Therapeutic effect of combination of acupuncture and medicine on patients with polycystic ovary syndrome monitored by transvaginal ultrasound
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摘要:
目的 采用经阴道超声检查方式动态监测多囊卵巢综合征不孕症患者的卵泡发育情况，探讨针药联合治疗方法的临床价值，为临床治疗提供进一步指导依据。 方法 选取2020年9月~2022年9月我院收治的多囊卵巢综合征妇女44例进行回顾性研究，按照药物与针药联合的方法将患者分成两组：其中21例患者采用西医常规疗法治疗（对照组），23例患者采用针刺联合西医常规疗法治疗（观察组）。观察两组患者治疗3月内排卵的状况、临床妊娠情况、影像学表现。 结果 治疗3月后，对照组和观察组总有效率分别为66.67%和82.60%，排卵率分别为52.38%和78.26%，妊娠率分别为28.57%和43.48%。观察组中的卵巢体积、卵泡数量、最大卵泡直径等均优于对照组（P < 0.05)。观察组中的排卵的成功率、妊娠率均高于对照组，差异均有统计学意义（P < 0.05）。 结论 经阴道超声动态监测下，准确观察患者的卵泡发育情况，为临床对多囊卵巢综合征不孕症患者的诊疗提供指导，有效提高患者受孕率。 Abstract:Objective The development of follicles in infertile patients with polycystic ovary syndrome was dynamically monitored by transvaginal ultrasonography, and the clinical value of combined acupuncture and drug therapy was discussed to provide further guidance for clinical treatment. Methods forty-four cases of polycystic ovary syndrome women admitted to our hospital from September 2020 to September 2022 were retrospectively studied. A total of 44 cases were divided into two groups according to the combination of medicine and acupuncture, of which 21 patients were treated with conventional western medicine (control group) and 23 patients were treated with acupuncture combined with conventional Western medicine (observation group). Ovulation, clinical pregnancy and imaging manifestations were observed in 2 groups within 3 months after treatment. Results After 3 months of treatment, the total effective rate of the control group and the observation group was 66.67% and 82.60%, the ovulation rate was 52.38% and 78.26%, the pregnancy rate was 28.57% and 43.48%, respectively. The ovarian volume, number of follicles and maximum follicle diameter in the observation group were better than those in the control group (P < 0.05). The ovulation success rate and pregnancy rate in the observation group was higher than those in the control group. The differences were statistically significant (P < 0.05). Conclusion Under the dynamic monitoring of transvaginal ultrasound, the follicular development of patients can be accurately observed, which provides guidance for clinical diagnosis and treatment of polycystic ovary syndrome infertility patients, effectively improves the pregnancy rate of patients. -
图 1 对照组患者治疗前后超声图
Figure 1. Ultrasound images of patients before and after treatment in control group. A-B: Before treatment, the patient, a 30-year-old female, had a maximum follicle size of 9 mm×5 mm on the right side and 8 mm×6 mm on the left; C-D: After treatment, this patient had a maximum follicle size of 12 mm×9 mm on the right and 15 mm×12 mm on the left.
图 2 观察组患者治疗前后超声图
Figure 2. Ultrasound images of patients in the observation group before and after treatment. A-B: Before treatment, the patient, a 32-year-old female, had a maximum follicle size of 13 mm×10 mm on the right side and 3 mm×6 mm on the left; C-D: After treatment, this patient had a dominant follicle visible on her right ovary, with a size of 21 mm×20 mm. The follicle wall was thin, smooth, with good tension, an echoless zone, and full shape.
表 1 两组患者一般资料比较
Table 1. Comparison of baseline data between the two groups
Group Age (year) Infertility (year) Minimum Maximum Mean±SD Shortest Longest Mean±SD Control group (n=21) 22 36 27.90±3.78 0.42 4.58 2.01±1.02 Observation group (n=23) 24 35 28.26±3.22 0.67 3.58 1.89±0.72 
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表 2 两组患者两组B超检查结果比较
Table 2. two groups of B ultrasonic examination results compared two groups of patients (Mean±SD)
Group Time Endometrial thickness (mm) Ovarian volume (cm3) Number of follicles/one (unilateral) Dominant follicle diameter (mm) Control group (n=21) Prior treatment 5.27±1.35 11.52±2.14 14.29±1.52 5.23±1.33 Post treatment 7.52±1.24 8.98±1.87* 10.19±1.60* 12.03±0.95* Observation group (n=23) Prior treatment 5.83±2.10 11.06±1.71 14.17±1.53 5.13±0.97 Post treatment 11.55±1.66 5.65±1.62# 6.30±0.97# 16.13±0.76# *P < 0.05 vs same group before treatment；#P < 0.05 vs control group after treatment.
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表 3 两组患者治疗前后排卵率、妊娠率比较
Table 3. Comparison of ovulation rate and pregnancy rate between the two groups before and after treatment [n(%)]
Group Ovulation rate Pregnancy rate Control group (n=21) 11(52.38) 6(28.57) Observation group (n=23) 18(78.26)* 10(43.48)* *P < 0.05 vs control group.
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表 4 临床效果对比
Table 4. Comparison of clinical effects (n)
Group Cure Effective Ineffective Total effective rate (%) Control group (n=21) 4 10 7 66.67 Observation group (n=23) 6 13 4 82.60* *P < 0.05 vs control group.
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[1] 郭森, 胡晓颖, 高艳玲. 施茵从脾肾论治肥胖型多囊卵巢综合征伴不孕症经验撷要[J]. 中国针灸, 2021, 41(04): 429-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202104019.htm [2] Renate KM. Polycystic Ovary Syndrome[J]. NursClinNorthAm, 2018, 53(3): 407-20. [3] 马堃. 中西医结合诊治肾虚血瘀型排卵障碍性不孕(不育)优势的探究[J]. 中国中药杂志, 2021, 46(11): 2623-8. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY202111001.htm [4] 王克华, 杨潇曼, 王晓丹. 多囊卵巢综合征痰湿证miRNA-483-3p差异表达的临床意义[J]. 中华中医药学刊, 2021, 39(10): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202110001.htm [5] Stener-Victorin E, Zhang H, Li R, et al. A cupuncture or metformin to improve insulin resistance in women with polycystic ovary syndrome: study protocol of a combined multinational cross sectional case-control study and a randomised controlled trial[J]. BMJ open, 2019, 9(1): e024733. doi: 10.1136/bmjopen-2018-024733 [6] 安俊丽, 王京, 丁先娥, 等. 针刺加中药对多囊卵巢综合征卵泡发育情况及临床疗效分析[J]. 世界科学技术-中医药现代化, 2018, 20(2): 229-2. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX201802016.htm [7] 尹燕, 张迎春, 张花, 等. 针药联合治疗来曲唑诱导排卵的多囊卵巢综合征不孕患者临床疗效观察[J]. 中国针灸, 2018, 38(1): 27-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE201801013.htm [8] 丁波, 袁丽, 孙文兵, 等. 经阴道超声监测卵泡发育在不孕患者中应用的价值研究[J]. 中国性科学, 2018, 27(1): 92-4. https://www.cnki.com.cn/Article/CJFDTOTAL-XKXZ201801029.htm [9] 唐荣, 吴清, 欧阳璟雯. 阴道多普勒超声在多囊卵巢综合征治疗过程中的应用价值[J]. 分子影像学杂志, 2020, 43(4): 655-8. doi: 10.12122/j.issn.1674-4500.2020.04.22 [10] 国家中医药管理局医政司. 24个专业105个病种中医临床路径[R]. 北京: 国家中医药管理局医政司, 2011: 480 [11] Liu J. Effect of letrozole combined with Metformin on serum sex hormone levels in PCOS infertile patients and the effect of ovulation promotion[J]. Chin Gen Prac, 2018, 21(z1): 214-2 [12] 段彩梅. 定经汤联合达英-35治疗不孕不育的临床分析——评《多囊卵巢综合征和内分泌不孕不育》[J]. 中国实验方剂学杂志, 2021, 27(22): 207. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202122029.htm [13] 乔杰, 齐新宇, 徐雅兰, 等. 关注影响女性健康的重要生殖内分泌疾病多囊卵巢综合征[J]. 中国实用妇科与产科杂志, 2020, 36(1): 1-9. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202001001.htm [14] 朱璇. 针药结合克罗米芬治疗多囊卵巢综合征导致不孕症临床分析[J]. 中国继续医学教育, 2017, 9(24): 197-9. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY201724125.htm [15] 许娟, 左玉. 针刺辅助治疗多囊卵巢综合征不孕患者疗效观察[J]. 中国针灸, 2018, 38(4): 358-61, 63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE201804005.htm [16] 刘丹琪, 相珊, 连方. 电针对痰湿型多囊卵巢综合征患者体外受精结局及差异基因表达的影响[J]. 中国中西医结合杂志, 2022, 42(10): 1180-6. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ202210005.htm [17] 虞莉青, 曹莲瑛, 谢菁, 等. 电针联合克罗米芬干预多囊卵巢综合征促排卵助孕的疗效研究[J]. 中国针灸, 2018, 38(3): 263-8. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE201803015.htm [18] 杨红, 李嘉, 张司明, 等. 针药结合疗法对多囊卵巢综合征不孕症患者子宫内膜容受性的影响[J]. 世界科学技术-中医药现代化, 2022, 24(8): 3255-3260. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202208042.htm [19] 刘红, 王瑶, 杨宇. 用经腹部超声检查诊断多囊卵巢综合征的效果分析[J]. 当代医药论丛, 2019, 17(20): 147-8. https://www.cnki.com.cn/Article/CJFDTOTAL-QYWA201920109.htm [20] Copp T, Mccaffery K, Azizi L, et al. Influence of the disease label'polycystic ovary syndrome'on intention to have an ultrasound and psychosocial outcomes: a randomised online study in young women[J]. Hum Reprod, 2017, 32(4): 876. [21] 赵文晖. 经阴道彩色多普勒超声在多囊卵巢综合征诊断中的价值[J]. 中国妇幼保健, 2014, 29(4): 627-9. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201404059.htm [22] 石华, 周青, 陈文卫, 等. 经阴道彩色多普勒超声在多囊卵巢综合征诊断中的价值[J]. 中国超声医学杂志, 2003(11): 61-2. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY200311022.htm [23] 尹丽君, 罗冬改, 叶小燕. 经阴道超声监测育龄女性卵泡发育评估不孕症的应用[J]. 中国妇幼卫生杂志, 2018, 9(5): 73-6 https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201805020.htm [24] 黄茵淳, 曾令红, 谢诚文, 等. 经阴道超声监测卵泡及子宫内膜发育状况可提高受孕率[J]. 分子影像学杂志, 2021, 44(2): 286-90. doi: 10.12122/j.issn.1674-4500.2021.02.14 -
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