李雅丹
【摘要】 目的:評價仿生物電刺激治療對卵巢儲備功能下降患者的短期療效。方法:選擇筆者所在醫(yī)院2018年1-12月83例卵巢儲備功能下降患者作為研究對象,采用隱匿數(shù)字隨機(jī)法分為兩組,對照組41例采用雌孕激素序貫治療;觀察組42例采用仿生物電刺激治療,監(jiān)測治療前后臨床癥狀及體征評分、陰道彩色多普勒參數(shù),以及血清雌二醇(E2)、卵泡刺激素(FSH)和促黃體生成素(LH),比較兩組療效。結(jié)果:觀察組治療后LH、FSH水平為(26.17±1.65)U/L、(43.25±3.69)mIU/ml,分別低于治療前的(38.16±1.80)U/L、(54.14±4.77)mIU/ml,差異有統(tǒng)計學(xué)意義(P<0.05)。觀察組治療后E2水平為(43.82±7.90)pg/ml,與治療前的(41.16±4.27)pg/ml比較,差異無統(tǒng)計學(xué)意義(P>0.05)。對照組治療后E2水平較治療前明顯升高,且高于觀察組治療后E2水平,差異有統(tǒng)計學(xué)意義(P<0.05)。兩組治療后LH、FSH水平差異無統(tǒng)計學(xué)意義(P>0.05)。觀察組治療后PI、OAV、AFCs分別為(1.90±0.31)、(5.06±0.62)cm3、(2.18±0.34)個,均高于治療前的(1.42±0.32)、(4.29±0.51)cm3、(1.55±0.28)個,差異有統(tǒng)計學(xué)意義(P<0.05)。兩組治療后PI、OAV、AFCs差異無統(tǒng)計學(xué)意義(P>0.05)。結(jié)論:仿生物電刺激治療卵巢儲備功能下降短期可達(dá)到雌孕激素治療相同的療效,長期療效有待進(jìn)一步觀察。
【關(guān)鍵詞】 仿生物電刺激 卵巢儲備功能下降 短期療效
[Abstract] Objective: To evaluate the short-term efficacy of bionic bioelectrical stimulation in patients with decreased ovarian reserve function. Method: A total of 83 cases with decreased ovarian reserve function in our hospital from January to December 2018 were selected as research objects. The patients were randomly divided into two groups by hidden number method. The control group received sequential treatment with estrogen and progesterone. In the observation group, 42 patients were treated with bionic bioelectric stimulation. Clinical symptoms and signs scores, vaginal color Doppler parameters and serum estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) before and after treatment were monitored in the observation group. Result: The levels of LH and FSH in the observation group were (26.17±1.65) U/L and (43.25±3.69) mIU/ml, lower than (38.16±1.80) U/L and (54.14±4.77) mIU/ml before treatment, respectively, with statistically significant differences (P<0.05). E2 level in the observation group was (43.82±7.90) pg/ml after treatment, and (41.16±4.27) pg/ml before treatment, there was no statistically significant difference (P>0.05). After treatment, E2 level in the control group was significantly higher than that before treatment, and higher than that after treatment in the observation group, with statistically significant difference (P<0.05). There was no significant difference in LH and FSH levels between the two groups after treatment (P>0.05). After treatment, the number of PI, OAV and AFCs in the observation group was (1.90±0.31), (5.06±0.62) cm3 and (2.18±0.34), which were all higher than (1.42±0.32), (4.29±0.51) cm3 and (1.55±0.28) before treatment, and the differences were statistically significant (P<0.05). There were no significant differences in PI, OAV and AFCs between the two groups after treatment (P>0.05). Conclusion: Bionic bioelectrical stimulation can achieve the same short-term efficacy as estrogen and progesterone therapy in the treatment of decreased ovarian reserve function, while the long-term efficacy remains to be further observed.
綜上所述,本研究結(jié)果顯示,仿生物電刺激治療卵巢儲備功能下降短期可達(dá)到雌孕激素治療相同的療效。同時仿生物電刺激治療是一種無創(chuàng)、安全、便捷的物理治療方法,為卵巢儲備功能下降的治療提供了新的思路和方向,由于本研究時間短,僅對短期效果進(jìn)行了評價,長期療效仍需繼續(xù)追蹤觀察,以獲得最佳周期數(shù)、治療時機(jī)等參數(shù),造福更多患者。
參考文獻(xiàn)
[1]高步嬋,趙銳,楊帆,等.當(dāng)歸芍藥散配合穴位埋線治療肝郁腎虛型卵巢儲備功能下降[J].中醫(yī)藥信息,2019,36(1):87-91.
[2]王云歡,包曉霞,王必勤,等.卵巢儲備功能下降的中醫(yī)臨床研究進(jìn)展[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2019,28(5):563-566.
[3] Oktay K,Moy F,Titus S,et al.Age-related decline in DNA repairfunction explains diminished ovarian reserve,earlier menopause,and possible oocyte vulnerability to chemotherapy in women with BRCA mutations[J].J Clin Oncol,2014,32(10):1093-1094.
[4]趙罌,梁東.育齡期婦女卵巢儲備功能下降與甲狀腺功能相關(guān)性的臨床研究[J].解放軍預(yù)防醫(yī)學(xué)雜志,2019,37(3):148-149.
[5]王云歡,張帆,包曉霞,等.郭氏序貫療法治療56例卵巢儲備功能下降的自身前后對照研究[J].環(huán)球中醫(yī)藥,2019,12(3):401-403.
[6]李春霞,朱紅芳,畢珺.中醫(yī)聯(lián)合仿生物電刺激對卵巢儲備功能下降女性內(nèi)分泌功能、骨代謝及生活質(zhì)量的影響[J].中國婦幼保健,2018,33(6):1426-1428.
[7]包紅桃,謝知慧,李應(yīng)福,等.滋養(yǎng)肝腎法對初老模型大鼠卵巢儲備功能下降的調(diào)節(jié)作用及機(jī)制[J].中國老年學(xué)雜志,2018,38(23):5813-5815.
[8]滕曉晶,施新顏,盧珍,等.卵巢儲備功能下降及卵巢早衰、多囊卵巢綜合征患者的血清抗苗勒管激素水平特征分析[J].中國婦幼保健,2018,33(20):4597-4599.
[9]胡曉薇,葉華娟,吳小妹.250例卵巢儲備功能下降患者的妊娠結(jié)局分析[J].中國婦幼保健,2018,33(17):3982-3985.
[10]王學(xué)梅,張賽,樊佳琪,等.穴位埋線治療卵巢儲備功能下降及卵巢早衰概述[J].河南中醫(yī),2017,37(11):1998-2000.
[11]何淑明,梁麗霞,黃惠芳,等.仿生物電刺激治療卵巢儲備功能下降患者的療效[J].廣東醫(yī)學(xué),2013,34(12):1851-1855.
[12] Taraciuk M B,Nolting M,F(xiàn)ernandez G,et al.Psychological as-sessment of patients with premature ovarian failure[J].Gynecol Endocrinol,2008,24(1):44-53.
(收稿日期:2019-07-23) (本文編輯:何玉勤)