宫腹腔镜手术联合少腹逐瘀汤灌肠治疗输卵管炎性不孕临床研究

Clinical Study of Uterine Laparoscopic Surgery Combined with Shaofu Zhuyu Decoction Enema in the Treatment of Tubal Inflammatory Infertility

目的:通过观察宫腹腔镜手术联合少腹逐瘀汤(Shaofu Zhuyu Decoction)灌肠治疗寒湿瘀滞型输卵管炎性不孕患者,探讨对子宫动脉血流指数(Uterine Arterial Resistance Index,RI and Uterine Arterial Pulsation Index,PI)及临床疗效的影响。方法:将66例输卵管炎性不孕患者随机分为对照组和治疗组,各33例,对照组予宫腹腔镜手术治疗,治疗组予宫腹腔镜手术联合少腹逐瘀汤灌肠治疗,治疗3个疗程后随访两组妊娠情况,比较未妊娠者的中医证候及局部体征积分、子宫动脉RI、PI变化,并随访术后6个月妊娠情况。结果:治疗结束后,宫内妊娠比较,治疗组为30%,对照组为12.5%(P>0.05);未妊娠者中医证候、局部体征积分、子宫动脉RI、PI值较治疗前均下降,治疗组低于对照组(P<0.05);治疗组的中医证候、局部体征总有效率高于对照组(P<0.05);术后6个月,宫内妊娠比较,治疗组为53.33%,对照组为28.13%,治疗组高于对照组(P<0.05)。结论:对于寒湿瘀滞型输卵管炎性不孕患者,手术联合少腹逐瘀汤灌肠在改善中医证候及局部体征、降低子宫动脉RI、PI方面更显著,有助于改善输卵管血流灌注,提高子宫内膜容受性(Endometrial receptivity,ER),增加临床妊娠率。

Objective:To observe the effect of hysteroscopic laparoscopic surgery combined with Shaofu Zhuyu decoction enema in the treatment of infertility patients with salpingitis due to cold-damp stasis type,and to explore the effect on uterine artery blood flow index(PI,RI)and clinical efficacy.Methods:66 cases of infertility patients with salpingitis were randomly divided into control group and treatment group,33 cases in each group.The control group was treated with laparoscopic surgery,and the treatment group was treated with laparoscopic surgery combined with Shaofu Zhuyu decoction enema.After 3 courses of treatment,the pregnancy status of the two groups was followed up,the TCM syndromes and local sign scores,uterine artery RI and PI changes in the non-pregnant patients were compared,and the pregnancy status was followed up 6 months after the operation.Results:After the treatment,the intrauterine pregnancy was compared in 30%of the treatment group and 12.5%of the control group(P>0.05).The TCM syndromes,local sign scores,uterine artery RI and PI values of non-pregnant patients were all decreased compared with those before treatment.,the treatment group was lower than the control group(P<0.05);the total effective rate of TCM syndromes and local signs in the treatment group was higher than that in the control group(P<0.05);6 months after operation,intrauterine pregnancy was compared,and the treatment group was 53.33%,the control group was 28.13%,the treatment group was higher than the control group(P<0.05).Conclusion:For infertility patients with salpingitis of cold-damp stasis type,surgery combined with Shaofu Zhuyu decoction enema is more significant in improving TCM syndromes and local signs,reducing uterine artery RI and PI,and is helpful to improve fallopian tube blood perfusion and improving endometrial receptivity(ER),increase clinical pregnancy rate.