中药联合宫腹腔镜治疗H-HSP60抗体阳性输卵管炎性不孕的临床研究

Clinical research on H-HSP60 antibody positive oviduct inflammatory infertility treated with Chinese medicine combined with hysteroscope and laparoscope

目的:探讨中药对输卵管炎性不孕患者宫腹腔镜术后HSP-60抗体、TNF-α浓度变化以及对患者妊娠率的影响。方法:将符合纳入标准的病例40例,按照随机对照原则分为两组,实验组21例,给予盆炎康合剂+助孕丸口服;对照组19例,给予输卵管通液+助孕丸口服;若在治疗期间妊娠,则终止治疗方案,改为安胎治疗;均连续3个月经周期为1疗程,随访至术后6月。治疗后测定患者血清HSP-60抗体、TNF-α的水平,记录两组患者宫内妊娠、异位妊娠的情况。结果:妊娠率、宫内妊娠率、异位妊娠率实验组分别为61.9%、38.1%、23.8%,对照组分别为52.6%、21.1%、31.6%;实验组妊娠率、宫内妊娠率高于对照组,异位妊娠率低于对照组,但差异无统计学意义(P>0.05)。治疗后两组血清HSP-60抗体Ig G、TNF-α浓度均较治疗前有所下降,且实验组治疗后血清两指标浓度明显低于对照组(P<0.05)。结论:盆炎康合剂可以降低输卵管炎性不孕患者体内血清HSP-60抗体、TNF-α浓度,平衡和改善机体的免疫功能;中药联合宫腹腔镜手术治疗治疗H-HSP60抗体阳性输卵管炎性不孕患者可提高患者妊娠率及宫内妊娠率。

Objective：To explore the influence of Chinese medicine on HSP 60 antibody, concentration of TNF alpha changes and the pregnancy rate of patients with tubal phlogistic infertility after hysteroscope combined with laparoscope treatment. Methods：40 patients included in the standard were divided into 2 groups, in accordance with the principle of randomization, 21 cases in the experiment group, given Penyankang mixture ＋ assisted pill as oral administration; 19 cases in the control group, given tubal liquid ＋ assisted oral; If during pregnancy, the termination of the treatment, instead of miscarriage prevention treatment. Three consecutive menstrual cycle is one course, postoperative follow-up to 6 months. After treatment, serum HSP 60 antibody, the level of TNF alpha, intrauterine pregnancy and ectopic pregnancy of patients were recorded .Results： Pregnancy rate, rate of intrauterine pregnancy and ectopic pregnancy rates in the experiment group were respectively 61.9%, 38.1% and 61.9%, while the control group were 52.6%, 21.1%, 31.6%; the pregnancy rate, intrauterine pregnancy rate in the experiment group were higher than those in the control group, ectopic pregnancy rate was lower than the control group, but there was no statistically significant difference （P〉0.05）. After treatment, the serum HSP 60 antibody IgG, concentration of TNF alpha were decreased, the two indicators and the experimental group after treatment serum concentration significantly lower than the control group （P〈0.05）. Conclusions：Penyankang mixture can reduce serum HSP 60 antibody, concentration of TNF alpha of patients with tubal infertility and improve the immune function; Laparoscopic surgery treatment combined with TCM in the treatment of patients with H - HSP60 antibody positive oviduct inflammatory infertility can improve the pregnancy rate and intrauterine pregnancy rate.