针刺改善体外受精-胚胎移植冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的随机对照研究

马娟娟; 伍奇; 吕云佳; 翁晓晨; 吴胜男; 帅文; 王铮; 张勤华

doi:10.16306/j.1008-861x.2022.05.006

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针刺改善体外受精-胚胎移植冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的随机对照研究

临床研究 | 更新时间：2022-11-01

- 针刺改善体外受精-胚胎移植冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的随机对照研究
- A randomized controlled study of acupuncture in improving endometrial peristalsis and pregnancy outcomes at peri⁃transfer period in patients of in vitro fertilization⁃embryo transfer undergoing frozen embryo transfer
- 上海中医药大学学报 2022年36卷第5期页码：27-33
- 作者机构：
  
  1.同济大学附属第一妇婴保健院（上海　201204）
  2.空军杭州特勤疗养中心疗养一区康复科（浙江　杭州　311113）
  3.上海市普陀区长征镇社区卫生服务中心（上海　200333）
- 作者简介：
  
  马娟娟，女，硕士，主治医师，主要从事中西医结合治疗不孕症临床研究
  王铮，副主任医师；E-mail： 435037539@qq.com
  张勤华，主任医师、副教授，博士生导师；E-mail： shumeier@163.com
- 基金信息：
  
  国家自然科学基金资助项目(81804129);上海市“科技创新行动计划”医学创新研究专项项目(20Z21900404);上海市卫健委中医药科研项目(2020LQ015);上海市综合医院中西医结合专项项目(ZHYY-ZXYJHZX-202106)
- DOI：10.16306/j.1008-861x.2022.05.006
  中图分类号：
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马娟娟,伍奇,吕云佳等.针刺改善体外受精-胚胎移植冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的随机对照研究[J].上海中医药大学学报,2022,36(05):27-33.

MA Juanjuan,WU Qi,LYU Yunjia,et al.A randomized controlled study of acupuncture in improving endometrial peristalsis and pregnancy outcomes at peri⁃transfer period in patients of in vitro fertilization⁃embryo transfer undergoing frozen embryo transfer[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(05):27-33.
马娟娟,伍奇,吕云佳等.针刺改善体外受精-胚胎移植冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的随机对照研究[J].上海中医药大学学报,2022,36(05):27-33. DOI： 10.16306/j.1008-861x.2022.05.006.

MA Juanjuan,WU Qi,LYU Yunjia,et al.A randomized controlled study of acupuncture in improving endometrial peristalsis and pregnancy outcomes at peri⁃transfer period in patients of in vitro fertilization⁃embryo transfer undergoing frozen embryo transfer[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(05):27-33. DOI： 10.16306/j.1008-861x.2022.05.006.

摘要

目的,2,观察针刺干预对体外受精-胚胎移植（IVF-ET）冻胚移植患者围移植期子宫内膜蠕动波及妊娠结局的影响。,方法,2,选取符合纳入标准、拟行冻融胚胎移植（FET）的患者150例，采用随机数字表分为治疗1组、治疗2组与对照组，每组各50例。对照组患者给予常规FET内膜方案进行内膜准备；治疗1组患者在常规进行内膜准备基础上，于月经第2天至移植前1 d行针刺治疗，隔日1次，治疗周期为1个月经周期，并在移植前30 min、移植后30 min均予针刺治疗；治疗2组患者在常规进行内膜准备基础上，于移植前30 min、移植后30 min予以针刺治疗。比较3组患者的种植率、临床妊娠率；于胚胎移植前30 min、移植后30 min，检测并计算所有患者的子宫内膜蠕动波频率（UPF），并比较不同UPF患者的临床妊娠率；于移植日检测所有患者的子宫内膜厚度及内膜血流搏动指数（PI）、阻力指数（RI）。,结果,2,研究过程中，治疗1组1例患者脱落，治疗2组2例患者脱落，对照组1例患者脱落，最终纳入统计分析者治疗1组49例、治疗2组48例、对照组49例。①治疗1组、治疗2组、对照组患者的临床妊娠率分别为48.98%、31.25%、28.57%，组间比较差异均无统计学意义（,P,>,0.05）；治疗1组、治疗2组、对照组患者的种植率分别为32.18%、17.65%、18.52%，治疗1组患者的种植率明显高于治疗2组和对照组（,P,<,0.05）。②移植后，3组患者的UPF较移植前均明显增加（,P,<,0.05），但治疗1组患者的UPF明显低于治疗2组和对照组（,P,<,0.05），治疗2组的UPF亦低于对照组（,P,<,0.05）；不同UPF组患者的临床妊娠率比较，差异有统计学意义（,P,<,0.05），B组（UPF,>,1且≤2次/min）患者的临床妊娠率最高。③移植日，治疗1组患者的子宫内膜厚度较治疗2组、对照组均明显增加（,P,<,0.05），治疗1组、治疗2组患者的子宫内膜血流PI较对照组均明显降低（,P,<,0.05）。,结论,2,针刺干预IVF-ET冻胚移植患者，能够有效调节患者的围移植期UPF，改善种植窗期子宫内膜厚度及血流，提高种植率，且1个月经周期的针刺干预方法具有更好的临床效果。

Abstract

Objective： To observe the effect of acupuncture intervention on endometrial peristalsis and pregnancy outcomes at peri-transfer period in patients of ,in vitro, fertilization-embryo transfer （IVF-ET） undergoing frozen embryo transfer.,Methods,2,A total of 150 patients who met the inclusion criteria and planned to undergo frozen-thawed embryo transfer （FET） were selected and divided into the treatment group 1， treatment group 2 and control group by random number table， 50 cases in each group. The patients in the control group were treated with conventional FET endometrial preparation. The patients in the treatment group 1 received acupuncture treatment from the 2nd day of menstruation to 1 d before transplantation on the basis of routine endometrial preparation， once every other day， and the treatment cycle was 1 menstrual cycle， in addition the patients received acupuncture treatment at 30 minutes before and after transplantation. On the basis of routine endometrial preparation， the patients in the treatment group 2 received acupuncture treatment at 30 minutes before and after transplantation. The implantation rate and clinical pregnancy rate of the three groups were compared. At 30 minutes before and after embryo transfer， the uterine peristalsis frequency （UPF） of all patients was detected and calculated， and the clinical pregnancy rates among different UPF patients were compared. The endometrial thickness， endometrial blood flow pulsatility index （PI） and resistance index （RI） of all patients were detected on the day of transplantation.,Results,2,During the study， 1 patient in the treatment group 1， 2 patients in the treatment group 2 and 1 patient in the control group shed off， finally 49 patients in the treatment group 1， 48 patients in the treatment group 2 and 49 patients in the control group were included in the statistical analysis. ①The clinical pregnancy rates of the treatment group 1， treatment group 2 and control group were 48.98%， 31.25% and 28.57% respectively， with no statistical difference among the three groups （,P,>,0.05）. The implantation rates of the treatment group 1， treatment group 2 and control group were 32.18%， 17.65% and 18.52% respectively， and the implantation rate of the treatment group 1 was significantly higher than that in the treatment group 2 and the control group （,P,<,0.05）. ②After transplantation， the UPF of the three groups was significantly increased compared with that before transplantation （,P,<,0.05）， but the UPF of the treatment group 1 was significantly lower than that of the treatment group 2 and the control group （,P,<,0.05）， and the UPF of the treatment group 2 was lower than that of the control group （,P,<,0.05）， too. There were statistical differences on the clinical pregnancy rate among the patients in the different UPF groups （,P,<,0.05）， and the clinical pregnancy rate of the group B （UPF,>,1 and ≤2 times/min） was the highest. ③On the day of transplantation， the endometrial thickness of the treatment group 1 was significantly thicker than that of the treatment group 2 and the control group （,P,<,0.05）， and the endometrial blood flow PI of the treatment group 1 and treatment group 2 was significantly lower than that of the control group （,P,<,0.05）.,Conclusion,2,Acupuncture intervention can effectively regulate the UPF at peri-transfer period in patients of IVF-ET undergoing frozen embryo transfer， improve the endometrial thickness and blood flow during the implantation window， and increase the implantation rate. In addition， the acupuncture intervention for 1 menstrual cycle has better clinical efficacy.

关键词

体外受精-胚胎移植冻胚移植针刺子宫内膜蠕动波妊娠结局随机对照试验

Keywords

in vitro fertilization-embryo transferfrozen embryo transferacupunctureendometrial peristalsispregnancy outcomesrandomized controlled trial

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