黄刘燕　　叶咏菊

[摘要] 目的 探討耳穴压豆辅助中医周期疗法在排卵障碍性不孕中的应用。 方法 选取2017年1月～2018年10月门诊治疗排卵障碍性不孕患者84例，随机数字表分为联合组和对照组各42例。对照组患者均予以中医周期疗法，联合组患者在对照组基础上加耳穴压豆治疗，两组患者均连用3个月经周期。观察并比较两组患者治疗前后卵泡刺激素（FSH）和雌二醇（E2）水平、卵泡直径和子宫内膜厚度的变化，并比较随访1年内的妊娠成功率。 结果 治疗3个月经周期后，两组患者血清FSH和E2水平较前明显上升（P<0.05），且联合组患者上升幅度较对照组更明显（P<0.05）;两组患者子宫内膜厚度和卵泡直径较前明显增加（P<0.05）或（P<0.01），且联合组患者增加幅度较对照组更明显（P<0.05）;随访1年，联合组患者妊娠成功率为42.86%（18/42），明显高于对照组的21.43%（9/42），组间比较，差异有统计学意义（χ2=4.42，P<0.05）。 结论 耳穴压豆辅助中医周期疗法治疗排卵障碍性不孕患者具有良好的协同作用，可促进卵泡发育，增加子宫内膜厚度，提高妊娠成功率，其作用机制可能与其能调节性激素水平，促进FSH和E2的分泌密切相关。

[关键词] 排卵障碍性不孕;中医周期疗法;耳穴压豆;卵泡刺激素;雌二醇

[中图分类号] R256.23          [文献标识码] B          [文章编号] 1673-9701（2021）11-0138-04

Application of auricular acupoint pressing bean combined with periodic therapy of Traditional Chinese Medicine in ovulatory dysfunction infertility

HUANG Liuyan YE Yongju

Department of Obstetrics and Gynecology， Lishui Hospital of Traditional Chinese Medicine in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To explore the application of auricular acupoint pressing bean combined with periodic therapy of Traditional Chinese medicine in ovulatory dysfunction infertility. Methods Eighty-four patients with ovulatory dysfunction infertility treated in the department of Obstetrics and Gynecology of our hospital from January 2017 to October 2018 were randomly divided into the combined group and the control group， with 42 patients in each group. Patients in the control group were given periodic traditional Chinese medicine therapy， and patients in the combined group were given auricular acupoint pressing bean therapy on the basis of the treatment in the control group. Patients in both groups were given three menstrual cycles in a row. Changes in follicle-stimulating hormone（FSH） and estradiol （E2） levels， follicular diameter， and endometrial thickness were observed and compared between the two groups before and after treatment， and pregnancy success rates were compared at 1 year of follow-up. Results After 3 cycles of menstrual treatment， the serum levels of FSH and E2 in the two groups were significantly increased（P<0.05 or P<0.01）， and the increase was more significant in the combined group than in the control group （P<0.05）. Endometrial thickness and follicular diameter were significantly increased in both groups（P<0.05 or P<0.01）， and the increase was more significant in the combined group than in the control group（P<0.05）. After follow-up for 1 year， the pregnancy success rate of the combined group was 42.86%（18/42）， which was significantly higher than that[21.43%（9/42）] of the control group， and the difference between the groups was statistically significant （χ2=4.42， P<0.05）. Conclusion Auricular acupoint pressing bean combined with periodic therapy of Traditional Chinese Medicine has a good synergistic effect in the treatment of ovulatory dysfunction infertility patients， which can promote follicular development， increase endometrial thickness， and improve the success rate of pregnancy. The mechanism of action may be closely related to its ability to regulate the level of sex hormones and promote the secretion of FSH and E2.

[Key words] Ovulatory dysfunction infertility; Periodic therapy of Chinese medicine; Auricular acupoint pressing bean; Follicle-stimulating hormone; Estradiol

不孕癥是妇产科较常见的一种疾病，其发病率占育龄妇女的10%～20%，其中排卵障碍性不孕最常见，占所有不孕症发病率的1/3[1，2]。传统的西医治疗排卵障碍性不孕主要以激素类药治疗为主，但总体来说治疗效果不理想，妊娠率低，限制了临床推广[3]。近年来中医在排卵障碍性不孕的治疗上发现具有独特之处，其中中医周期性疗法能遵循并协调阴阳变化，改善内分泌紊乱，确保孕成，用于排卵障碍性不孕效果较好，但部分病情顽固者效果仍欠理想[4，5]。耳穴压豆是一种常用的中医外治手段，治疗排卵障碍性不孕具有一定效果，但其辅助中医周期疗法治疗排卵障碍性不孕患者国内鲜有报道[6]。本研究分析了耳穴压豆辅助中医周期疗法在排卵障碍性不孕中的应用，现报道如下。……