活血通瘀法联合热敷方加针刺治疗输卵管阻塞性不孕的临床研究

Clinical study of Huoxue Tongyu method combined with hot compress formula and acupuncture in the treatment of tubal obstructive infertility

目的观察活血通瘀法联合热敷方加针刺对输卵管阻塞性不孕患者输卵管形态、子宫微循环、复通率和预后的影响。方法选取2021年1月至2022年1月于南通大学附属南京江北医院治疗的98例输卵管阻塞性不孕患者作为研究对象。按照随机数字表法分组,49例为对照组,给予活血通瘀法联合热敷方治疗;49例为针刺联合组,给予活血通瘀法联合热敷方加针刺治疗。治疗前、后检测两组卵巢动脉的阻力指数(RI)、血管化血流指数(VFI)、搏动指数(PI),治疗前、后观察两组输卵管迂曲、僵直、似串珠样改变情况,治疗后比较两组输卵管阻塞率、输卵管通而不畅率、输卵管通畅率。随访12个月,记录两组受孕成功率。结果治疗后,针刺联合组VFI较对照组高(P<0.05),PI、RI较对照组低(P<0.05);针刺联合组输卵管迂曲、僵直、似串珠样改变发生率低于对照组(P<0.05);针刺联合组输卵管通畅率、受孕成功率高于对照组(P<0.05)。结论活血通瘀法联合热敷方加针刺治疗输卵管阻塞性不孕患者,可改善其输卵管形态及子宫微循环,提高复通率及受孕成功率,改善预后结局。

Objective To observe the effects of Huoxue Tongyu method combined with hot compress formula and acupuncture on tubal morphology,uterine microcirculation,recanalization rate and prognosis of patients with tubal obstructive infertility.Methods A total of 98 patients with tubal obstructive infertility treated in Nanjing Jiangbei Hospital Affiliated to Nantong University from January 2021 to January 2022 were selected as the study objects.According to random number table method,49 cases were divided into control group,and were treated with Huoxue Tongyu method combined with hot compress formula.49 cases of acupuncture combined group were treated with Huoxue Tongyu method combined with hot compress formula and acupuncture.The resistance index(RI),vascularized blood flow index(VFI)and pulsation index(PI)of ovarian arteries of the two groups were detected before and after treatment.The tubal flexion,rigidity and beaded changes condition of the two groups were observed before and after treatment.Tubal blocking rate,tubal obstruction rate and tubal patency rate were compared between the two groups after treatment.After 12 months of follow-up,the pregnancy success rate of both groups was recorded.Results After treatment,VFI of acupuncture combined group was higher than that of control group(P<0.05),PI and RI were lower than those of control group(P<0.05).The incidences of tubal flexion,rigidity and beaded changes in acupuncture combined group were lower than those in control group(P<0.05).The tubal patency rate and pregnancy success rate of acupuncture combined group were higher than those of control group(P<0.05).Conclusions In the treatment of tubal obstructive infertility patients,Huoxue Tongyu method combined with hot compress formula and acupuncture can improve tubal morphology and uterine microcirculation,increase the recurrence rate and the success rate of conception,and improve the prognosis.