Clinical Study On Pregnancy Outcome Treated With Stage By Stage Acupuncture And Moxibustion Therapy Based On The Chong Channel Being Sea Of Blood Theory In Repeated IVF-ET Failure Patients

Objective: To observe the synergistic effect of stage by stage acupuncture and moxibustion therapy based on the Chong Channel Being Sea of Blood Theory in Repeated IVF-ET Failure PatientsMethods: Seventy-two patients with failed IVF-ET transplantation were devided into the acupuncture group(36)and the control group(36)according to the random number table.In the control group,the basic long-term superovulation plan of Gn RH-a/r-FSH/HMG/HCG in IVF-ET was used for basic treatment.The acupuncture group was assisted with acupuncture treatment at the same time as basic treatment.The main points were Gongsun and Neiguan.According to the stage of female physiological cycle combined with the characteristics of TCM syndrome differentiation,stage by stage acupuncture treatment prescriptions were used:Menstrual period: Hegu,Sanyinjiao,Ganshu,Shenshu,Ciliao,Baliao(if there is a hypomenorrhea,then moxibustion);Follicular phase: Huangshu,Uterine Moxibustion,Sanyinjiao,Zusanli,Taixi,Rangu moxibustion,Houxi,local flash cupping on Shuidao(until partial flushing);Luteal phase: Sanyinjiao,Zhiyang,Geshu,Shenshu moxibustion,Lieque,Zhaohai,Baliao points' moxibustion.Ear points: endocrine,uterus,Shenmen,brainstem,kidney,subcortical,sympathetic.We use air conduction methods on the abdomen acupuncture points,and the rest are given the mild reinforcing-reducing method.During the follicular phase,ovulation,luteal phase,we use warm acupuncture,electro-acupuncture,warm acupuncture with moxibustion,respectively.In the menstrual period,we decide whether to take warm acupuncture on the basic of the menstrual amount,the treatment was 3 times a week,and last for 3months.14 days after the transplantation we used urine HCG or blood ?-HCG to observe,if the results are positive also combined with some clinical manifestations,then it can be diagnosed as pregnancy.Transvaginal B-ultrasound was performed 5 weeks after the transplantation,if there are some fetal cyst fetal buds and fetal heart then it can be diagnosed as clinical pregnancy.At the same time,the endometrial thickness,live birth rate,fetal abscess rate,and clinical symptoms of TCM were observed.Results:(1)Comparison of clinical efficacy of the two groups: acupuncture group:28 cases cured,3 cases effective markedly,3 cases effective,2 cases ineffective,total effective rate was 94.44%;control group: 13 cases cured,5 cases effective markedly,3 cases effective,invalid in 15 cases,the total effective rate was 58.33%.After the chi-square test,the total clinical efficacy of the acupuncture group and the control group was evaluated.The square value was 15.929,P=0.001(<0.05),indicating that there was a significant difference between the two groups in the total clinical efficacy with statistical significance.(2)Comparison of TCM symptom scores between the two groups:(1)Before treatment: scores for the acupuncture group were higher(82.53)than(81.69),t-test value is 0.523,and p-value is 0.03(>0.05).There is no significant difference between them,which is comparable.(2)After one month of treatment,the scores were: the average score(50.28)in the acupuncture group was lower than(62.17),the t-test value was-4.914,and the p-value was 0.000(<0.05),indicating that there was a significant difference between the two groups after 1 month of treatment.(3)After 2months of treatment,the scores were: The average score of the acupuncture group(31.838)was lower than(48.42),the t-test value was-10.846,and the p-value was0.000(<0.05),indicating that there was a significant difference between the two groups after 2 months of treatment.(4)Integration after 3 months of treatment: The average score in the acupuncture group(11.42)was lower than(35.61),the t-test value was-15.343,and the p-value was 0.000(<0.05),which indicated that there are significant differences between the two groups after 3 months' treatment.In general,after a period of integral treatment,acupuncture group and control group can both improve the patients' clinical symptoms by traditional Chinese medicine,and the acupuncture group showed better effect than the control group significantly.(3)Comparison of the TCM symptom evaluation between the two groups: After treatment,the total effective rate of acupuncture group was 97.22%,and the total effective rate of control group was 66.67%.After chi-square test,the score of two groups of clinical symptoms in acupuncture group and control group was 15.907,P=0.001(<0.05),which indicated the difference was significant statistically.It shows that in the efficacy scores of TCM clinical symptoms,the effective rate of acupuncture group is significantly higher than the control group,and the efficacy of the acupuncture group is better than the control group.(4)The Comparison of endometrial thickness(mm)before treatment,after 1month's treatment,after 2 months' treatment,and after 3 months' treatment:(1)Endometrial Thickness(mm)before treatment(ng/ml): The average score of the acupuncture group(4.94)was lower than the control group(5.25),the t-test value was-1.701,and the p-value was 0.093(>0.05),which indicated there is no significant difference between the two groups before treatment,which is suitable for the following analysis.(2)Endometrial thickness(mm)after 3 months ‘ treatment:Endometrial thickness in the acupuncture group was significantly higher than the control group,and the t-test value was 8.068,with a p-value of 0.000(<0.05),which indicated: After 3 months of treatment,there are significant differences between the two groups.And that shows the therapeutic effect of the acupuncture group was significantly higher than the control group.(5)The Comparison of the success rate and pregnancy rate of grafts after 6 months' treatment: In the acupuncture group,there were 5 cases of natural pregnancy,16 cases of 1 time ‘s successful transplantation,7 cases of 2 times' successful transplantation,4cases of biochemical pregnancy,and 4 cases of no pregnancy.The pregnancy rate was77.78%;In the control group,0 cases of natural pregnancy and 8 cases of 1 time's successful transplantation.5 cases were successfully transplanted 2 times,biochemical pregnancy was 8 cases,and 15 cases were not pregnant.The pregnancyrate was 36.11%.The Chi-square test showed that the chi-square rate of the pregnancy rate was 13.190 for 6 months after the end of treatment in the acupuncture group and the control group,P = 0.01(<0.05),the difference was statistically significant,and the pregnancy rate was significantly higher in the acupuncture group.In the acupuncture group,the effective rate of the acupuncture group was significantly higher than the control group after treatment,and the acupuncture group had better efficacy than the control group.(6)The Comparison of live alimentary rate and fetal death rate after the treatment between two groups: In the acupuncture group,live alimentary rate was 85.71%,and the fetal death rate was 14.29;In the control group,live birth rate was61.54%,and the fetal death rate was 38.46.But the live alimentary rate of acupuncture group was higher than the control group,which indicated that after the treatment,the effective rate of the acupuncture group was significantly higher than the control group,and that shows the therapeutic effect of the acupuncture group was significantly higher than the control group.Conclusion: The stage by stage acupuncture and moxibustion therapy based on the Chong Channel Being Sea of Blood Theory can improve the clinical symptoms,pregnancy rate,clinical pregnancy rate and live birth rate of Repeated IVF-ET Failure Patients,indicating that this kind of therapy has a positive effect,and its mechanism may be related to the improvement of endometrial thickness and improvement of endometrial receptivity.