活血补肾法加宫腔镜分离术治疗宫腔粘连所致月经过少、继发性闭经、继发不孕57例临床观察

Clinical Observation on Activating Blood and Tonifying Kidney plus Uteroscope Exclusion for Treatment of 57 Cases of Scanty Menstruation,Secondary Amenorrhea and Secondary Sterility Caused by Intrauterine Adhesions

目的观察活血补肾法加宫腔镜分离术治疗宫腔粘连(IUA)所致月经过少、继发性闭经、继发不孕的临床疗效。方法将89例IUA患者随机分组,中药组57例,其中月经过少29例,继发性闭经17例,继发不孕11例。以活血补肾法为主加减,结合月经周期中月经后期滋肾益阴,补肾填精,经间期加重活血化瘀,以疏通冲任气血,经前期温肾助阳,活血通经进行治疗。对照组32例,其中月经过少17例,继发性闭经9例,继发不孕6例,采用雌—孕激素人工周期疗法,均用药3～12个月。结果IUA不同病情程度、IUA导致月经过少、继发性闭经两组疗效相当,差异无显著性意义(P>0.05)。继发性不孕中药组优于对照组,两组比较,差异有显著性意义(P<0.05)。结论活血补肾法治疗宫腔粘连宫腔镜术后月经过少、继发性闭经、继发不孕病症有较好的疗效,体现了中医药治疗本病的综合作用和特色优势。

Objective To observe the therapeutic effect of herbal medicine for activating blood and tonifying kidney plus uteroscope exclusion for,scanty menstruation,secondary amenorrhea and secondary sterility intrauterine adhesions(IUA).-Methods The 89 IUA cases were randomized into two groups.Of the herbal group(57 cases),29 cases were scanty menstruation,17 cases were secondary amenorrhea,and 11 cases were secondary sterility.The herbal formula with the functions to activate blood and tonify kidney were applied.At the late stage of menstruation,the herbs to reinforce the kidney yin and essence were prescribed.During menstruation,the herbs to activate blood to remove blood stasis were prescribed in order to circulate qi and blood of Chong-thoroughfare and Ren-conception meridians.Before menstruation,the herbal formula with the functions to warm kidney yang and activate blood for regulate menstruation were adopted.Of the control group(32 cases),17 cases were scanty menstruation,9 cases were secondary amenorrhea,and 6 cases were secondary sterility.The artificial periodical therapy with estrogen-progestogen was used for 3-12 months.-Results The therapeutic effect for scanty menstruation and secondary amenorrhea caused by IUA was almost the same with no significant difference(P>0.05).For the secondary sterility,the effect of herbal group was significantly superior to that of control group(P<0.05).-Conclusion The herbal medicines with the functions to activate blood and tonify kidney are effective for the treatment of scanty menstruation,secondary amenorrhea and secondary sterility caused by intrauterine adhesions,showing a comprehensive function and superiority of Chinese medicine.