中药汤剂联合芬吗通对宫腔粘连患者血液流变学指标的影响及安全性

Effect and safety analysis of traditional Chinese medicine combined with Femoston on hemorheology indi-cators in patients with intrauterine adhesion

目的探讨在芬吗通基础上增加中药治疗宫腔粘连的临床疗效,及对患者血液流变学指标和安全性的影响。方法根据治疗方法将濮阳市妇幼保健院2020年3月至2022年4月收治的92例宫腔粘连患者分为常规组、试验组各46例。常规组使用芬吗通治疗,试验组使用芬吗通+中药汤剂治疗,治疗3个月经周期。对2组疗效,治疗前后宫腔粘连评分(粘连类型、月经情况、粘连范围)、子宫内膜下动脉阻力指数(RI)、搏动指数(PI)、子宫内膜厚度、血浆黏度、全血低切黏度、全血高切黏度水平以及皮疹、胃肠道反应、头痛、乳房胀痛发生情况进行比较。结果常规组治疗总有效率80%,试验组98%(P<0.05);试验组治疗后宫腔粘连评分(粘连类型、月经情况、粘连范围)、RI、PI评分及血浆黏度、全血低切黏度、全血高切黏度水平[(2.13±0.31)分、(2.01±0.61)分、(2.19±0.45)分、0.69±0.11、1.79±0.31、(1.30±0.08)mPa·s、(7.01±0.09)mPa·s、(3.12±0.12)mPa·s]低于常规组和治疗前(2.52±0.53)分、(2.43±0.59)分、(2.54±0.32)分、0.85±0.10、2.02±0.52、(1.41±0.09)mPa·s、(7.62±0.12)mPa·s、(3.65±0.21)mPa·s,子宫内膜厚度(3.56±0.36)mm薄于常规组(4.02±0.23)mm,P<0.05。2组不良反应发生率(13%、4%)比较差异无统计学意义(P>0.05)。结论在芬吗通基础上增加中药治疗宫腔粘连可改善患者临床疗效,降低宫腔粘连发生的风险与子宫内膜下动脉阻力,增加子宫内膜厚度,促进子宫内膜修复,恢复患者子宫内膜血流,促进患者康复,安全性良好。

Objective To explore the clinical efficacy of traditional Chinese medicine combined with Fenmoton in intrauterine adhesions,as well as the impact on hemorheological indicators and safety in patients.Methods A total of 92 patients with intrauterine adhesions who visited Puyang Maternal and Child Health Hos-pital from March 2020 to April 2022 were divided into a control group and an experimental group according to treatment method,with 46 cases in each group.The control group was treated with Femoston,while the experi-mental group was treated with Femoston combined with traditional Chinese medicine.Both groups were treated for 3 menstrual cycles.The therapeutic effects,intrauterine adhesion scores(adhesion type,menstrual status,adhesion range)before and after treatment,resistance index(RI)and pulsatility index(PI)of uterine artery,endometrial thickness,plasma viscosity,whole blood low-shear viscosity,whole blood high-shear viscosity levels,as well as the occurrences of rash,gastrointestinal reactions,headache,and breast tenderness before and after treatment were compared between two groups.Results The total effective rate of the experimental group(98%)was higher than that of the control group(80%).After treatment,the intrauterine adhesion scores(adhesion type,menstrual status,adhesion range),RI,PI,plasma viscosity,whole blood low-shear viscosity,and whole blood high-shear viscosity levels in the experimental group were(2.13±0.31)points,(2.01±0.61)points,(2.19±0.45)points,0.69±0.11,1.79±0.31,(1.30±0.08)mPa·s,(7.01±0.09)mPa·s,and(3.12±0.12)mPa·s respectively.The above indicators in the con-trol group were(2.52±0.53)points,(2.43±0.59)points,(2.54±0.32)points,0.85±0.10,2.02±0.52,(1.41±0.09)mPa·s,(7.62±0.12)mPa·s,and(3.65±0.21)mPa·s,respectively.These indicators in the experimental group were lower than those in the control group and before treatment.And the endometrial thickness in the experimental group(3.56±0.36)mm was thinner than that in the control group(4.02±0.23)mm and before treatment(P<0.05).The dif-ference in adverse reactions between the two groups(13%vs 4%)was not statistically significant(P>0.05).Conclusion The combination of Femoston and traditional Chinese medicine can improve the clinical efficacy of patients with intrauterine adhesions,reduce the risk of intrauterine adhesions and resistance in the uterine artery,increase endometrial thickness,promote endometrial repair,restore endometrial blood flow,and promote patient recovery.This treatment method has good safety and can provide reference for the clinical treatment of intrauterine adhesions.