重度宫腔粘连术后应用麒麟丸联合人工周期治疗临床疗效观察

Clinical observation of Qilin pill combined with hormone replacement treatment in patients with severe intrauterine adhesions

目的观察重度宫腔粘连患者粘连分离术后应用麒麟丸联合戊酸雌二醇的临床疗效。方法选取2016年10月至2017年12月于我院行宫腔粘连分离术治疗的100例重度宫腔粘连患者为研究对象,随机分为研究组(50例)及对照组(50例)。研究组自术后当日给予麒麟丸联合戊酸雌二醇片促进内膜修复,对照组仅给予戊酸雌二醇片促进内膜修复。比较两组患者治疗后的子宫内膜厚度、宫腔镜复查次数及恢复时间。结果两组患者治疗3个周期后子宫内膜厚度均有显著改善(P<0.05),且研究组子宫内膜厚度显著优于对照组[(0.77±0.13)cmvs.(0.66±0.12)cm,P<0.05];研究组术后恢复至正常宫腔所需时长较对照组显著缩短[(3.22±0.89)个月vs.(3.64±0.96)个月,P<0.05],粘连复发率亦显著低于对照组(16.0%vs.20.0%,P<0.05);自术后宫腔恢复正常后继续随访12个月,研究组辅助生殖治疗临床妊娠率显著高于对照组(38.0%vs.32.0%,P<0.05)。结论重度宫腔粘连分离术后应用麒麟丸联合戊酸雌二醇辅助治疗,可改善子宫内膜厚度,缩短术后恢复至正常宫腔所需时间,提高术后临床妊娠率,降低宫腔粘连复发几率。

Objective:To observe the efficacy of Qilin pill combined with hormone replacement treatment in the patients with severe intrauterine adhesions after transcervical resection of adhesion(TCRA).Methods:A total of 100 women who underwent TCRA for severe intrauterine adhesions in our hospital from October 2016 to December 2017 were included in the study.All patients were randomly assigned to estradiol valerate alone group(control group,n=50)and estradiol valerate combined with Qilin pill group(research group,n=50).The endometrial thickness,the number of hysteroscopy and the recovery time after treatment were compared between the two groups.Results:After 3 cycles of treatment,the endometrial thickness of both groups improved significantly(P<0.05).The endometrial thickness of the research group was significantly better than that of the control group[(0.77±0.13)cm vs.(0.66±0.12)cm,P<0.05].The recovery time in the research group was significantly shorter than that in the control group[(3.22±0.89)months vs.(3.64±0.96)months,P<0.05],and the adhesion recurrence rate was significantly lower than that in the control group(16.0%vs.20.0%,P<0.05).After 12 months of follow-up,the clinical pregnancy rate of the research group was significantly higher than that of the control group(38.0%vs.32.0%,P<0.05).Conclusions:After TCRA,Qilin pill combined with hormone replacement treatment can improve the thickness of endometrium,reduce the frequency of re-examination,shorten the time needed to recover to normal uterine cavity after operation,improve the clinical pregnancy rate and reduce the recurrence rate of intrauterine adhesion.