何氏养巢颗粒联合针灸治疗卵巢储备功能减退伴不孕症肾虚证患者的随机双盲对照研究

王玲; 马景; 许嘉瑜; 张涵; 龚燕; 杜婷婷; 马扬; 金硕; 章勤

doi:10.3969/j.issn.1006-2157.2023.09.005

您当前的位置：

首页 >

文章列表页 >

何氏养巢颗粒联合针灸治疗卵巢储备功能减退伴不孕症肾虚证患者的随机双盲对照研究

“中医药防治妇科疾病”专题 | 更新时间：2023-10-09

- 何氏养巢颗粒联合针灸治疗卵巢储备功能减退伴不孕症肾虚证患者的随机双盲对照研究
- Effect of HE’s Yangchao Granule combined with acupuncture in treating infertile patients with diminished ovarian reserve with kidney deficiency syndrome: a randomized, double-blind, controlled trial
- 北京中医药大学学报 2023年46卷第9期页码：1218-1226
- 作者机构：
  
  浙江中医药大学附属杭州市中医院　杭州　310007
- 作者简介：
  
  王玲，女，在读硕士生
  # 章勤，女，主任医师，教授，博士生导师，主要研究方向：中西医结合诊治妇科疾病，E-mail：zhaqin01@163.com
- 基金信息：
  
  浙江省重点研发计划(2019C03086);浙江省中医药科技计划中医药现代化专项项目(20GZS20220221ZX012);浙江省中医药创新团队(2022SJCXTD);国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
- DOI：10.3969/j.issn.1006-2157.2023.09.005
  中图分类号： R271.9
- 收稿日期：2023-02-17，
  
  网络出版日期：2023-07-11，
  
  纸质出版日期：2023-09-30
- 稿件说明：
移动端阅览
王玲, 马景, 许嘉瑜, 等. 何氏养巢颗粒联合针灸治疗卵巢储备功能减退伴不孕症肾虚证患者的随机双盲对照研究[J]. 北京中医药大学学报, 2023,46(9):1218-1226.

WANG Ling, MA Jing, XU Jiayu, et al. Effect of HE’s Yangchao Granule combined with acupuncture in treating infertile patients with diminished ovarian reserve with kidney deficiency syndrome: a randomized, double-blind, controlled trial[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(9): 1218-1226.
王玲, 马景, 许嘉瑜, 等. 何氏养巢颗粒联合针灸治疗卵巢储备功能减退伴不孕症肾虚证患者的随机双盲对照研究[J]. 北京中医药大学学报, 2023,46(9):1218-1226. DOI： 10.3969/j.issn.1006-2157.2023.09.005.

WANG Ling, MA Jing, XU Jiayu, et al. Effect of HE’s Yangchao Granule combined with acupuncture in treating infertile patients with diminished ovarian reserve with kidney deficiency syndrome: a randomized, double-blind, controlled trial[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(9): 1218-1226. DOI： 10.3969/j.issn.1006-2157.2023.09.005.

摘要

目的

评估何氏养巢颗粒联合针灸治疗卵巢储备功能减退(DOR)伴不孕症肾虚证患者的疗效。

方法

使用随机、双盲、对照的临床试验方法，纳入120例DOR伴不孕症肾虚证患者，按1∶1∶1∶1的比例随机分配到何氏养巢颗粒＋假针灸组、安慰剂＋针灸组、何氏养巢颗粒＋针灸组、安慰剂＋假针灸组，每组各30例。1个月经周期为1个疗程，所有患者接受3个疗程治疗，治疗结束后随访3个月。治疗前及每个疗程结束后月经周期第2～3天，静脉血检测患者抗米勒管激素(AMH)、卵泡刺激素(FSH)含量及FSH/黄体生成素(LH)值，超声检查窦卵泡计数(AFC)。治疗前及每个疗程结束后月经周期第5天，计算患者中医证候积分、月经失血图评分。治疗结束后3个月，进行妊娠情况随访。

结果

3个疗程后，与安慰剂＋假针灸组比较，何氏养巢颗粒＋针灸组AMH升高(

0.05)、AFC增多(

0.05)，FSH及FSH/LH值下降(

0.05)。3个疗程后，与安慰剂＋假针灸组比较，何氏养巢颗粒＋针灸组、安慰剂＋针灸组、何氏养巢颗粒＋假针灸组月经失血图评分均升高(

0.05)，中医证候积分均下降(

0.05)。

结论

针药结合、单纯针灸、单纯何氏养巢颗粒在改善DOR伴不孕症肾虚证患者的中医症状、月经量方面均有一定疗效。针药结合可明显提高DOR伴不孕症肾虚证患者AMH含量、降低FSH含量及FSH/LH值、增加AFC数量，比单纯何氏养巢颗粒或针灸效果更佳。

Abstract

Objective

To evaluate the efficacy of

’

s Yangchao

Granule(HSYC) combined with acupuncture for infertile patients with diminished ovarian reserve(DOR) with kidney deficiency syndrome.

Methods

This was a randomized

double-blinded

controlled clinical trial. A total of 120 infertile patients with DOR with kidney deficiency syndrome were randomly assigned into the HSYC+ sham-acupuncture group

placebo+ acupuncture group

HSYC+ acupuncture group

and placebo+ sham-acupuncture group at a 1∶1∶1∶1 ratio

with 30 patients each group. One menstrual cycle was one course of treatment

and all participants received three courses of treatment and were followed for an additional three months. Before and after each treatment course

anti-Müllerian hormone(AMH)

follicle stimulating hormone(FSH)

and the value of FSH/luteinizing hormone(LH) were measured on the second or third day of menstruation through blood tests. Meanwhile

the antral follicle count(AFC) was examined by ultrasound. Before and after each treatment course

the traditional Chinese medicine(TCM) syndrome score and menstrual blood loss map score were calculated on the fifth day of menstruation. Besides

the pregnancy condition was followed three months after treatment.

Results

After three courses of treatment

compared with the placebo+ sham-acupuncture group

AMH was increased(

0.05)

AFC was increased(

0.05)

FSH and FSH/LH were decreased(

0.05) in the HSYC+ acupuncture group. After three courses of treatment

compared with the placebo+ sham-acupuncture group

the menstrual blood loss map score was increased(

0.05)

and the TCM syndrome score was decreased(

0.05) in the HSYC+ acupuncture

placebo+ acupuncture

and HSYC+ sham-acupuncture group.

Conclusion

The combination of HSYC and acupuncture

or acupuncture

or HSYC has a certain effect on improving the TCM symptoms and menstrual blood volume of infertile patients with DOR with kidney deficiency syndrome. The combination of HSYC and acupuncture can significantly increase the level of AMH

reduce the level of FSH and the value of FSH/LH

and increase AFC of infertile patients with DOR with kidney deficiency syndrome

which is better than the effects of HSYC or acupuncture treatment alone.

关键词

Keywords

references

Practice Committee of the American Society for Reproductive Medicine . Testing and interpreting measures of ovarian reserve: a committee opinion [J]. Fertil Steril , 2015 ， 103 ( 3 ): 9 － 17 .

BARAD D . Hormonal Effects in Reproductive Technology with Focus on Diminished Ovarian Reserve [J]. Adv Exp Med Biol , 2020 , 1242 : 13 － 36 .

PASTORE LM , CHRISTIANSON MS , STELLING J , et al . Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR [J]. J Assist Reprod Genet , 2018 , 35 ( 1 ): 17 － 23 .

MORIN SJ , PATOUNAKIS G , JUNEAU CR , et al . Diminished ovarian reserve and poor response to stimulation in patients<38 years old: a quantitative but not qualitative reduction in performance [J]. Hum Reprod , 2018 , 33 ( 8 ): 1489 － 1498 .

DEVINE K , MUMFORD SL , WU M , et al . Diminished ovarian reserve in the United States assisted reproductive technology population: diagnostic trends among 181，536 cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System [J]. Fertil Steril , 2015 , 104 ( 3 ): 612 － 619 .

WANG Y , YUAN YC , MENG D , et al . Effects of environmental, social and surgical factors on ovarian reserve: Implications for age-relative female fertility [J]. Int J Gynaecol Obstet , 2021 , 154 ( 3 ): 451 － 458 .

YANG LQ , XU HB , CHEN Y , et al . Melatonin: Multi-Target Mechanism Against Diminished Ovarian Reserve Based on Network Pharmacology [J/OL]. Front Endocrinol(Lausanne) , 2021 , 12 : 630504 [ 2023－02－05 ]. https：//www.frontiersin.org/articles/10.3389/fendo.2021.630504/full https：//www.frontiersin.org/articles/10.3389/fendo.2021.630504/full .

唐培培，郭银华，谈勇，等 . 调周法联合辅酶Q10对高龄DOR不孕症患者卵巢功能及高孕激素状态下促排卵方案IVF结局的影响：附30例临床资料 [J]. 江苏中医药， 2020 ， 52 ( 9 )： 35 － 37 .

SCHWARZE JE , CANALES J , CROSBY J , et al . DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve: A systematic review and meta-analysis [J]. JBRA Assist Reprod , 2018 , 22 ( 4 ): 369 － 374 .

XU YY , NISENBLAT V , LU CL , et al . Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial [J/OL]. Reprod Biol Endocrinol , 2018 , 16 ( 1 ): 29 [ 2023－02－05 ]. https：//rbej.biomedcentral.com/articles/10.1186/s12958－018－0343－0 https：//rbej.biomedcentral.com/articles/10.1186/s12958－018－0343－0 .

杨柳青，方晓红，王如烨，等 . 何氏养巢方对DOR小鼠超排卵和卵母细胞质量的影响 [J]. 浙江中医杂志， 2021 ， 56 ( 11 )： 792 － 793 .

杨福霞，杨卓欣．针刺调经促孕治疗卵巢储备功能下降的前瞻性病例序列研究 [J]. 中国针灸， 2020 ， 40 ( 6 )： 619 － 622 .

李晓彤，许焕芳，刘保延，等．调经促孕针刺法治疗卵巢储备功能下降的随机对照试验 [J]. 中华中医药杂志， 2018 ， 33 ( 5 )： 1736 － 1739 .

谢幸．妇产科学 [M]. 9版．北京：人民卫生出版社， 2018 .

卵巢储备功能减退临床诊治专家共识专家组，中华预防医学会生育力保护分会生殖内分泌生育保护学组 . 卵巢储备功能减退临床诊治专家共识 [J]. 生殖医学杂志， 2022 ， 31 ( 4 )： 425 － 434 .

罗颂平，刘雁峰．中医妇科学 [M]. 3版 . 北京：人民卫生出版社， 2016 : 281 － 286 .

章勤，杨柳青，陈墨林婧，等．何氏养巢颗粒治疗肾虚型卵巢储备功能下降的临床观察 [J]. 浙江中医药大学学报， 2020 ， 44 ( 5 )： 434 － 437 .

ZAKHERAH MS , SAYED GH , EL-NASHAR SA , et al . Pictorial blood loss assessment chart in the evaluation of heavy menstrual bleeding: diagnostic accuracy compared to alkaline hematin [J]. Gynecol Obstet Invest , 2011 , 71 ( 4 ): 281 － 284 .

YANG LQ , ZHAO Y , XU HB , et al . Network Pharmacology-Based Prediction and Verification of the Potential Mechanisms of He’s Yangchao Formula against Diminished Ovarian Reserve [J/OL]. Evid Based Complement Alternat Med , 2022 , 2022 : 8361808 [ 2023－02－05 ]. https：//www.hindawi.com/journals/ecam/2022/8361808/ https：//www.hindawi.com/journals/ecam/2022/8361808/ .

赵颖，章勤 . 何氏养巢颗粒对DOR小鼠卵巢储备功能的影响 [J]. 浙江临床医学， 2019 , 11 ( 1 ): 1479 － 1481 .

方育恩，舒蒙蒙，杨炜敏，等 . 针药结合辅助治疗卵巢储备功能减退的临床观察及对颗粒细胞线粒体活性的影响 [J]. 北京中医药大学学报， 2022 ， 45 ( 11 )： 1168 － 1174 .

李苗苗，苏至嘉，薛蓓蓉 . 针灸联合克罗米芬对卵巢储备功能下降患者窦卵泡计数血清学指标及中医证候积分的影响 [J]. 中国妇幼保健， 2022 ， 37 ( 23 )： 4442 － 4446 .

沈洁，高友玲，卢鸽，等 . 电针对卵巢储备功能下降患者子宫内膜容受性和IVF-ET妊娠结局的影响 [J]. 中国针灸， 2022 ， 42 ( 8 )： 879 － 883 .

刘穗 . 针灸对卵巢储备功能下降患者子宫、卵巢形态及血流动力学参数的影响 [J]. 吉林中医药， 2022 , 42 ( 8 ): 984 － 988 .

杨福霞，杨卓欣．针刺调经促孕治疗卵巢储备功能下降的前瞻性病例序列研究 [J]. 中国针灸， 2020 ， 40 ( 6 )： 619 － 622 .

吕孝丽，郜洁，周月希，等 . 罗颂平治疗卵巢储备功能下降不孕症经验 [J]. 中医杂志， 2020 , 61 ( 13 ): 1139 － 1141 .

钟小蓓，王迪华，冯玉蓉，等．益肾暖宫方联合针灸对多次IVF-ET肾阴虚患者卵巢储备功能、子宫内膜厚度及妊娠结局的影响 [J]. 世界中西医结合杂志， 2022 , 17 ( 2 ): 336 － 340 .

浏览量

376

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于“一气周流”理论的傅青主种子思想探析

从科学出发到从技术出发——针灸系统工程学研究范式讨论

海派蔡氏妇科育肾周期疗法治疗不孕症的理论与实践

基于“二阳之病发心脾”探讨肠道微生物群与不孕症的关系

针药结合辅助治疗卵巢储备功能减退的临床观察及对颗粒细胞线粒体活性的影响