温阳化浊法针刺对脾肾阳虚型反复种植失败患者子宫内膜容受性及妊娠结局的影响OA
Effect of Wenyang Huazhuo acupuncture therapy on endometrial receptivity and pregnancy outcomes in patients with repeated implantation failure of spleen and kidney yang deficiency pattern
目的:观察温阳化浊法针刺对脾肾阳虚型反复种植失败(RIF)患者子宫内膜容受性及冻融胚胎移植结局的影响.方法:将80例脾肾阳虚型RIF患者随机分为对照组(40例,脱落3例)和治疗组(40例,脱落4例).对照组行常规胚胎解冻移植(FET).治疗组于FET前2月至FET日行温阳化浊法针刺治疗,每次留针30 min,隔日1次,每周3次.两组FET后均予以黄体支持治疗.比较两组临床妊娠率、胚胎种植率、持续妊娠率、活产率;超声检测FET周期排卵日/内膜转化日子宫内膜厚度、形态、血流,子宫动脉血流动力指数(PI)、阻力指数(RI)、收缩期峰值速度/舒张末期流速(S/D);Western blot法检测子宫内膜组织黄体中期子宫内膜同源框基因10(HOXA10)、整合素β5(ITGB5)、白细胞抑制因子(LIF)的蛋白表达情况.结果:与对照组相比,治疗组临床妊娠率、胚胎种植率、持续妊娠率、活产率均显著升高(P<0.05,P<0.01);治疗组FET前内膜转化日/排卵日的子宫内膜明显增厚(P<0.05),子宫内膜A型率显著增高(P<0.01),子宫动脉RI显著降低(P<0.01),子宫内膜血流、PI、S/D差异无统计学意义;治疗组黄体中期子宫内膜 HOXA10、ITGB5和LIF的蛋白表达水平均显著升高(P<0.05、P<0.001).结论:温阳化浊法针刺可以提高脾肾阳虚型RIF患者冻融胚胎移植周期的种植率、妊娠率及活产率,有效改善妊娠结局,其机制可能与上调黄体中期子宫内膜HOXA10、ITGB5和LIF的蛋白表达量,改善子宫内膜容受性有关.
Objective To observe the effect of Wenyang Huazhuo(warming yang and resolving turbidity)acupuncture therapy on endometrial receptivity and the outcome of frozen-thawed embryo transfer in patients with repeated implantation failure(RIF)of spleen and kidney yang deficiency.Methods A total of 80 patients with RIP of spleen and kidney yang deficiency were randomly divided into a control group(40 cases,3 cases dropped out)and a treatment group(40 cases,4 cases dropped out).In the control group,frozen embryo transfer(FET)was operated.In the treatment group,starting 2 months before FET and ending on the day of FET,Wenyang Huazhuo acupuncture therapy was given once every other day,3 times a week and the needles were retained for 30 min in each treatment.Luteal support therapy was administered after FET in two groups.The comparison was conducted in clinical pregnancy rate,embryo implantation rate,sustained pregnancy rate and live birth rate between two groups.Using ultrasound,endometrial thickness and morphology,endometrial blood flow,uterine artery hemodynamic index(PI),resistance index(RI),and peak systolic velocity/end diastolic flow velocity(S/D)were detected on ovulation day/endometrial transformation day in FET cycle separately;and using Western blot method,the protein expressions of the mid-luteal endometrial homologous frame gene 10(HOXA10),integrin β5(ITGB5)and leukocyte inhibitory factor(LIF)in endometrial tissue were detected.Results Compared with the control group,in the treatment group,clinical pregnancy rate,embryo implantation rate,sustained pregnancy rate and live birth rate increased(P<0.05,P<0.01);the endometrial thickness on the endometrial transformation day/ovulation day before FET was thickened(P<0.05),the rate of endometrial type A increased(P<0.01),and the RI of the uterine artery decreased(P<0.01);endometrial blood flow,PI,and S/D ratio showed no statistically significant differences.The protein expressions of the mid-luteal endometrial HOXA10,ITGB5 and LIF increased(P<0.05,P<0.001)in the treatment group.Conclusion Wenyang Huazhuo acupuncture therapy can increase the implantation rate,pregnancy rate and live birth rate in frozen-thawed embryo transfer cycle for the patients with RIF of spleen and kidney yang deficiency,and effectively improve the pregnancy outcome,which may be related to the up-regulation of the protein expressions of the mid-luteal endometrial HOXA10,ITGB5 and LIF and the improvement of endometrial receptivity.
伏瑛瑛;王宝娟;夏天;窦真
天津市西青区中医医院,天津 300380天津中医药大学第一附属医院,天津 300381||国家中医针灸临床医学研究中心,天津 300381天津中医药大学第一附属医院,天津 300381||国家中医针灸临床医学研究中心,天津 300381天津中医药大学第一附属医院,天津 300381||国家中医针灸临床医学研究中心,天津 300381
温阳化浊针刺反复种植失败子宫内膜容受性妊娠结局
Wenyang Huazhuo(warming yang and resolving turbidity)AcupunctureRepeated implantation failureEndometrial tolerancePregnancy outcome
《针刺研究》 2026 (4)
501-508,8
天津中医药大学第一附属医院拓新工程科研项目(No.YB202122)
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