养膜调经汤联合经宫腔镜宫腔粘连分离术治疗中-重度宫腔粘连的临床观察

Clinical Effect Observation of Nourishing Endometria Regulating Menstruation Decoction Combined with Transcervical Resection of Adhesions in Treatment of Moderate or Severe Intrauterine Adhesions

目的:研究养膜调经汤在中-重度宫腔粘连治疗中的应用价值。方法:60例中-重度宫腔粘连病患采取经宫腔镜宫腔粘连分离术,放置宫内避孕环,术后随机分成两组,30例对照组接受雌孕激素人工周期治疗,30例治疗组联合养膜调经汤治疗。结果:两组患者治疗后IUA评分、子宫内膜厚度较治疗前有显著性差异(P<0.05);与对照组比较,治疗组在增加月经量、增加子宫内膜厚度、降低宫腔粘连评分方面有显著性差异(分别P=0.036,P=0.049,P=0.046),但术后两组妊娠率无显著性差异。结论:联合养膜调经汤治疗更有利于促进子宫内膜的生长,增多月经量,预防宫腔再粘连,一定程度上促进妊娠,综合疗效优于单纯雌孕激素人工周期。

Objective：To observe the application value of Nourishing Endometria Regulating Menstruation Decoction in treat- ment of moderate or severe intrauterine adhesions. Methods ： Sixty patients with moderate or severe intrauterine adhesion diagnosed by hysteroscopy, conducted transcervical resection of adhesions （TCRA）, and installed intra uterine device （IUD）successfully were randomly divided into 2 groups. Thirty patients treated with artificial cycle methods only were selected as control group and the other 30 patients treated with treatment combined with Nourishing Endometria Regulating Menstruation Decoction were selected as treatment group. Results ： There were obvious differences on the scores of IUA, the thickness of endometrium before and after thera- py （ P 〈 0.05 ）. Compared with control group, treatment group can significantly increase menstrual quantity and the thickness of endometrium and reduce IUA score（P -- 0.036 ,P = 0. 049, P = 0. 046 ）. Pregnancy rates of two groups had no significant differ- ence. Conclusion：Treatment combined with Nourishing Endometria Regulating Menstruation Decoction provides better comprehen- sive efficacy than artificial cycle methods with estrogen and progesterone on thickening endometrium, increasing menstruation, pre- venting re - adhesion and promoting reproductive to some extent.