(hào)：2169473