丹荔输通汤治疗输卵管阻塞29例临床观察

Clinical efficacy of Danli Shutong decoction in treatment of fallopian tube obstruction: An analysis of 29 cases

目的:观察丹荔输通汤治疗输卵管阻塞(气滞血瘀型)患者的临床疗效及对血清细胞间黏附分子-1(ICAM-1)、血管内皮生长因子(VEGF)水平的影响。方法:将60例输卵管阻塞(气滞血瘀型)患者随机分为治疗组与对照组,每组各30例。对照组采用宫腔注药治疗,治疗组在宫腔注药基础上加丹荔输通汤口服液治疗。结果:总有效率治疗组为89. 66%,对照组为46. 43%,2组比较,差异有统计学意义(P <0. 01); 2组中医证候积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P <0. 01);输卵管通畅率治疗组为77. 59%,对照组为53. 57%,组间比较,差异有统计学意义(P <0. 01); 2组血清ICAM-1水平、VEGF水平治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P <0. 01)。结论:丹荔输通汤能明显提高输卵管阻塞(气滞血瘀型)患者的临床疗效及输卵管通畅率,可能与ICAM-1、VEGF水平变化有关,提示ICAM-1水平升高、VEGF水平降低可能是输卵管阻塞的病理机制之一。

Objective:To observe the clinical efficacy of Danli Shutong decoction in the treatment of fallopian tube obstruction(with Qi stagnation and blood stasis)and its effects on the serum levels of intercellular adhesion molecule-1(ICAM-1)and vascular endothelial growth factor(VEGF).Methods:Sixty patients with fallopian tube obstruction(with Qi stagnation and blood stasis)were randomly divided into treatment group and control group,with 30 cases in each group.The control group was treated with intrauterine injection of the relevant drug,and the treatment group was given oral liquid of Danli Shutong decoction in addition to the treatment for the control group.Results:The treatment group had a significantly higher overall response rate than the control group(89.66% vs 46.43% ,P<0.01).After treatment,both groups showed a significant change in traditional Chinese medicine (TCM)syndrome score(P<0.01),and there was a significant difference in TCM syndrome score between the two groups(P<0.01).The tubal patency rate was significantly higher in the treatment group than in the control group (77.59% vs 53.57% ,P<0.01).After treatment,both groups showed significant changes in serum levels of ICAM-1 and VEGF(P<0.01),and there were significant differences in serum levels of ICAM-1 and VEGF between the two groups(P<0.01).Conclusion:Danli Shutong decoction can significantly improve the clinical outcome and tubal patency rate of patients with fallopian tube obstruction(with Qi stagnation and blood stasis),which may be related to the changes in ICAM-1 and VEGF levels,suggesting that increased ICAM-1 level and reduced VEGF level may be one of the pathogenic mechanisms of fallopian tube obstruction.