Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression

YOU Xiu-mi; XU Jin-bang; YANG Juan; LIAO Jun

doi:10.13703/j.0255-2930.20230608-k0002

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Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression

Clinical Research | 更新时间：2024-06-03

- Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression
- Chinese Acupuncture & Moxibustion Vol. 43, Issue 12, Pages: 1399-1404(2023)
- 作者机构：
  
  1.福建中医药大学针灸学院，福州350102
  2.福建省妇幼保健院/福建医科大学妇儿临床医学院中医科，福州350001
- 作者简介：
- 基金信息：
- DOI：10.13703/j.0255-2930.20230608-k0002
  CLC： R 246.3
- Received：08 June 2023，
  
  Online First：10 October 2023，
  
  Published：12 December 2023
- 稿件说明：
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游秀密,许金榜,杨娟等.针药结合治疗肾虚血瘀型反复种植失败不孕的临床疗效及对血清p38MAPK、JAK/STAT蛋白表达的影响[J].中国针灸,2023,43(12):1399-1404.

YOU Xiu-mi,XU Jin-bang,YANG Juan,et al.Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression[J].Chinese Acupuncture & Moxibustion,2023,43(12):1399-1404.
游秀密,许金榜,杨娟等.针药结合治疗肾虚血瘀型反复种植失败不孕的临床疗效及对血清p38MAPK、JAK/STAT蛋白表达的影响[J].中国针灸,2023,43(12):1399-1404. DOI： 10.13703/j.0255-2930.20230608-k0002.

YOU Xiu-mi,XU Jin-bang,YANG Juan,et al.Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression[J].Chinese Acupuncture & Moxibustion,2023,43(12):1399-1404. DOI： 10.13703/j.0255-2930.20230608-k0002.

摘要

目的

观察针刺联合中药对反复种植失败（RIF）不孕患者妊娠结局及血清p38丝裂原活化蛋白激酶（MAPK）、Janus激酶（JAK）/信号转导和转录激活因子（STAT）蛋白表达的影响。

方法

将62例拟行人工周期冻融胚胎移植的肾虚血瘀型RIF不孕患者随机分为观察组（31例，脱落4例）和对照组（31例，剔除3例）。对照组予人工周期冻融胚胎移植常规方案治疗。在对照组基础上，观察组予针刺联合中药治疗，针刺穴取百会、关元，双侧内关、子宫、归来、足三里、太冲、肾俞、次髎，每次30 min，隔日1次；中药予补肾活血方，每日1剂。于月经第3~5天开始，治疗至移植前1 d。比较两组患者临床妊娠率、胚胎种植率、活产率、生化妊娠率，治疗前及移植前1 d中医症状评分、血小板计数（PLT）、血浆D-二聚体含量。于治疗前及移植前1 d采用Western blot法检测两组患者血清p38MAPK、JAK、STAT蛋白表达。

结果

观察组临床妊娠率、胚胎种植率、活产率高于对照组（

0.05），生化妊娠率低于对照组（

0.05）。移植前1 d，两组中医症状评分、PLT、血浆D-二聚体含量较治疗前降低（

0.05），观察组中医症状评分、血浆D-二聚体含量低于对照组（

0.05）。移植前1 d，两组患者血清p38MAPK、JAK、STAT蛋白表达均少于治疗前（

0.05），观察组血清p38MAPK蛋白表达少于对照组（

0.05）。

结论

针药结合能提高肾虚血瘀型RIF不孕患者的临床妊娠率、胚胎种植率、活产率，降低生化妊娠率，其作用机制可能与降低血浆D-二聚体含量及下调血清p38MAPK蛋白表达有关。

Abstract

Objective

To observe the effects of acupuncture combined with Chinese herbal medication on pregnancy outcomes in patients with recurrent implantation failure (RIF) infertility of kidney deficiency and blood stasis

and to explore its effects on the protein expression of serum p38MAPK and JAK/STAT.

Methods

Sixty-two patients with RIF infertility of kidney deficiency and blood stasis who were scheduled for artificial cycle frozen-thawed embryo transfer

were randomly divided into an observation group (31 cases

4 cases dropped out) and a control group (31 cases

3 cases were eliminated). The patients in the control group were treated with conventional artificial cycle frozen-thawed embryo transfer. On the basis of the control group

the patients in the observation group were treated with acupuncture combined with Chinese herbal medication. Acupuncture was applied at Baihui (GV 20)

Guanyuan (CV 4) and bilateral Neiguan (PC 6)

Zigong (EX-CA 1)

Guilai (ST 29)

Zusanli (ST 36)

Taichong (LR 3)

Shenshu (BL 23)

Ciliao (BL 32)

with each session lasting for 30 minutes

once every other day. Chinese herbal medication was administered to

Bushen Huoxue

(tonifing the kidney and activating blood circulation) decoction

with one dose per day

starting from the 3rd to 5th day of the menstrual cycle and continuing until 1 day before embryo transfer. Clinical pregnancy rate

embryo implantation rate

live birth rate

and biochemical pregnancy rate were compared between the two groups. TCM symptom score

platelet count (PLT)

and plasma D-dimer level were assessed before treatment and 1 day before embryo transfer. Western blot method was used to detect the expression of serum P38MAPK

JAK

and STAT proteins before treatment and 1 day before embryo transfer.

Results

In the observation group

the clinical pregnancy rate

embryo implantation rate

and live birth rate were higher (

0.05)

while the biochemical pregnancy rate was lower (

0.05) than those in the control group. One day before embryo transfer

both groups showed a decrease in TCM symptom scores

PLT

and plasma D-dimer levels compared to those before treatment (

0.05)

and the observation group had lower TCM symptom scores and plasma D-dimer levels than the control group (

0.05). One day before embryo transfer

the expression levels of serum p38MAPK

JAK

and STAT proteins in both gro

ups were lower than those before treatment (

0.05)

and the observation group had lower serum p38MAPK protein expression than the control group (

0.05).

Conclusion

Acupuncture combined with Chinese herbal medication can improve the clinical pregnancy rate

embryo implantation rate

live birth rate

and reduce the biochemical pregnancy rate in RIF infertility patients of kidney deficiency and blood stasis. Its mechanism of action may be related to down-regulating plasma D-dimer level and protein expression of serum p38MAPK.

关键词

Keywords

references

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