通管散配合腹腔镜治疗输卵管远端阻塞性不孕疗效观察

Oviduct-clear particle combined with laparoscopic surgery for treatment of infertility caused by distal occlusion of oviduct

目的:观察通管散配合腹腔镜手术治疗输卵管远端阻塞性不孕的临床疗效。方法:选择经腹腔镜证实为输卵管远端阻塞并排除其他不孕因素的不孕患者150例,经腹腔镜下输卵管粘连分离与成形或造口术后,根据患者意愿分为中药组76例和对照组74例。中药组术后第8天辅以通管散口服、保留灌肠,同时配合盆腔治疗仪治疗,每月1疗程(10d),经期停用,共3疗程;对照组术后不予中药干预。随访观察术后1年两组妊娠情况。结果:中药组妊娠率为46.1%(35/76),高于对照组21.6%(16/74),差异有统计学意义(P<0.01)。双侧输卵管评分:6～8分妊娠率中药组达31.6%(24/76),明显高于对照组13.5%(10/74)(P<0.01);3～5分妊娠率中药组达14.5%(11/76),高于对照组8.1%(6/74)(P<0.05);输卵管评分0～2分者术后两组妊娠率为0。输卵管评分6～8分者术后妊娠率高于3～5分者。结论:通管散配合腹腔镜手术治疗输卵管远端阻塞性不孕疗效优于单纯腹腔镜手术治疗,而且对输卵管病变轻者效果更佳。

Objective： Through the method of using oviduct-clear particle with laparoscopic surgery for treatment of infertility caused by distal occlusion of oviduct. Methods： 150 cases of infertility patients confirmed by laparoscopic tubal infertility distal obstruction and rule out other factors. After laparoscopic tubal adhesions or stoma and forming the separation surgery, according to the wishes of patients divided into traditional Chinese medicine group of 76 patients and a control group of 74 patients. The medicine group was supported by the 8th day after the tube scattered through oral, enema,also got treated by pelvic therapeutic equipment,one treatment period for one month （10 days） ,stopped during menstrual period,altogether 3 periods. The Chinese medicine group was not interfered, followed and observed the pregnancy of the two groups after 1 year. Results： Medicines pregnancy rate was 46.1%（35/76） ,which was higher than the other group 21.6%（16/74）. Difference was statistically significant. Bilateral tubal pregnancy assessment 6 to 8 minutes of traditional Chinese medicine group 31.6% （24/76）, which was obviously higher than the other group 13.5% （10/74） （P〈0.01）. To the person who got 0-2 points in the oviduct, pregnancy rate was 0 after operation. To the person who got score 6 to 8,their post operation pregnancy rate was higher than that of 3-5 scores. Conclusion： The measure of using oviduct-clear particle with laparoscopic surgery for treatment of infertility caused by distal occlusion of oviduct is better than that of using laparoscope only. This measure has better effect to the patients who do not have serious oviduct problems.