“调经促孕”针法治疗频次对早发性卵巢功能不全临床疗效的影响

卓缘圆; 蒋丽娇; 罗燕; 黄杏贤; 杨卓欣

doi:10.3981/j.issn.1000-7857.2024.05.00475

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科技导报 ›› 2024, Vol. 42 ›› Issue (21) : 114-121. DOI: 10.3981/j.issn.1000-7857.2024.05.00475

专题：中医临床研究的范式与应用

“调经促孕”针法治疗频次对早发性卵巢功能不全临床疗效的影响

作者信息 -

1. 深圳市中医院针灸科, 深圳 518033;
2. 广州中医药大学第四临床医学院, 深圳 518033

作者简介:

卓缘圆，主任医师，研究方向为针灸治疗神经系统及妇科疾病，电子信箱：qinyuan64@163.com；杨卓欣（通信作者），教授，主任医师，研究方向为针灸治疗神经系统及妇科疾病，电子信箱：48132537@qq.com

Effect of treatment frequency of Tiaojing Cuyun acupuncture on clinical efficacy of premature ovarian insufficiency

Author information -

1. Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China;
2. Fourth College of Clinical Medicine, Guangzhou University of Chinese Medicine, Shenzhen 518033, China

摘要

基于真实世界研究方法探讨“调经促孕”针法治疗频次对早发性卵巢功能不全（prematureovarian insufficiency，POI）临床疗效的影响。采用前瞻性队列研究设计，将100例POI患者按照针刺疗程不同暴露水平分为强暴露组和弱暴露组，以卵泡刺激素（follicle stimulating hormone，FSH）降低10 IU/L作为主要结局事件，分析病例的人口统计学和临床特征，并比较治疗前后的血清性激素水平、Kupperman量表得分、卵巢峰值收缩速度（peak systolic velocity，PSV）和阻力指数（resistance Index，RI），采用Logistic回归模型确定暴露针刺刺激量的最优节点。结果显示，针刺总疗程6周为最敏感划分节点，≥6周为强暴露组，强暴露组73例，弱暴露组27例。治疗前后，2组的FSH水平降低，而雌二醇（estradiol，E2）和抗苗勒氏激素（anti-Müllerian hormone，AMH）水平显著增加（P<0.05）。2组的Kupperman评分和RI降低，PSV增加。且强暴露组相对于弱暴露组疗效更优。Logistic回归分析显示，年龄、初潮年龄和针灸治疗次数与疗效有相关性（P<0.05），表明“调经促孕”针法可有效改善早发性卵巢功能不全，且针刺总疗程≥6周疗效更佳。

Abstract

This article studies the impact of treatment frequency of the Tiaojing Cuyun acupuncture (acupuncture for regulating menstruation and promoting pregnancy) in the treatment of premature ovarian insufficiency (POI) based on real-world evidence.Using a prospective cohort study design, 100 POI patients were categorized into strong exposure and weak exposure groups based on different levels of acupuncture stimulation, with a primary outcome event of a 10 IU/L decrease in follicle stimulating hormone (FSH).Demographic and clinical characteristics of the cases were analyzed, and serum hormone levels before and after treatment, Kupperman scale scores, peak systolic velocity (PSV), and resistance index (RI） were compared with a logistic regression model to determine the optimal threshold of acupuncture stimulation exposure.The results indicated that the total acupuncture treatment duration of 6 weeks was the most sensitive dividing point, with 6 weeks or longer being considered as the high-exposure group.There were 73 cases in the high-exposure group and 27 cases in the low-exposure group.Before and after treatment, the FSH levels decreased in both groups, while the levels of estradiol (E2) and anti-Müllerian hormone (AMH) significantly increased (P<0.05).The Kupperman scores and RI decreased while PSV increased in both groups.Furthermore, the strong exposure group showed superior efficacy compared to the weak exposure group.Logistic regression analysis indicated that age, age at menarche, and the number of acupuncture treatments were correlated with efficacy (P<0.05).The "Tiaojing Cuyun" acupuncture technique can effectively improve premature ovarian insufficiency, and the efficacy is even better with a total acupuncture treatment duration of 6 weeks or longer.

导出引用

卓缘圆, 蒋丽娇, 罗燕, 黄杏贤, 杨卓欣. “调经促孕”针法治疗频次对早发性卵巢功能不全临床疗效的影响[J]. 科技导报, 2024, 42(21): 114-121 https://doi.org/10.3981/j.issn.1000-7857.2024.05.00475

ZHUO Yuanyuan, JIANG Lijiao, LUO Yan, HUANG Xingxian, YANG Zhuoxin. Effect of treatment frequency of Tiaojing Cuyun acupuncture on clinical efficacy of premature ovarian insufficiency[J]. Science & Technology Review, 2024, 42(21): 114-121 https://doi.org/10.3981/j.issn.1000-7857.2024.05.00475

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