宫腔粘连的相关因素分析与中医证型分布研究

Analysis of Factors Associated with Uterine Adhesions and Distribution of TCM Evidence Patterns

目的:探讨影响宫腔粘连(IUA)患者的相关因素与中医证型分布的研究。方法:选取2016年1月—2020年12月山东中医药大学第二附属医院行宫腔镜检查病人215例作为研究对象,按照纳入标准及排除标准,将经宫腔镜诊断的115例符合西医诊断宫腔粘连患者为观察组,收集观察组的中医四诊资料及病史。另外100例未发生粘连者为对照组,分析影响宫腔粘连患者发生的因素及与中医证型的分布。结果:单因素分析结果表明,观察组人工流产次数、稽留流产清宫、诊断性刮宫、宫腔操作次数、子宫内膜炎率均高于对照组(P<0.05),logistic回归分析显示,人工流产次数、稽留流产清宫、诊断性刮宫、宫腔操作次数及子宫内膜炎是宫腔粘连的相关危险因素(P<0.05)。在中医证型的分布中,宫腔粘连患者证型以肾虚证、血瘀证为主。结论:诱发宫腔粘连的相关危险因素较多,临床应对影响宫腔粘连的相关危险因素积极采取防治措施,结合中医疗法应以活血补肾为主。

Objective:To explore the related factors and the distribution of TCM syndromes affecting patients with intrauterine adhesion(IUA).Methods:From January 2016 to December 2020,215 patients who underwent hysteroscopy in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected as the research objects.According to the inclusion and exclusion criteria,115 cases diagnosed by hysteroscopy were in line with Western medicine diagnosis.The patients with intrauterine adhesions were in the observation group,and the data and medical history of the four diagnostic methods of traditional Chinese medicine were collected in the observation group.The other 100 cases without adhesions were used as the control group,and the factors affecting the occurrence of intrauterine adhesions and the distribution of TCM syndrome types were analyzed.Results:The results of univariate analysis showed that the number of induced abortion,missed abortion curettage,diagnostic curettage,uterine cavity operation,and endometritis rate in the observation group were higher than those in the control group(P<0.05).Logistic regression analysis showed that induced abortion The number of times,missed abortion curettage,diagnostic curettage,the number of intrauterine operations and endometritis were related risk factors for intrauterine adhesions(P<0.05).In the distribution of TCM syndrome types,the syndrome types of intrauterine adhesion patients are mainly kidney deficiency syndrome and blood stasis syndrome.Conclusion:There are many related risk factors for inducing intrauterine adhesions.Clinical measures should be actively taken to prevent and treat the relevant risk factors affecting intrauterine adhesions.Combined with traditional Chinese medicine therapy,the main method is to promote blood circulation and invigorate the kidney.