雌孕激素联合滋肾育胎丸在中重度宫腔粘连术后子宫内膜修复中的作用

The Role of Estrogen and Progesterone Combined with Zishen Yutai Pills in Endometrial Repair for Patients with Moderate to Severe Intrauterine Adhesions after Surgery

目的:评估雌孕激素联合滋肾育胎丸能否促进中重度宫腔粘连(IUA)术后患者的子宫内膜修复。方法:选取2023年1—12月在赣州市人民医院就诊的64例中重度IUA患者为研究对象,随机分为研究组和对照组,术后两组患者宫腔均放置医用透明质酸钠凝胶及球囊子宫支架,对照组常规使用术后雌-孕激素序贯疗法,研究组在对照组基础上加服滋肾育胎丸。随访患者月经恢复情况,术后行宫腔镜检查观察宫腔解剖及形态恢复情况、子宫内膜厚度、宫腔再粘连情况。结果:两组患者术后首次月经恢复情况、术后1个月宫腔恢复情况相比差异均无统计学意义(P>0.05);术后2个月,研究组宫腔恢复总有效率和子宫内膜厚度均高于对照组(P<0.05);术后3个月,研究组月经恢复总有效率和宫腔粘连治愈率均高于对照组,差异均有统计学意义(P<0.05)。结论:雌孕激素联合滋肾育胎丸治疗相比单独使用雌孕激素效果更佳,能促进月经恢复,增强中重度IUA术后子宫内膜修复和预防再粘连。

Objective:To evaluate whether estrogen and progesterone combined with Zishen Yutai Pills can promote endometrial repair in patients with moderate to severe intrauterine adhesions(IUA)after surgery.Method:A total of 64 patients with moderate to severe IUA treated in Ganzhou People's Hospital from January to December 2023 were selected and randomly divided into study group and control group.Medical sodium hyaluronate gel and balloon uterine stent were placed in the uterine cavity of the two groups after operation.The control group was routinely treated with postoperative estrogen-progesterone sequential therapy,and the study group was given Zishen Yutai Pills on the basis of the control group.The recovery of menstruation was followed up,and hysteroscopy and vaginal four-dimensional color ultrasound were performed to observe the anatomy and morphological recovery of uterine cavity,endometrial thickness and re-adhesion of uterine cavity.Result:There were no statistically significant differences in the recovery of the first postoperative menstruation and intrauterine recovery one month after surgery between the two groups(P>0.05).At two months postoperatively,the rate of intrauterine recovery and endometrial thickness in the study group were significantly higher than those in the control group(P<0.05).By three months postoperatively,the overall effective rate of menstrual recovery and the cure rate of intrauterine adhesions in the study group were higher than those in the control group,with all differences being statistically significant(P<0.05).Conclusion:Estrogen and progesterone combined with Zishen Yutai Pills is more effective than estrogen and progesterone alone,which can promote the recovery of menstruation,enhance the repair of endometrium after moderate to severe IUA and prevent re-adhesion.