补肾化瘀方预防宫腔粘连术后再粘连的临床疗效观察

Clinical study on the Curative Effect of Bushenhuayu ReciPe with TCRA treating IUA

目的:观察名老中医李丽芸经验方补肾化瘀方对预防宫腔粘连分离术后发生再粘连的临床疗效。方法:选取肾虚血瘀型宫腔粘连患者42例,按照简单随机对照法分为治疗组和对照组,对照组采用TCRA联合上环术,术后雌孕激素序贯治疗;治疗组于对照组基础上加用补肾化瘀方中药,连续治疗3个月。观察治疗前后中医证候及主症评分、宫腔粘连评分、子宫内膜厚度。结果:中医整体疗效、中医主证的经量、色质比较,两组中医证候积分均较治疗前下降,差异有统计学意义(P<0.05),且治疗组下降较对照组幅度更大,差异有统计学意义(P<0.05)。两组IUA评分治疗后较治疗前下降,IUA评分差值两组间比较差异有统计学意义(P<0.05);B超内膜厚度与治疗前比较差异有统计学意义(P<0.05),治疗后组间内膜厚度比较及两组治疗前后内膜厚度差值比较差异无统计学意义(P>0.05)。结论:补肾化瘀方能够有效预防宫腔粘连松解术后再粘连,能明显改善中医症状,增加月经量、改善月经色质。

Objective:Applies the experienced Bushen Huayu Prescription,combined with Transcervical Resection of Adhesion(TCRA)to treat IUA and observe the clinical effect and safety of the prescription.Methods:According to western medicine and traditional Chinese medicine(kidney deficiency and blood stasis)diagnostic criteria,42 patients in our hospital who are treated by intrauterine adhesiolysis with hysteroscope are chose and divided into 2 groups:(1)control group has 22 cases:artificial cycle treatment after surgery;(2)treatment group has 20 cases:add the Bushen Huayu Prescription on the basis of control group.The two groups of people are treated for three menstrual cycles.In this period,the effectiveness and safety of drug are evaluated by comparing the curative effect,TCM symptom complex score,IUA score,endometrial thickness monitored by type-B ultrasonic and clinical observation of adverse effect.Results:Compared by TCM syndrome efficacy,the overall efficacy of TCM syndrome of treatment group is better than the control group.In TCM cardinal symptoms,menstrual quantity and color quality,after analysis,the difference has statistical significance and difference of the menstrual cycles and period time between two groups has no statistical significance.Compare two groups IUA scores between after and before treatment and the difference has statistical significance.After treatment,monitored by type-B ultrasonic,the endometrial thickness of two groups of patients has significant difference compared with that before treatment and comparison between two groups has no significant difference.Conclusion:Bushen Huayu Prescription can effectively prevent the IUA lysis postoperative re-adhesion.For the improvement of TCM cardinal symptoms,menstrual quantity and color quality.After three menstrual cycles treatment,hysteroscopy shows the IUA score of treat-ment group is lower than that of control group,illustrating that Bushen Huayu Prescription has more curative effect and no obvious ad-verse reactions.It is safe and worth popularizing.