影响子宫内膜异位症患者妊娠的相关因素及中药治疗对妊娠结局的影响

Related factors affecting pregnancy in patients with endometriosis and the impact of traditional Chinese medicine treatment on pregnancy outcomes

目的探究影响子宫内膜异位症患者妊娠的相关因素以及中药治疗对妊娠结局的影响。方法选取在本院就诊的121例子宫内膜异位症患者为研究对象,根据是否成功妊娠分为妊娠成功组(69例)与妊娠失败组(52例)。对影响子宫内膜异位症患者妊娠的相关因素进行单因素和多因素分析。采用倾向评分匹配(PSM)函数对中药组与非中药组进行匹配,比较两组妊娠率和活产率。结果单因素分析结果显示,年龄、r-AFS分期、有无子宫腺肌病、是否使用促性腺激素释放激素激动剂(GnRH-a)、是否使用中药及随访时间是子宫内膜异位症患者妊娠的影响因素(P<0.05);多因素回归分析结果显示,年龄≥35岁(OR=1.789,P=0.011)、r-AFSⅢ~IV期(OR=2.010,P=0.009)、存在子宫腺肌病(OR=1.525,P=0.018)、随访时间>6个月(OR=1.384,P=0.021)是子宫内膜异位症患者妊娠的独立危险因素(P<0.05),使用GnRH-a(OR=0.801,P=0.007)、使用中药(OR=0.723,P=0.004)是子宫内膜异位症患者妊娠的独立保护因素(P<0.05);经PSM匹配,共32对配对成功;中药组妊娠率为56.25%、活产率为50.00%,高于非中药组的28.13%、25.00%,差异有统计学意义(t=5.189、4.267,P=0.023、0.039)。结论年龄≥35岁、r-AFSⅢ~IV期、存在子宫腺肌病、使用GnRH-a、使用中药及随访时间>6个月是子宫内膜异位症患者妊娠的影响因素,中药治疗可提高子宫内膜异位症患者妊娠率及活产率。

Objective To explore the relevant factors affecting pregnancy in patients with endometriosis and the impact of traditional Chinese medicine treatment on pregnancy outcomes.Methods 121 patients with endometriosis who visited our hospital were selected as the research subjects,and were divided into a successful pregnancy group(69 cases)and a failed pregnancy group(52 cases)based on whether the pregnancy was successful or not.Conduct univariate and multivariate analysis on the relevant factors affecting pregnancy in patients with endometriosis.Match the traditional Chinese medicine group with the non traditional Chinese medicine group using the propensity score matching(PSM)function,and compare the pregnancy rate and live birth rate between the two groups.Results Univariate analysis showed that age,r-AFS staging,presence or absence of adenomyosis,use of gonadotropin releasing hormone agonists(GnRH-a),use of traditional Chinese medicine,and followup time were influencing factors for pregnancy in patients with endometriosis(P<0.05);The results of multivariate regression analysis showed that age≥35 years old(OR=1.789,P=0.011),r-AFS stage II-IV(OR=2.010,P=0.009),presence of adenomyosis(OR=1.525,P=0.018),and follow-up time>6 months(OR=1.384,P=0.021)were independent risk factors for pregnancy in patients with endometriosis(P<0.05).GnRH-a(OR=0.801,P=0.007)was used the use of traditional Chinese medicine(OR=0.723,P=0.004)is an independent protective factor for pregnancy in patients with endometriosis(P<0.05);After PSM matching,a total of 32 pairs were successfully paired;The pregnancy rate and live birth rate in the traditional Chinese medicine group were 56.25%and 50.00%,respectively,higher than those in the non traditional Chinese medicine group,which were 28.13%and 25.00%,with statistically significant differences(t=5.189,4.267;P=0.023,0.039).Conclusion Age≥35 years old,r-AFS stage II-IV,presence of adenomyosis,use of GnRH-a,use of traditional Chinese medicine,and follow-up time>6 months are the influencing factors for pregnancy in patients with endometriosis.Traditional Chinese medicine treatment can improve the pregnancy rate and live birth rate of patients with endometriosis.