针药结合联合雌孕激素序贯疗法预防宫腔粘连分解术后再粘连临床观察

Clinical Effect of Acupuncture-Medicine Therapy Combined with Estrogen-Progesterone Sequential Therapy in Preventing Readhesion after Transcervical Resection of Adhesion

目的观察针药结合联合雌孕激素序贯疗法预防宫腔粘连分解(transcervical resection of adhesion,TCRA)术后再粘连的临床疗效。方法将60例患者随机分为对照组和观察组,对照组采用雌孕激素序贯治疗,观察组在采用雌孕激素序贯治疗的基础上,加用自拟补肾化瘀方和针刺治疗,两组均治疗3个月经周期,治疗结束后观察两组临床疗效,宫腔镜下观察宫腔粘连程度的改善情况以及超声监测子宫内膜厚度变化。结果两组临床疗效的分布比较,差异具有统计学意义(P<0.05),观察组疗效优于对照组。治疗前两组患者宫腔粘连程度评分比较,差异无统计学意义(P>0.05)。两组治疗后宫腔粘连程度较治疗前改善(P<0.05),其中以观察组的改善程度更显著(P<0.05)。治疗前两组子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后两组子宫内膜厚度均较治疗前显著增加(P<0.05),观察组子宫内膜厚度增加幅度明显大于对照组(P<0.05)。结论针药结合联合雌孕激素序贯疗法在预防TCRA术后再粘连、改善临床症状等方面具有良好疗效。

Objective To investigate the clinical effect of acupuncture-medicine therapy combined with es-trogen-progesterone sequential therapy in preventing readhesion after transcervical resection of adhesion （TCRA）. Methods A total of 60 patients were randomly divided into control group and experimentalgroup. The patients in the control group were given estrogen-progesterone sequential therapy, and those in the experimental group were given self-made kidney-tonifying and blood stasis-removing prescription com-bined with acupuncture in addition to the estrogen-progesterone sequential therapy . Both groups were trea-ted for 3 menstrual cycles. The clinical outcome was observed after the treatment ended,hysteroscopy was performed to observe the improvement in the degree of intrauterine adhesion,and ultrasound was used to monitor the change in endometrial thickness. Results There was a significant difference in the distribution of clinical outcomes between the two groups （P 〈0. 05）,and the experimental group had significantly bet-ter clinical outcomes than the control group. There was no signiticant difference in the degree of intrauter-ine adhesion between the two groups before treatment （P ＇^〉0. 05） ; both groups had a signiticant improve-ment in the degree of intrauterine adhesion after treatment （P 〈0. 05） ,and the experimental group had a signiiicantlygreater improvement thanthe control group （P〈〇. 05）. There was no signiticant difference in endometrial thickness between the two groups before treatment （P 〉 0. 05） ; both groups had a signiticant increase in endometrial thickness after treatment （P〈0. 05） ,and the experimental group had a significant-ly greater increase compared with the control group （P〈0. 05）. Conclusion Acupuncture-medicine thera-py combined wth estrogen-progesterone sequential therapy has a good clinical effect in preventing readhesion after TCRA and improving clinical symptoms.