通管助孕汤保留灌肠联合宫腔镜下输卵管插管通液术治疗气滞血瘀型输卵管炎性阻塞性不孕症临床研究

Effect of Tongguan Zhuyun Decoction Retention Enema Combined with Hysteroscopic Tubal Cannulation Hydrotubation Surgery on Traditional Chinese Medicine Syndromes,Clinical Signs,Tubal Patency Rate and Pregnancy Rate of Patients with Salpingitis Obstructive

目的:观察通管助孕汤保留灌肠联合宫腔镜下输卵管插管通液术治疗对气滞血瘀型输卵管炎性阻塞性不孕症(SOI)患者中医证候、临床体征、输卵管通畅率及妊娠率的影响。方法:采用简单随机抽样法将92例SOI患者分为对照组(n=46)和观察组(n=46),对照组仅采取单纯宫腔镜下输卵管插管通液术治疗,观察组在对照组基础上加用通管助孕汤保留灌肠治疗,两组均治疗3个月经周期;比较两组临床疗效、治疗前后中医证候积分、临床体征积分、输卵管通畅率及妊娠率。结果:观察组治疗总有效率及愈显率分别为97. 83%、67. 39%,均明显高于对照组的82. 61%、45. 65%(P <0. 05)。治疗后,观察组中医证候积分、临床体征积分分别为(5. 25±1. 17)分、(1. 36±0. 45)分,均明显低于对照组的(7. 46±1. 95)分、(2. 14±0. 67)分(P <0. 05)。观察组治疗后输卵管通畅率、治疗后随访6个月内妊娠率分别为67. 39%、50. 00%,均明显高于对照组的45. 65%、26. 09%,差异均有统计学意义(P <0. 05)。结论:通管助孕汤保留灌肠联合宫腔镜下输卵管插管通液术治疗SOI疗效显著,能够明显改善患者中医证候、临床体征,并提高输卵管通畅率及妊娠率。

Objective: To observe the effect of Tongguan Zhuyun Decoction retention enema combined with hysteroscopic tubal cannulation hydrotubation surgery on TCM syndromes,clinical signs,tubal patency rate and pregnancy rate of patients with salpingitis obstructive infertility( SOI) of Qi stagnation and blood stasis. Methods: 92 patients with SOI were randomly divided into controlled group( n = 46) and observation group( n = 46). The controlled group was treated with simple hysteroscopic tubal cannulation hydrotubation surgery. On the basis,the observation group was treated with Tongguan Zhuyun Decoction retention enema.The two groups were treated for 3 menstrual cycles. The clinical curative effect,scores of TCM syndromes and clinical signs,tubal patency rate and pregnancy rate were compared between the two groups. Results: The total effective rate and cured and markedly effective rate in the observation group( 97. 83% and 67. 39%) were significantly higher than those in the controlled group( 82.61% and 45. 65%( P < 0. 05). After treatment,scores of TCM syndromes and clinical signs in the observation group [( 5. 25±1. 17) and( 1. 36±0. 45) ] were significantly lower than those in the controlled group [( 7. 46± 1. 95) and( 2. 14± 0.67) ]( P < 0. 05). The tubal patency rate after treatment and pregnancy rate of the observation group during 6 months of follow-up after treatment( 67. 39% and 50. 00%) were significantly higher than those of the controlled group( 45. 65% and 26.09%)( P < 0. 05). Conclusion: Tongguan Zhuyun Decoction retention enema combined with hysteroscopic tubal cannulation hydrotubation surgery is effective in the treatment of SOI. It can significantly improve TCM syndromes and clinical signs and improve the tubal patency rate and pregnancy rate.