电针干预对多囊卵巢综合征患者卵子质量及肿瘤坏死因子-α的影响

目的：观察电针对多囊卵巢综合征（PCOS）患者卵子质量的影响,并探讨其作用机制。方法：将接受体外受精-胚胎移植（IVF-ET）的PCOS患者200例按照随机数字表法分为电针组（102例）、对照组（98例）,两组均给予达英-35及促性腺激素释放激素激动剂超促排卵,电针组在超促排卵过程中加肾俞、气海、足三里、三阴交、内关、子宫等穴位电针干预,比较两组患者卵子质量、最终的妊娠结局及肿瘤坏死因子-α（TNF-α）水平。结果：（1）电针干预可显著提高PCOS患者的优胚率（P〈0.05）,并可将临床妊娠率提高8.36%;（2）电针干预可明显降低卵泡液TNF-α水平（13.61±15.46 vs 34.09±93.53,P〈0.05）;（3）妊娠患者血清、卵泡液TNF-α水平均低于非妊娠患者妊娠：（53.91±63.32）pg/mL,（14.93±25.37）pg/mL,非妊娠：（76.82±82.96）pg/mL,（25.04±35.79）pg/mL]差异有统计学意义（均P〈0.05）。结论：电针能够改善PCOS患者卵子质量,提高IVF-ET的临床妊娠率,其机制可能与TNF-α水平有关。

Effect of electroacupuncture on egg quality and tumor necrosis factor-a of patients with polycystic ovarian syndrome

Objective To observe the effect of electroacupuncture （EA） on egg quality of polycystic ovarian syndrome （PCOS） patients, and to explore its mechanism. Methods Two hundred patients who received in vitro fertilization-embryo transfer （IVF-ET） were divided into an EA group （102 cases） and a control group （98 cases） according to random number table. All the patients in the two groups were given Diane-35 and gonadotropin-releasing hormone agonist （GnRH-α） for ovarian hyperstimulation. Besides, EA intervention was applied to Shenshu （肾俞 BL 23）, Qihai （气海 GV 6）, Zusanli （足三里ST 36）, Sanyinjiao （三阴交 SP 6）, Neiguan （内关 PC 6） and Zigong （子宫 EX-CA1）, etc. in the EA group. Then egg quality, final outcome of pregnancy and levels of tumor necrosis factor-α （TNF-α） were compared between the two groups. Results （1） EA intervention significantly improved high quality embryo rate of PCOS patients （P〈0.05）, and clinical pregnancy rate was increased by 8.36%; （2） EA intervention significantly reduced the TNF-α levels of follicular fluid （13.61±15.46 vs 34.09±93.53, P〈0.05）; （3） TNF-α levels of serum and follicular fluid in the pregnancy group were lower than those of non-pregnancy group pregnancy group： （53.91±63.32） pg/mL, （14.93±25.37） pg/mL, nonpregnancy group： （76.82 ± 82.96） pg/mL, （25.04 ± 35.79） pg/mL], and the differences were significant （both P〈0.05）. Conclusion EA improves egg quality of PCOS patients and increases the clinical pregnancy rate of IVF-ET, the mechanism may be related to TNF-α levels.