Influence Of Acupuncture And Physiotherapy Upon The Endometrial Receptivity Of Pcos Infertile Patients

Objective:To observe the effects of acupuncture and physiotherapy upon the endometrial receptivity of kidney deficiency and blood stasis type of PCOS infertile patients, and the effects of acupuncture upon the endometrial receptivity of rats. Methods: The 120 cases of PCOS infertile patients were randomly divided into acupuncture and physiotherapy group (40 cases), physical therapy group (40 cases) and control group (40 cases). The changes in TCM situation, serum estragen (E2), progesterone (P) levels, endometrial thickness, spiral artery PI and RI in embryo implantation phase among the three groups were observed. Sixty Wistar rats were randomly divided into normal group (N group), model group (M group) and acupuncture group (A group). The expression of integrin-B3 in glandular epithelium and luminal epithelium in 4-day pregnant rats, the number of implanted blastocysts, and the weight of uterine and a single blastocyst in 8-day pregnant rats were observed. Results:Clinical research:(1) Symptoms of kidney deficiency and blood stasis points in the acupuncture and physiotherapy group and the physical therapy group were lower than that in the control group, and there was a significant difference (P<0.05). Kidney deficiency and blood stasis syndrome points in the acupuncture and physiotherapy group were lower than that in the physical therapy group, but there was no significant difference (P>0.05). (2) Serum P levels in the three groups before and after treatment were greatly different (P<0.01). The levels of serum E2 were not largely different (P>0.05). After treatment serum E2 levels and serum P levels in the acupuncture and physiotherapy group were higher than that in the physical therapy group, (P>0.05). (3)The endometrium in the acupuncture and the physiotherapy group were much thicker than that in the control group difference (P<0.05). The endometrium in the physical therapy group was thicker than that in the control group (P> 0.05). The endometrium in the acupuncture therapy group was much thicker than that in the physical therapy group (P>0.05). (4) The vascular resistances both in the acupuncture and physiotherapy therapy group and the physical therapy group were less than that in the control group and there was a significant difference in both PI and RI (P<0.05). The vascular resistance in the acupuncture and physiotherapy group was less than that in the physical therapy group, but there was no significant difference in both PI and RI (P>0.05). Experimental research:(1) The average numbers of blastocyst implantation in the acupuncture group and model group were largely reduced compared with that in the nomal group (P<0.01). The average numbers of blastocyst implantation in the acupuncture group was higher than that in the model group, but there was no significant difference (P>0.05). (6) Compared with that in the normal group, the uterine weight and the weight of a single blastocyst in the model group and acupuncture group were lower (P<0.01). The uterine weight and the weight of a single blastocys in the acupuncture group were higher than that in the model group (P<0.05). (7) Compared with that in the normal group, the integrin-B3 contents in the glandular epithelial cells and luminal epithelial cells in the model group and acupuncture group were reduced (P<0.01). The integrin-B3 contents in the glandular epithelial cells and luminal epithelial cells in the acupuncture group were higher than that in the model group (P<0.05). Conclusion:The acupuncture and physiotherapy treatment of kidney deficiency PCOS infertile patients can increase endometrial receptivity and achieve a better efficacy, which might be caused by improving endometrial blood flow and increasing endometrial integrin-B3 contents.