中西医结合疗法对宫腔粘连术后患者子宫内膜厚度及妊娠结局的影响

Effect of combined therapy of TCM and western medicine on endometrial thickness and pregnant outcome of patient after operation of intrauterine adhesion-lysis

目的:观察针药联合雌孕激素序贯疗法对宫腔粘连术后患者子宫内膜厚度及妊娠结局的影响。方法:将80例宫腔粘连分解术后的患者随机分为两组各40例,对照组予坤灵丸结合芬吗通,治疗组予针药结合芬吗通。3个月后,比较两组治疗前后子宫内膜厚度、IUA评分及血清肿瘤坏死因子α(TNF-α)、转化生长因子β(TGF-β)水平变化情况,并随访1年。结果:两组患者子宫内膜厚度均明显升高(P﹤0.05),且治疗组升高较对照组明显(P﹤0.05)。与治疗前比较,两组治疗后IUA评分改善(P﹤0.05),且治疗组优于对照组(P﹤0.05);两组治疗后TNF-α、TGF-β水平均明显下降(P﹤0.05),且治疗组各指标好转均优于对照组(P﹤0.05)。随访1年,治疗组妊娠率优于对照组(P﹤0.05)。结论:针药联合雌孕激素序贯疗法对宫腔粘连术后患者能修复子宫内膜厚度,减轻术后炎症反应,预防宫腔粘连的复发,增加妊娠几率。

Objective:To observe the effect of treatment combined estrogenic-progesterone sequential therapy, acupuncture and Chinese medical herbs on endometrial thickness and pregnant outcome of patients after operation of intrauterine adhesion-lysis.Methods:80 cases of patients after operation of intrauterine adhesion-lysis were randomly divided into two groups,40 cases in each group.The control group was treated with Kunling pills and Femoston,while the treatment group was treated with acupuncture,Chinese medical herbs and Femoston.After treatment for 3 months,the changes of endometrial thickness,IUA score and levels of serum tumor necrosis factorα(TNF-α)and transforming growth factorβ(TGF-β)were compared in two groups before and after treatment.Both groups were followed up for 1 year.Results:the endometrial thickness of patients in both groups was increased significantly(P﹤ 0.05)and the increasing value of treatment group was greater than that of control group(P ﹤ 0.05).Compared with before treatment in both groups,IUA score after treatment for 3 months was better than before treatment(P ﹤0.05),and IUA score of treatment group was better than that of control group(P﹤0.05);the levels of serum tumor necrosis factorα(TNF-α)and transforming growth factorβ(TGF-β)were decreased significantly in both groups after treatment for 3 months(P﹤0.05),and the improvement of each index in treatment group was better than in control group(P﹤0.05).After following-up for 1 year,the pregnancy rate in treatment group was better than in control group(P﹤ 0.05).Conclusion:The effect of sequential therapy of and estrogenic-progesterone hormone,acupuncture Chinese medical herbs on endometrial thickness and pregnant outcome of patients after operation of intrauterine adhesionlysis is significantly better,which can repair the endometrial thickness and reduce the postoperative reactions of inflammation,so as to prevent from the postoperative recurrence of intrauterine adhesion,increase the probability of pregnancy.