复膜汤保留灌肠对气虚血瘀型宫腔粘连术后再粘连的影响

Effect of Fumo Decoction Retention Enema on Re-adhesion After Uterine Cavity Adhesion of Qi Deficiency and Blood Stasis Type

目的:观察复膜汤保留灌肠预防气虚血瘀型宫腔粘连(intrauterine adhesion,IUA)术后再粘连的有效性及其对凝血功能和炎症反应的影响。方法:112例IUA患者随机分为对照组和观察组,每组各56例。对照组给予雌孕激素序贯疗法,观察组在对照组治疗基础上给予复膜汤保留灌肠,比较两组患者宫腔粘连评分、子宫内膜厚度、炎症因子指标、凝血功能指标、中医证候疗效及不良反应。结果:治疗后,两组患者宫腔粘连评分降低(P<0.05),观察组低于对照组(P<0.05)。两组患者子宫内膜厚度增加(P<0.05),观察组高于对照组(P<0.05)。两组患者血清白细胞介素-6和肿瘤坏死因子-α水平均降低(P<0.05),观察组低于对照组(P<0.05)。两组患者纤维蛋白原(fibrinogen,FIB)和D-二聚体(D-Dimer,DD)水平降低(P<0.05),部分凝血酶原时间(activated partial thromboplastin time,APTT)升高(P<0.05);观察组的FIB和DD低于对照组(P<0.05),APTT高于对照组(P<0.05)。观察组治疗后中医证候疗效优于对照组(P<0.05)。结论:复膜汤保留灌肠联合雌孕激素序贯疗法治疗IUA,能降低宫腔粘连评分,增加子宫内膜厚度,降低炎症因子水平和改善凝血功能,且不良反应较少。

Objective:To observe the effectiveness of Fumo Decoction retention enema to prevent intrauterine adhesion(IUA)after qi deficiency and blood stasis(IUA)and its effect on coagulation function and inflammation.Methods:112 patients with IUA were randomly assigned to a control group or an observation group,56 in each group.The control group was given estrogen and progesterone sequential treatment,and the observation group was given Fumo Decoction to retain the enema on the basis of the control group,comparing the scores of intrauterine adhesions,endometrial thickness,inflammatory factors,coagulation function,and TCM syndromes And adverse reactions.Results:After treatment,the scores of intrauterine adhesions decreased in the two groups(P<0.05),the observation group was lower than the control group(P<0.05);the endometrial thickness of the two groups increased(P<0.05),the observation group was higher than the control Group(P<0.05);serum interleukin-6 and tumor necrosis factor-αlevels in two groups of patients decreased(P<0.05),the observation group was lower than the control group(P<0.05);fibrinogen in two groups of patients Fibrinogen(FIB)and D-Dimer(D-Dimer,DD)levels decreased(P<0.05),and activated partial thromboplastin time(APTT)increased(P<0.05);FIB in the observation group And DD were lower than the control group(P<0.05),APTT was higher than the control group(P<0.05);the observation group was better than the control group in the efficacy of traditional Chinese medicine syndrome after treatment(P<0.05).Conclusion:Fumo Decoction combined with es-trogen and progesterone sequential therapy for IUA can reduce the intrauterine adhesion score,increase the endometrial thickness,reduce the level of inflammatory factors and improve blood coagulation function,and have fewer adverse reactions.