通管冲剂治疗衣原体感染所致输卵管性不孕机制研究

The Study of Mechanism About the Tongguan Dissolvent on Curing the Tubal Infertility Caused by Chlamydia Trachomatis

目的:通过测定衣原体感染所致输卵管性不孕患者不同治疗方案用药前后外周血单个细胞TLR4及血清IL-6、IL-8水平的变化及最终的妊娠结局,探讨通管冲剂治疗衣原体感染所致输卵管性不孕的机理。方法:选取2006年7月—2007年3月于山东中医药大学第二附属医院生殖科因输卵管因素致不孕而就诊的患者60例,随机分为两组,其中30例作为实验组,给予阿奇霉素+通管冲剂(成药)治疗,另30例作为对照组,只给予阿奇霉素治疗,测定两组患者用药前后外周血单个细胞TLR4及血清IL-6、IL-8的水平,比较两组患者用药前后各项指标的变化及最终的妊娠结局。结果:两组患者治疗前各项指标无明显差异(P>0.05);实验组治疗前后各项指标有显著差异性:IL-6(P<0.05)、IL-8(P<0.01)、TLR4(P<0.05);对照组治疗前后各项指标变化不明显(P>0.05);实验组与对照组治疗后各项指标相比较,前者降低更明显:IL-6(P<0.05)、IL-8(P<0.01)、TLR4(P<0.01);两组患者流产率与宫外孕发生率无明显差异(P>0.05),但临床妊娠率差异显著(P<0.05)。结论:通管冲剂可抑制TLR4引发的一系列炎性反应,降低IL-6、IL-8的水平,可以缓解衣原体感染所致的输卵管病理损伤,其活血化瘀、温经通络散结之功效可明显改善输卵管的功能,对输卵管性不孕有较好的治疗作用。

Objective：To study the level of IL-6,IL-8 and TLR4 before and after using different medicine and the relationship between them and the pregnancy outcomes.And to investigate the mechanism of Tongguan dissolvent curing the tubal infertility caused by Chlamydia Trachomatis.Methods：60 infertility patients by tubal factors were divided into two groups stochasticly.30 patients who were taken as observed group were given TCM-west medicine and others as controlled group only were given west medicine.We measured these patients′ level of TLR4,IL-6 and IL-8 before and after using different medicine,observed the outcomes of them.Compared every target′s changes and the differences between them.Results：The level of IL-6,IL-8 and TLR4 of all patients has no significant difference;the level of observed group were significantly lower after TCM-west medicine,IL-6（P0.05）、IL-8（P0.01）、TLR4（P0.05）;but the controled group have no significantly changes after west medicine,P0.05;the levele of observed group were more significantly lower than the controled group,IL-6（P0.05）,IL-8（P0.01）,TLR4（P0.01）;the abortion rate and the extrauterine pregnance rate have no significant difference between the two groups,P0.05;but the clinical pregnance rate were obviously different between them.Conclusion：Tongguan dissolvent may appease the pathologic damnification of Fallopian tube caused by CT,its function of Huo xue hua yu and Wen jing tong luo san jie may help to cure the tubal infertility.