补肾活血调周法联合中药封包治疗宫腔粘连疗效观察及对PDGF-BB、TGF-β1、bFGF的影响

Curative Effect of Method of Tonifying Kidney,Activating Blood and Regulating Menstrual Cycle Combined with Chinese Medicine Packages on Intrauterine Adhesions and Its Effect on PDGF-BB,TGF-β1 and bFGF

目的:观察补肾活血调周法联合中药封包治疗宫腔粘连(IUA)的临床疗效,以及对血小板源性生长因子(PDGF)-BB、转化生长因子-β1 (TGF-β1)及碱性成纤维细胞生长因子(bFGF)的影响。方法:选取40例行宫腔镜下宫腔粘连分离术治疗的IUA患者,采用随机数字表法分为对照组(应用补肾活血调周法治疗)及试验组(采用补肾活血调周法联合中药封包治疗),每组20例。2组均治疗3个月经周期,随访1年。比较2组临床疗效,子宫内膜厚度,子宫动脉血流参数[搏动指数(PI)、阻力指数(RI)],血清PDGF-BB、TGF-β1、bFGF水平,宫腔再粘连发生率及妊娠率。结果:治疗后,试验组总有效率85.00%,高于对照组55.00%(P<0.05)。2组子宫内膜厚度均较治疗前增加(P<0.05),PI、RI均较治疗前降低(P<0.05);试验组子宫内膜厚度大于对照组(P<0.05),PI、RI均低于对照组(P<0.05)。2组血清PDGF-BB、TGF-β1、bFGF水平均较治疗前降低(P<0.05),试验组血清PDGF-BB、TGF-β1、bFGF水平均低于对照组(P<0.05)。随访3个月,试验组再粘连发生率5.88%,低于对照组27.27%(P<0.05)。随访1年,试验组妊娠率40.00%,高于对照组5.00%(P<0.05)。结论:补肾活血调周法联合中药封包治疗IUA,可增加子宫内膜厚度,改善子宫动脉血流及临床症状,有效调节PDGF-BB、TGF-β1、bFGF水平,减少宫腔再粘连发生,提高妊娠率。

Objective:To observe the clinical effect of method of tonifying kidney,activating blood and regulating menstrual cycle combined with Chinese medicine packages on intrauterine adhesions(IUA),and its effect on platelet-derived growth factor(PDGF-BB),transforming growth factor-β1(TGF-β1)and basic fibroblast growth factor(bFGF).Methods:A total of 40 cases of IUA patients who underwent hysteroscopic separation of uterine adhesions were divided into the control group(treated with method of tonifying kidney,activating blood and regulating menstrual cycle)and the trial group(treated with method of tonifying kidney,activating blood and regulating menstrual cycle combined with Chinese medicine packages)according to random number table method,with 20 cases in each group.Both groups were treated for three menstrual cycles and followed up for one year.Clinical effects,endometrial thickness,uterine artery blood flow parameters[pulse index(PI)and resistance index(RI)],levels of PDGF-BB,TGF-β1 and bFGF in serum,incidence of uterine readhesion,and pengnancy were compared between the two groups.Results:After treatment,the total effective rate was 85.00%in the trial group,higher than that of 55.00%in the control group(P<0.05).Endometrial thickness in the two groups was increased when compared with that before treatment(P<0.05),and PI and RI were decreased when compared with those before treatment(P<0.05).The endometrial thickness in the trial group was higher than that in the control group(P<0.05),and PI and RI were lower than those in the control group(P<0.05).The levels of PDGF-BB,TGF-β1 and bFGF in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of PDGF-BB,TGF-β1 and bFGF in serum in the trial group were lower than those in the control group(P<0.05).After three months of follow-up,the incidence of readhesion was 5.88%in the trial group,lower than that of 27.27%in the control group(P<0.05).Following up for one year,the pregnancy rate was 40.00%in the trial group,higher than that of 5.00%in the control group(P<0.05).Conclusion:The method of tonifying kidney,activating blood and regulating menstrual cycle combined with Chinese medicine packages for IUA can increase endometrial thickness,improve uterine artery blood flow and clinical symptoms,effectively regulate the levels of PDGF-BB,TGF-β1 and bFGF,reduce the occurrence of uterine readhesion,and increase the pregnancy rate.