经阴道彩色多普勒超声观测中药内膜薄方改善薄型子宫内膜容受性的研究

Clinical study on improving endometrial receptivity of thin endometrium treated with traditional Chinese medicine using transvaginal color Doppler ultrasound

目的探讨经阴道彩色多普勒超声观测中药内膜薄方改善薄型子宫内膜容受性的临床价值。方法选取我院经超声检查证实的子宫薄型内膜患者52例,经中药内膜薄方治疗3个月,采用经阴道彩色多普勒超声观察比较治疗前后子宫内膜厚度、分型及内膜血流参数情况。结果子宫薄型内膜患者内膜厚度由治疗前的(6.25±0.98)mm治疗后增至(9.08±1.31)mm,前后比较差异有统计学意义(P=0.000)。治疗后A型内膜所占比例由治疗前的21.2%增至治疗后的59.6%,C型内膜比例由治疗前的44.2%降至治疗后的13.5%,前后比较差异均有统计学意义(P=0.000、0.001)。治疗后子宫内膜血流分型Ⅰ型所占比例由治疗前的17.3%增至治疗后的55.8%,前后比较差异有统计学意义(P=0.000)。子宫内膜及内膜下血流搏动指数由治疗前的1.63±0.58降至治疗后的0.98±0.33,阻力指数由治疗前的0.83±0.15降至治疗后的0.62±0.09,前后比较差异均有统计学意义(P=0.000、0.001)。结论中药内膜薄方的应用可增加薄型子宫内膜厚度,改善其血供情况,明显提高内膜的容受性;经阴道彩色多普勒超声可帮助临床评估用药疗效,提高妊娠成功率。

Objective To investigate the clinical value of traditional Chinese medicine in improving endometrial receptivity of thin endometrium using transvaginal color Doppler ultrasound. Methods Fifty-two patients with thin endometrium were treated with traditional Chinese medicine for 3 months. The endometrial thickness,endometrial type and blood flow index before and after treatment were measured by transvaginal color Doppler ultrasound. Results Endometrial thickness increased from（6.25± 0.98）mm to（9.08±1.31）mm after treatment （P=0.000）. The proportion of type A endometrium increased from 21.2%to 59.6%（P=0.000）,while the proportion of type C endometrium decreased from 44.2%to 13.5%（P=0.001）. TypeⅠblood flow increased from 17.3%to 55.8%（P=0.000）. PI of endometrial and subendometrial blood flow decreased from 1.63±0.58 to 0.98±0.33（P=0.000）, RI of endometrial and subendometrial blood flow decreased from 0.83±0.15 to 0.62±0.09（P=0.001）. Conclusion Traditional Chinese medicine may increase the thickness of thin endometrium,augment blood supply,and improve endometrial receptivity significantly. Transvaginal color Doppler ultrasound is an effective modality in evaluation of traditional Chinese medicine treatment in patients with thin endometrium.