| Objective: To verify the clinical efficacy and discuss the mechanism of action by observing the effect of staged acupuncture therapy based on "Chong Meridian Is the Sea of Blood" in the treatment of IVF-ET poor ovarian response(POR)patientsMethod: The 66 patients who met the inclusion criteria for IVF-ET POR were randomly divided into 33 patients in the control group and 33 patients in the staged acupuncture group.The control group was treated with the mild-stimulation regimen.while the staged acupuncture group was treated with staged acupuncture therapy based on "Chong Meridian Is the Sea of Blood",with Gongsun-point(SP4)and Neiguan-point(PC6)as the main acupoints,and the supporting acupuncture points and acupuncture methods were used according to the physiological cycle of menstruation(menstruation,follicular phase,ovulation and luteal phase)and the specific type of symptoms.The timing of the treatment is 1 menstrual cycle before the mild-stimulation regimen programme,once every other day,3 times a week,each time for 30 minutes,for a total of 12 treatments.The number of retrieved oocytes by ovarian puncture was recorded;the quality of embryos was assessed and graded from a morphological point of view and the high-grade embryo rate was calculated;the levels of sex hormones(FSH,LH and E2)were measured before and after treatment by enzyme-linked immunoassay;the anxiety and depression status of patients before and after treatment were scored using anxiety self-rating scale(SAS),depression selfrating scale(SDS)and the Chinese Medicine Evidence Score.The number of retrieved oocytes and the high-grade embryo rate were compared between the two groups;the Chinese medicine syndrome scores and the efficacy were compared;the SAS and SDS scores were compared between the two groups;the correlation between the number of retrieved oocytes and the high-grade embryo rate and the SAS and SDS scores was analyzed.SPSS Statistics26.0 software was used for data collation and statistical analysis.Results:1.Baseline analysis: Age before treatment(P=0.496),infertility years(P=0.154),AMH value(P=0.809),TCM syndrome score(P=0.764),basal sex hormones: FSH(P=0.469),LH(P=0.367),FSH/LH(P=0.783),E2(P=0.857).There were no significant difference after statistical analysis(P> 0.05),and baseline data of the two groups was comparable.2.Main outcome indicators:(1)the number of retrieved oocytes in the post-treatment staged acupuncture group was significantly higher than that in the control group,and there was significant difference(P=0.000);(2)the high-grade embryo rate in the post-treatment staged acupuncture group was significantly higher than that in the control group,and t there was significant difference(P=0.000);3.Secondary outcome indicators:(1)Basal sex hormone :(1)comparison between the two groups: basal FSH,E2,and FSH/LH in the staged acupuncture group were lower than those in the control group after treatment,and there was significant difference(P < 0.05);basal LH in the staged acupuncture group was higher than that in the control group after treatment,and there was significant difference(P < 0.05).(2)Basal FSH,E2,and FSH/LH in the staged acupuncture group after treatment were lower than those before treatment,and there was significant difference(P <0.05);Basal LH in the staged acupuncture group after treatment was higher than that before treatment,and there was significant difference(P < 0.05);(3)basal FSH and FSH/LH in the control group after treatment were lower than those before treatment,and there was significant difference(P < 0.05);Basal LH and E2 in the control group after treatment was higher than those before treatment,and there was significant difference(P < 0.05);(2)TCM symptom scores and evidence efficacy evaluation: the symptom scores of the staged acupuncture group were significantly lower than those of the control group after treatment,and there was significant difference(P < 0.05);the total effective rate of the staged acupuncture group was higher than that of the control group after treatment,and there was significant difference(P < 0.05).(3)SAS and SDS scores: comparison between the two groups: SAS and SDS scores in the staged acupuncture group were lower than those in the control group after treatment,and there were significant difference(P < 0.05).Within-group comparison: SAS and SDS scores in the staged acupuncture group were lower than those before treatment,and there were significant difference(P < 0.05);SAS and SDS scores in the control group was higher than those before treatment,and there were significant difference(P < 0.05).(4)Correlation analysis:(1)the number of retrieved oocytes in the staged acupuncture group was negatively correlated with SAS and SDS scores,and there were significant difference(P < 0.05);the number of retrieved oocytes in the control group was negatively correlated with SAS and SDS scores,and there were significant difference(P < 0.05).(2)the high-grade embryo rate in the staged acupuncture group was negatively correlated with SAS and SDS scores,and there were no significant difference(P > 0.05);the high-grade embryo rate in the control group was negatively correlated with SAS and SDS scores,and there were significant difference(P < 0.05).Conclusions: 1.The staged acupuncture therapy based on "Chong Meridian Is the Sea of Blood" can significantly increase the number of retrieved oocytes and the high-grade embryo rate in IVF-ET POR patients.2.The staged acupuncture therapy based on "Chong Meridian Is the Sea of Blood" can improve the basal sex hormones(FSH,LH,E2)of IVF-ET POR patients and relieve their anxiety and depression.3.The staged acupuncture therapy based on "Chong Meridian Is the Sea of Blood" improved the number of retrieved oocytes and the high-grade embryo rate in IVF-ET POR patients,which may be related to the improvement of basal FSH,E2 and FSH/LH on the one hand,and the relief of anxiety and depression on the other. |
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