活血消异方对子宫内膜异位症不孕患者妊娠结局的影响

Effect of Huoxue Xiaoyi Prescription(活血消异方)on Pregnancy Outcome of Infertile Patients with Endometriosis

目的:探讨活血消异方对子宫内膜异位症(EMs)不孕患者腹腔镜术后妊娠结局的影响。方法:选取116例因不孕症行腹腔镜手术、术后病理诊断为EMs者,随机分为试验组和对照组各58例,试验组予活血消异方加减治疗6个月,发现妊娠则停药,对照组则予期待治疗,期间两组患者每月行阴道超声监测排卵,观察卵泡发育和子宫内膜情况,比较术后半年自然妊娠情况,并随访活产情况。结果:共完成随访106例,术后半年自然妊娠率为40.57%(43/106)。妊娠组患者HCG日子宫内膜厚度低于未妊娠组(P<0.05)。试验组完成随访54例,对照组完成随访52例,两组患者年龄、体质量指数、不孕时间、不孕类型、EMs分期的分布上比较,差异无统计学意义(P>0.05);试验组术后半年自然妊娠率为50.00%(27/54),高于对照组的30.77%(16/52)(P<0.05),试验组活产率为44.44%(24/54),高于对照组的25.00%(13/52)(P<0.05),试验组累计成熟卵泡排卵率[51.01%(152/298)]与对照组[45.80%(109/238)]比较,差异无统计学意义(P>0.05);试验组术后第1个月HCG日子宫内膜厚度与对照组比较,差异无统计学意义(P>0.05),术后第6个月低于对照组(P<0.05)。结论:HCG日子宫内膜厚度可能是影响EMs不孕患者术后自然妊娠的因素,活血消异方可降低EMs不孕患者HCG日子宫内膜厚度,提高自然妊娠率、活产率,且不影响成熟卵泡排卵。

Objective:To explore the effect of Huoxue Xiaoyi Prescription on the pregnancy outcome o f infertility patients with endometriosis(EMs)after laparoscopic surgery.Methods:Totally 116 cases of infertility w ith laparoscopic surgery and postoperative pathological diagnosis of Ems were randomly divided into experimental group and control group,58 cases in each group.The experimental group was treated with Huoxue Xiaoyi P rescription for six months,and the drug was stopped when pregnancy was found.The control group did not receive any medication.During the period,the two groups underwent monthly vaginal ultrasound to monitor ovulation.The follicular development and endometrium were observed,and the natural pregnancy six months after the operation,was compared.The live birth followed up.Results:A total of 106 cases were followed up,and the natural pregnancy rate was 40.57%(43/106)in the first half of the year.The pregnancy group showed lower endometrial thickness than nonpregnant group(P<0.05).Totally 54 cases in the experimental group and 52 cases in the control group were followed up.There was no significant difference in age,body mass index,infertility time,infertility type and EMs stage between the two groups(P>0.05).The experimental group showed higher natural pregnancy rate[50.00%(27/54)]than control group[30.77%(16/52)](P<0.05),and the birth rate of experimental group[44.44%(24/54)]was higher than that of the control group[25.00%(13/52)](P<0.05).There was no significant difference in cumulative mature follicle ovulation rate between expermental group[51.01%(152/298)]and control group[45.80%(109/238)](P>0.05).There was no significant difference in endometrial thickness of HCG day between the two groups at the first month after operation(P>0.05),while the experimental group showed lower endometrial thickness of HCG day than control group at the sixth month after operation(P<0.05).Conclusion:Endometrial thickness on HCG days may be a factor that affects the natural pregnancy of patients with EMs infertility;Huoxue Xiaoyi Prescription can reduce the thickness of the endometrium on HCG days,improve the natural pregnancy rate and live birth rate,and show no effect the ovulation of mature follicles.