益母逐瘀汤联合人工周期治疗宫腔粘连分离术后患者 肾虚血瘀证疗效及机制研究

Effect and mechanism analysis of Yimu Zhuyu decoction combined with artificial cycle on kidney deficiency and blood stasis syndrome after intrauterine adhesion separation

目的:分析益母逐瘀汤联合人工周期治疗宫腔粘连分离术后患者肾虚血瘀证的疗效及机制。方法:选取90例宫腔粘连分离术后肾虚血瘀证患者随机分为人工周期组(45例)和中西结合组(45例)。人工周期组采用人工周期治疗,中西结合组在人工周期组的基础上加用益母逐瘀汤治疗,两组均治疗3个月经周期。统计两组治疗3个月经周期后的临床疗效,比较两组治疗前和治疗3个月经周期后血清血小板源性生长因子(PDGF)、纤细酶原激活物抑制物-1(PAI-1)、基质金属蛋白酶-9(MMP-9)水平、阴道彩色多普勒超声检查结果、宫腔粘连评分、肾虚血瘀证评分、月经恢复情况。结果:治疗3个月经周期后,中西结合组总有效率高于人工周期组(P<0.05)。治疗3个月经周期后与治疗前比较,两组血清PDGF、PAI-1水平及子宫动脉血流阻力指数(RI)、子宫动脉搏动指数(PI)、宫腔粘连、肾虚血瘀证评分降低,中西结合组低于人工周期组(P<0.05);两组血清MMP-9水平、子宫内膜厚度、宫腔容积升高,中西结合组高于人工周期组(P<0.05)。治疗3个月经周期后与治疗前比较,两组经量正常、周期正常、经期正常患者占比升高,中西结合组高于人工周期组(P<0.05)。结论:益母逐瘀汤联合人工周期治疗宫腔粘连分离术后肾虚血瘀证患者,可有效抑制子宫内膜纤维化,改善患者子宫情况,促进患者月经恢复正常,具有较好的临床疗效。

Objective:To analyze the curative effect and mechanism of Yimu Zhuyu decoction combined with artificial cycle in treating kidney deficiency and blood stasis syndrome after intrauterine adhesion separation.Methods:A total of 90 patients with kidney deficiency and blood stasis syndrome after intrauterine adhesion separation were divided into the labor cycle group(45 cases)and the Chinese-western combination group(45 cases)by random number table method.The labor cycle group was treated with artificial cycle,while the Chinese-western combination group was treated with Yimu Zhuyu decoction on the basis of the labor cycle group.Both groups were treated for 3 menstrual cycles.The clinical effects of the two groups after 3 menstrual cycles were counted,and the levels of serum platelet-derived growth factor(PDGF),PAI-1 and MMP-9,color doppler ultrasonography,scores of intrauterine adhesion,kidney deficiency and blood stasis syndrome,and menstrual recovery were compared between the two groups before treatment and 3 menstrual cycles after treatment.Results:After 3 menstrual cycles,the total effective rate of the Chinese-western combination group was higher than that of the labor cycle group(P<0.05).After 3 menstrual cycles,the levels of serum PDGF and PAI-1 and uterine artery resistance index(RI),uterine artery pulsation index(PI),the scores of intrauterine adhesion and kidney deficiency and blood stasis in the two groups decreased compared with before treatment,and the Chinese-western combination group was lower than the labor cycle group(P<0.05);The level of serum MMP-9,endometrial thickness and uterine cavity volume of the two groups increased,and the Chinese-western combination group was higher than the labor cycle group(P<0.05).After 3 menstrual cycles,the proportion of patients with normal menstrual flow,normal menstrual cycle and normal menstrual period in the two groups increased compared with before treatment,and the Chinese-western combination group was higher than the labor cycle group(P<0.05).Conclusion:Yimu Zhuyu decoction combined with artificial cycle in the treatment of patients with kidney deficiency and blood stasis syndrome after intrauterine adhesion separation can effectively inhibit endometrial fibrosis,improve the patient's uterus,and promote the patient's menstruation to return to normal,and has a good clinical curative effect.