穴位电刺激对薄型子宫内膜的治疗效果初探

摘要

Objective:To investigate the clinical effect of electrical stimulation in treating patients with thin endometrium.Methods:Ninety six patients with thin endometrium (145 cycles) were collected from the First Affiliated Hospital of Nanjing Medical University from January 2014 to November 2016.The cycles were divided into three groups according to the thickness of endometrium:endometrial thickness≤3 mm in group A (12 cycles),3 mm＜endometrial thickness≤5 mm in group B (60 cycles),5 mm＜endometrial thickness≤7 mm in group C (73 cycles).All patients were treated with low-frequency electrical acupoint stimulation from the 5th to 7th day of menstruation.The differences in endometrial thickness,uterine arterial artery resistance index (RI) were compared before and after treatment.Results:There were no significant differences in the terms of age,BMI and infertile duration among the three groups (P＞0.05).The endometrial thickness in group A had no statistically significance after treatment (P=0.09),and the bilateral uterine artery RI was also not significantly changed after treatment (P＞0.05).The endometrial thickness in group B [(3.91±0.07) mm vs.(6.32±0.15) mm] and group C [(5.39±-0.07) mm vs.(7.77±0.12) mm] were significantly increased after the treatment (all P＜0.01).The uterine arterial artery RI were all significantly decreased in group B and group C [left RI:group B (0.90 ± 0.04) vs.(0.87 ± 0.05),group C (0.88 ± 0.04) vs.(0.84 ± 0.05),P ＜ 0.01;right RI:group B (0.90±0.04) vs.(0.87±0.05),group C (0.88±0.05) vs.(0.84±0.05),P＜0.01].Conclusions:Low-frequency electrical acupoint stimulation can significant improve emdometrial thickness and reduced RI in thin endometrium (3 mm to 7 mm),it is worthy of clinical application,but its long-term clinical treatment and related mechanisms remains to be further studied.%目的 探讨穴位电刺激对薄型子宫内膜的治疗效果. 方法 收集南京医科大学第一附属医院2014年1月至2016年11月拟行冻胚移植的薄型子宫内膜患者96人为研究对象,共计145个周期.记录患者的年龄、体重指数(BMI)及不孕年限等情况.根据子宫内膜厚度将其分为3组,A组:子宫内膜厚度≤3 mm,共12个周期;B组:3 mm＜子宫内膜厚度≤5 mm,共60个周期;C组:5 mm＜子宫内膜厚度≤7 mm,共73个周期.所有患者均于月经第5～7天应用PHENIX系列神经肌肉刺激治疗仪U8,予以阴道及“中极”、“关元”、“子宫”、“足三里”、“三阴交”、“太冲”及“肾俞”等部位低频脉电刺激治疗(交流电,频率:40 Hz,脉宽:250 μs,每次30 min),1次/d,5～8次为1周期.观察治疗前后子宫内膜厚度、子宫动脉血流阻力指数(RI)的变化情况. 结果 3组患者年龄、BMI及不孕年限比较无显著性差异(P＞0.05).A组子宫内膜厚度治疗前后无显著性差异(P=0.09);治疗前后双侧子宫动脉RI亦无显著变化(P＞0.05).B组与C组治疗后内膜厚度均显著增加[B组:(3.91±0.07) mmvs.(6.32±0.15) mm,C组:(5.39±0.07) mm vs.(7.77±0.12) mm,P均＜0.01],双侧子宫动脉RI则显著下降[左侧RI:B组(0.90±0.04) vs.(0.87±0.05),C组(0.88±0.04) vs.(0.84±0.05);右侧RI:B组(0.90±0.04) vs.(0.87±0.05),C组(0.88±0.05) vs.(0.84±0.05),P均＜0.01]. 结论 低频穴位电刺激对内膜厚度为3～7 mm薄型子宫内膜患者的治疗安全有效,值得临床推广,但其长期的临床治疗效果及相关机制还有待于进一步研究.