自拟温经汤联合宫腔镜治疗寒凝血瘀型子宫内膜息肉临床观察

Clinical efficacy of the Wenjing decoction plus hysteroscopy on endometrial polyps of the cold coagulation and blood stasis type

目的:观察自拟温经汤治疗寒凝血瘀型子宫内膜息肉的临床疗效及对血管内皮生长因子表达的影响。方法:60例患者随机分为观察组和对照组,每组30例。对照组仅行宫腔镜手术,观察组手术后给予温经汤治疗。观察治疗前后临床综合疗效,记录每月的月经量、经期及血管内皮生长因子表达的变化,于治疗后3个月、6个月分别记录子宫内膜厚度,并对中医证候进行评分,评估子宫内膜息肉复发率。结果:比较两组的临床疗效,差异有统计学意义(P<0.05),观察组优于对照组。观察组治疗后月经周期、经量、色质、腹痛、舌脉等症状改善情况有统计学意义(P<0.05)。对照组的腹痛、舌脉症状改善情况无统计学意义(P>0.05)。观察组子宫内膜厚度及血管内皮生长因子均较前降低,治疗前后的差异有统计学意义(P<0.05),观察组优于对照组。两组复发率比较,差异有统计学意义(P<0.05),观察组优于对照组。结论:自拟温经汤联合宫腔镜治疗寒凝血瘀型子宫内膜息肉对临床疗效有明显的提高作用,可减少月经量,缩短经行时间,减少复发率。

Objective:To observe the clinical efficacy of the Wenjing decoction(温经汤)on endometrial polyps of the cold coagulation and blood stasis type and its effect on the expression of vascular endothelial growth factor(VEGF).Methods:A total of 60 patients were randomly divided into the observation group and the control group,with 30 cases in each group.The control group only underwent hysteroscopic surgery,and the observation group was treated with the Wenjing decoction after surgery.The comprehensive clinical efficacy before and after treatment was observed,the monthly menstrual flow,menstrual period and changes in VEGF expression were recorded,the endometrial thickness was recorded at 3 months and 6 months after treatment,and TCM syndromes were scored to evaluate the recurrence rate of endometrial polyps.Results:The clinical efficacy in the two groups was compared,the observation group was better than the control group(P<0.05).There were significant differences in the improvement of menstrual cycle,menstrual volume,color quality,abdominal pain,tongue pulse and other symptoms in the observation group before and after treatment(P<0.05).There was no significant difference in the symptom improvement of abdominal pain and tongue pulse within the control group before and after treatment(P>0.05).The endometrial thickness and vascular endothelial growth factor in the observation group were lower after treatment,and there was a statistical significance before and after treatment(P<0.05),and the observation group was better than the control group.The difference in recurrence rate was statistically significant(P<0.05).Between the groups,and the observation group was better than the control group.Conclusion:The Wenjing decoction plus hysteroscopy on endometrial polyps with cold coagulation and blood stasis can significantly improve the clinical efficacy,reduce menstrual flow,shorten menstrual time,and reduce recurrence rate.