温肾通络法联合介入再通术治疗输卵管阻塞性不孕临床观察

Clinical Observation on the Treatment of Tubal Obstructive Infertility by Warm Kidney Channel Combined with Interventional Recanalization

目的:观察中医温肾通络法联合介入再通术对输卵管阻塞性不孕的临床疗效。方法:选取80例输卵管阻塞性不孕肾虚痰湿证患者,随机分为对照组和治疗组各40例,治疗组患者行输卵管介入再通术,术中予以丹红注射液输卵管腔内灌注,术后加用以温肾通络为主的中药口服、灌肠、下腹外敷中医综合治疗;对照组患者行输卵管介入再通术,术中行西药输卵管腔内灌注,术后予西药行宫腔通液。观察比较两组患者治疗前后中医证候积分改善情况和临床疗效。结果:治疗后治疗组患者腰骶胀痛、下腹胀痛、带下异常、神疲乏力、形寒肢冷、经行加重、月经不调、胸胁乳房胀痛、大小便异常、证候总积分均比对照组低(P<0.05),治疗组输卵管通畅性较对照组高(P<0.05),治疗组患者白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)水平较对照组低(P<0.05),两组患者在治疗过程中均未发生不良反应。结论:温肾通络法联合介入再通术治疗输卵管阻塞性不孕肾虚痰湿证临床疗效明显,能够提升输卵管复通率,降低输卵管局部炎症水平,改善输卵管局部微环境,提高妊娠率,值得临床推广应用。

Objective:To observe the clinical effect of warming kidney and dredging collaterals combined with interventional recanalization on Tubal Obstructive Infertility.Methods:80 cases of Tubal Obstructive Infertility with kidney deficiency and phlegm dampness syndrome were randomly divided into control group and treatment group.The patients in the treatment group underwent tubal interventional recanalization.During the operation,Danhong injection was injected into the tubal cavity,and after the operation,traditional Chinese medicine oral administration,enema and external application of lower abdomen were added;The patients in the control group were treated with fallopian tube interventional recanalization,intrauterine perfusion with western medicine during operation,and intrauterine fluid with western medicine after operation.The improvement of TCM syndrome score and clinical effect were observed and compared between the two groups before and after treatment.Results:After treatment,the total scores of lumbosacral pain,lower abdominal pain,abnormal band down,mental fatigue,cold shape and limb,menstrual aggravation,irregular menstruation,chest and flank breast pain,abnormal defecation and defecation in the treatment group were lower than those in the control group(P<0.05);The patency of fallopian tube in the treatment group was higher than that in the control group(P<0.05);Interleukin-6(IL-6)and tumor necrosis factor in the treatment groupα(TNF-α)The level was lower than that in the control group(P<0.05);There were no adverse reactions in the two groups.Conclusion:Wenshen Tongluo method combined with interventional recanalization is effective in the treatment of Tubal Obstructive Infertility with kidney deficiency and phlegm dampness syndrome.It can improve the recanalization rate of fallopian tube,reduce the level of local inflammation of fallopian tube,improve the local microenvironment of fallopian tube and improve the pregnancy rate.It is worthy of clinical application.