温经化癥汤治疗寒凝血瘀型子宫内膜异位症所致不孕症治疗效果的影响

Effects of Wenjinghuazheng Decoction on Infertility Caused by Cold Coagulation and Blood Stasis Endometriosis

目的探讨温经化癥汤治疗寒凝血瘀型子宫内膜异位症所致不孕症治疗效果的影响。方法将2020年1月至2020年12月在义乌市上溪镇中心卫生院吴店分院妇科治疗的92例寒凝血瘀型子宫内膜异位症所致不孕症患者随机分为两组,对照组使用米非司酮治疗,在此基础上,观察组使用温经化癥汤治疗,对比两组的临床疗效、中医证候积分、子宫内膜相关指标、血清激素及其他血生化指标。结果观察组治疗有效率为95.65%,高于对照组的73.91%(P<0.05);观察组治疗后不孕、性交痛、腰腹疼痛、经前或经期小腹冷痛、月经有血块、经色紫黯等中医证候积分低于对照组(P<0.05);观察组治疗后异位包块直径小于对照组,子宫内膜血流搏动指数(PI)、阻力指数(RI)、动静脉血流比值(S/D)均低于对照组(均P<0.05);观察组治疗后促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平均低于对照组(均P<0.05);观察组治疗后糖类抗原125(CA125)、糖类抗原199(CA199)、地诺前列素(PGF2α)、前列腺素E2(PGE2)水平均低于对照组(均P<0.05)。结论温经化癥汤治疗寒凝血瘀型子宫内膜异位症所致不孕症治疗效果显著,能有效减轻证候,促进异位病灶萎缩,改善内膜血流动力学,调节性激素水平,降低致痛物质及肿瘤标志物水平.

Objective To investigate the therapeutic effect of Wenjinghuazheng Decoction on infertility caused by cold coagulation and blood stasis endometriosis,the influence of TCM syndrome scores and serum indexes.Methods From January 2020 to December 2020,92 cases of infertility due to cold-congealed blood stasis-type endometriosis patients treated in the gynaecology department of Wudian Branch of Yiwu Shangxi Town Central Health Hospital were randomly divided into two groups,and the control group was treated with mifepristone.The control group was treated with mifepristone,and on this basis,the observation group was treated with Wenjinghuazheng decoction,and the clinical efficacy,Chinese medicine syndrome points,endometrium-related indexes,serum hormones and other blood biochemical indexes of the two groups were compared.The clinical efficacy of the two groups was compared.Results The effective rate of treatment in the observation group was 95.65%,which was higher than 73.91%in the control group(P<0.05);Infertility,painful sexual intercourse,and pain in the lower back and abdomen in the observation group after treatment,Cold pain in the abdomen before or during menstruation,blood clots during menstruation,purple colour of menstruation,and other TCM evidence points were lower than those of the control group(P<0.05);The diameter of the ectopic mass in the observation group was smaller than that in the control group after treatment,and the uterine endometrial blood flow pulsatility index(PI),resistance index(RI),and arteriovenous blood flow ratio(S/D)were lower than those of the control group(all P<0.05);Follicle stimulating hormone(FSH)in the observation group after treatment,luteinising hormone(LH),oestradiol(E2)and progesterone(P)levels were lower than those of the control group(all P<0.05);In the observation group,the levels of glycan antigen 125(CA125),glycan antigen 199(CA199),dinoprost(PGF2α)and prostaglandin E2(PGE2)were lower than those in the control group(all P<0.05).Conclusions Wenjinghuazheng Decoction has significant therapeutic effect on infertility caused by cold coagulation and blood stasis type endometriosis,which can effectively relieve syndromes,promote atrophy of ectopic focus,improve endometrial hemodynamics,regulate sex hormone levels,and reduce the levels of pain-causing substances and tumor markers.