补肾活血方治疗重度宫腔粘连术后再粘连35例

Clinical effect of kidney-tonifying and blood-activating prescription in treatment of readhesion after surgery for severe intrauterine adhesion:An analysis of 35 cases

目的:观察补肾活血方治疗重度宫腔粘连(IUA)术后再粘连的临床疗效及其对子宫内膜组织中β-catenin、CD117蛋白的影响。方法:选取70例行宫腔镜下宫腔粘连分离术(TCRA)的重度IUA患者,将其随机分为治疗组和对照组,每组各35例。对照组在术后给予人工周期治疗,治疗组在对照组基础上给予口服补肾活血方治疗,2组疗程均为3个月经周期。观察2组治疗前后中医证候积分、宫腔粘连评分、子宫内膜厚度、宫腔容积、β-catenin蛋白和CD117蛋白的表达变化,并评价2组临床疗效。结果:总有效率治疗组为85.71%(30/35),对照组为77.14%(27/35),2组比较,差异有统计学意义(P<0.05);2组中医证候积分、宫腔粘连评分、子宫内膜厚度、宫腔容积、β-catenin蛋白和CD117蛋白表达水平治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P<0.05)。结论:补肾活血方能有效改善重度IUA患者术后中医证候,减轻再粘连程度,预防宫腔再次粘连,并增加β-catenin蛋白和CD117蛋白的表达。

Objective:To investigate the clinical effect of kidney-tonifying and blood-activating prescription in the treatment of readhesion after surgery for severe intrauterine adhesion(IUA) and its effect on β-catenin and CD117 proteins in endometrial tissue.Methods:A total of 70 patients with severe IUA who underwent transcervical resection of adhesions were enrolled and randomly divided into treatment group and control group,with 35 patients in each group.The patients in the control group were given artificial menstrual cycle treatment,and those in the treatment group were given oral administration of kidney-tonifying and blood-activating prescription in addition to the treatment in the control group;the course of treatment was 3 menstrual cycles for both groups.The two groups were observed in terms of traditional Chinese medicine(TCM) syndrome score,intrauterine adhesion score,endometrial thickness,uterine volume,and changes in the protein expression levels of β-catenin and CD117,and clinical outcome was evaluated for both groups.Results:There was a significant difference in overall response rate between the treatment group and the control group [85.71%(30/35) vs 77.14%(27/35),P<0.05].After treatment,both groups had significant changes in TCM syndrome score,intrauterine adhesion score,endometrial thickness,uterine volume,and the protein expression levels of β-catenin and CD117,and there were significant differences in these indices between the two groups after treatment(P<0.05).Conclusion:For patients with severe IUA,kidney-tonifying and blood-activating prescription can effectively improve postoperative TCM syndrome,alleviate the degree of readhesion,prevent uterine readhesion,and increase the protein expression levels of β-catenin and CD117.