| 引用本文: |
黄紫纯,匡继林,朱维昊.通管方治疗宫腹腔镜术后输卵管性不孕患者的疗效及其对炎症因子、子宫动脉血流的影响[J].湖南中医药大学学报,2020,40(12):1539-1543[点击复制] |
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| 通管方治疗宫腹腔镜术后输卵管性不孕患者的疗效及其对炎症因子、子宫动脉血流的影响 |
| 黄紫纯,匡继林,朱维昊 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第二附属医院, 湖南 长沙 410005) |
| 摘要: |
| 目的 探讨通管方对宫腹腔镜术后输卵管性不孕症患者的炎症因子、子宫动脉血流及疗效影响。方法 符合纳入标准的60例输卵管性不孕患者，随机分为对照组30例、治疗组30例。2组均行宫腹腔镜手术治疗，术后3 d予预防感染治疗。对照组于术后下个月经周期开始监测排卵，指导受孕；治疗组在对照组基础上于每次月经干净2 d后开始内服通管方，14 d为1疗程，连续服用3个月。观察术前、术后3个月两组患者炎症因子（血清IL-6、TNF-α）、子宫动脉血流参数（PI、RI、S/D）及临床症状情况；观察术后6个月未孕者输卵管情况；观察术后1年患者妊娠情况。结果 两组患者术后血清IL-6、TNF-α水平均下降（P<0.05），治疗组明显低于对照组，差异有统计学意义（P<0.05）。术后两组RI及S/D均较术前降低（P<0.05），且治疗组低于对照组，差异有统计学意义（P<0.05）。术后3个月治疗组症状改善总有效率为90.0%，对照组为56.7%，两组比较差异有统计学意义（P<0.01）。术后6个月未孕者，治疗组经B超下子宫输卵管造影证实输卵管疏通率80.0%，对照组为56.7%，两组比较差异有统计学意义（P<0.01）。术后6个月、1年宫内妊娠率，治疗组分别为53.3%、66.7%，对照组分别为26.7%、36.7%，两组间比较差异有统计学意义（P<0.05）。结论 通管方治疗宫腹腔镜术后输卵管性不孕患者，通过降低其炎症因子的表达、改善子宫动脉血流及临床症状、降低术后输卵管粘连和阻塞情况，有效提高了临床妊娠率。 |
| 关键词: 输卵管性不孕 宫腹腔镜手术 通管方 活血化瘀法 |
| DOI：10.3969/j.issn.1674-070X.2020.12.019 |
| 投稿时间：2020-09-01 |
| 基金项目:湖南省中医药管理局科研计划项目（202011）。 |
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| Efficacy of Tongguan Prescription in Treating Tubal Infertility Patients After Hysteroscopy Combined with Laparoscopic Surgery and Its Effects on Inflammatory Factors and Uterine Artery Blood Flow |
| HUANG Zichun,KUANG Jilin,ZHU Weihao |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410005, China) |
| Abstract: |
| Objective To explore effects of Tongguan Prescription on inflammatory factors, uterine artery blood flow and its efficacy in patients with tubal infertility after hysteroscopy combined with laparoscopic surgery. Methods Sixty cases of tubal infertility patients meeting inclusion criteria were randomly assigned into 2 groups, with 30 cases in a control group and 30 cases in a treatment group. All the patients in the 2 groups received hysteroscopy combined with laparoscopic surgery and 3-day intravenous drip of antibiotics after the surgery. In the control group, ovulation was monitored and conception was guided at the beginning of the next menstrual cycle after the surgery. Based on this, the treatment group took Tongguan Prescription after 2 days of each menstrual period, with 14 days as a course of treatment, and the treatment lasted for 3 months. Inflammatory factors (serum IL-6 and TNF-α), blood flow parameters of the uterine artery (PI, RI and S/D) and clinical symptoms in the 2 groups were observed before the surgery and 3 months after the surgery. Tubal conditions of non-pregnant patients 6 months after the surgery and pregnancy rates 1 year after the surgery were observed. Results The levels of serum IL-6 and TNF-α in the 2 groups were decreased after the surgery (P<0.05), and those in the treatment group were significantly lower than those in the control group, with statistically significant difference (P<0.05). The RI and S/D in the 2 groups were decreased compared with those before the surgery (P<0.05), and those in the treatment group were lower than those in the control group, with statistically significant difference (P<0.05). The total effective rate of symptom improvement 3 months after the surgery was 90.0% in the treatment group, while 56.7% in the control group, whose difference was statistically significant (P<0.01). For those who were not pregnant 6 months after the surgery, hysterosalpingography under B-mode ultrasound confirmed that the tubal dredging rate in the treatment group was 80.0%, while 56.7% in the control group. The difference was statistically significant between the 2 groups (P<0.01). Intrauterine pregnancy rates were 53.3% and 66.7% in the treatment group 6 months and 1 year after the surgery, respectively, while 26.7% and 36.7% in the control group, respectively. The difference was statistically significant between the 2 groups (P<0.05). Conclusion Tongguan Prescription is used to treat tubal infertility patients after hysteroscopy combined with laparoscopic surgery. By decreasing expressions of inflammatory factors, improving uterine artery blood flow and clinical symptoms, and alleviating tubal adhesion and obstruction after the surgery, it can effectively increase the clinical pregnancy rate. |
| Key words: tubal infertility hysteroscopy combined with laparoscopic surgery Tongguan Prescription promoting blood circulation and removing blood stasis method |
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