中医活血通络兼补肾法对输卵管妊娠保守性手术后输卵管功能的影响

Effect of Therapy of Activating Blood, Unblocking Collaterals and Tonifying Kidney on Uterine Tube Function of Tubal Pregnancy Patients After Conservative Surgery

【目的】探讨中药活血通络兼补肾法治疗对输卵管妊娠保守性手术后生育功能的影响及作用机制。【方法】选取有生育要求的输卵管妊娠行腹腔镜保守性手术治疗患者45例,随机分为中药组21例及对照组24例,术后监测2组细胞因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化情况,2个月后进行输卵管功能评估并追踪宫内妊娠率情况。【结果】(1)中药组术后输卵管通畅率较对照组显著升高,差异有统计学意义(P<0.05)。(2)中药组术后14 d的TNF-α及IL-6水平均比术后3 d显著降低,差异有统计学意义(P<0.05);而对照组术后14 d的TNF-α及IL-6水平虽比术后3 d有所降低,但差异无统计学意义(P>0.05)。【结论】中药活血通络兼补肾法对输卵管妊娠保留功能性手术后的治疗有助于恢复输卵管的功能,其机制可能与抑制炎症反应有关。

Objective To explore the therapeutic effect and mechanism of Chinese medicine with the actions of activating blood, unblocking collaterals and tonifying kidney on reproductive function of tubal pregnancy patients after conservative surgery. Methods Forty-five tubal pregnancy patients after laparoseopic conservative surgery were randomly divided into Chinese medicine group （N=21） and control group （N =24） . After the laparoscopic conservative surgery, Chinese medicine group was given oral use and coloclysis of Chinese herbs with the actions of activating blood, unblocking collaterals and tonifying kidney, and the control group was given chalybeate if moderate or severe anemia occurred. The changes of serum interleukin-6 （IL-6） and tumor necrosis factor alpha （TNF-α） were monitored during the treatment course of 2 months, and then the function of uterine tube was evaluated and the intrauterine pregnancy rate was followed-up. Results The fallopian tube patency rate in Chinese medicine group was higher than that in the control group （P〈0.05） after the surgery. Serum TNF-α and IL-6 levels on postoperative day 14 were lower than those on postoperative day 3 in both groups, and the differences were significant in Chinese medicine group （P〈0.05） but insignificant in the control group （P〉0.05） Conclusion Chinese medicine with the actions of activating blood, unblocking collaterals and tonifying kidney is helpful for the recovery of reproductive function of tubal pregnancy patients after conservative surgery, and the mechanism may be related to inhibiting inflammatory reaction.