经阴道三维彩超评价中药内膜薄方改善薄型子宫内膜容受性的研究

Study on efficacy of Chinese herbal drugs on improving endometrial receptivity detected by using trans-vaginal three-dimensional color Doppler ultrasound in patients with thin endometrium

目的探讨经阴道三维彩超评估中药内膜薄方改善薄型子宫内膜容受性的临床价值。方法选取重庆市江北区中医院2015年6月至2016年10月确诊的薄型子宫内膜患者76例,采用该院自拟中药内膜薄方治疗3个月,通过经阴道三维彩超观测治疗前后子宫内膜的厚度、容积、内膜及内膜下血流参数改变情况,进行统计学分析。结果与治疗前比较,治疗3个月后患者子宫内膜厚度、容积明显增加,子宫内膜及内膜下血流阻力指数(RI)、搏动指数(PI)明显下降,差异均有统计学意义(P<0.05)。应用三维能量多普勒检测治疗3个月后子宫内膜及内膜下血管指数(VI)、血流指数(FI)、血管-血流指数(VFI)均明显高于治疗前,差异均有统计学意义(P<0.05)。结论中药内膜薄方可增加薄型子宫内膜的厚度及容积,改善内膜及内膜下血供,明显提高其容受性,经阴道三维彩超能简便客观地评估临床用药疗效,具有较高的实用价值。

Objective To explore the clinical value of transvaginal three-dimensional color Doppler ultrasound in assessing effects of Chinese herbal drugs on improving endometrial receptivity in patients with thin endometrium. Methods A total of 76 ca- ses of patients diagnosed with thin endometrium in Jiangbei District Hospital of Traditional Chinese Medicine from June 2015 to Oc- tober 2016 were selected and treated with Chinese herbal prescription for three months. The endometrial thickness, endometrial vol- ume and blood flow indexes before and after treatment were measured by using transvaginal three-dimensional color Doppler ultra- sound. Results After 3 months treatment,the endometrial thickness and endometrial volume were increased, and the pulse index （PI） and resistance index （RI） of endometrial blood flow were decreased, compared with those before treatment, there were statisti- cally significant differences （P〈0. 05）. The results of three-dimensional color Doppler ultrasound indicates that after 3 months treatment the vascularization index （VI）, flow index （FI） and vascularization flow index （VFI） were significantly higher than those before treatment,there were statistically significant differences （P〈0.05）. Conclusion The Chinese herbal prescription could in- crease the thickness and volume of endometrium, augment blood supply, and improve endometrial receptivity significantly. Trans- vaginal color three-dimensional Doppler ultrasound is a convenient and objective method for evaluating clinical efficacy of Chinese herbal prescription in patients with thin endometrium,which has high practical value.