热敏灸联合穴位注射对输卵管积水性不孕症宫腹腔镜术后患者子宫内膜容受性的影响  

Effects of the combined therapy of heat sensitive moxibustion and acupoint injection on endometrial receptivity of hypdrosalphinx infertility in the patients after hysteroscopy and laparoscopy

作　　者：刘艳玲[1] 潘丽贞[1] 王英[1] 

机构地区：[1]福建中医药大学附属南平市人民医院妇产科,南平353000

出　　处：《中国针灸》2018年第1期22-26,共5页Chinese Acupuncture & Moxibustion

基　　金：福建省自然科技基金项目:2014 J 01397

摘　　要：目的:在术后常规抗炎基础上,探讨热敏灸联合穴位注射治疗与单纯热敏灸治疗对经宫腹腔镜输卵管造口术后不孕症患者子宫内膜容受性的影响。方法:将210例输卵管积水性不孕症宫腹腔镜术后患者用随机数字表法分为热敏灸联合穴位注射组、热敏灸组、对照组,各70例。对照组仅术后静脉滴注头孢西丁钠抗炎1周。热敏灸组在对照组治疗基础上于阴道血止后行热敏灸治疗,穴取腰阳关、关元、气海、肾俞、三阴交、阴陵泉、子宫,并随证加减。热敏灸联合穴位注射组在热敏灸组治疗方案的基础上,于阴道止血后在"天宫穴"(经验穴,即宫颈下旁开1.0 cm,左右各一穴)行穴位注射(利多卡因1 m L、丁胺卡那2 m L、丹参注射液2 m L),左右两侧交替进行。两组均每天治疗1次,10 d为一疗程,共治疗3个疗程。观察各组患者治疗前后子宫内膜类型、厚度及子宫动脉搏动指数(plusatility index,PI)和阻力指数(resistance index,RI)的变化情况。结果:治疗后热敏灸联合穴位注射组、热敏灸组窗口期A型子宫内膜例数明显高于对照组[57.1%(40/70)vs 31.4%(22/70),50.0%(35/70)vs 31.4%(22/70),均P<0.05]。各组治疗后窗口期子宫内膜均较治疗前增厚(均P<0.05),且热敏灸联合穴位注射组改善程度优于热敏灸组与对照组(均P<0.05),热敏灸组改善情况优于对照组(P<0.05)。除对照组RI外,各组治疗后PI、RI均较治疗前降低(均P<0.05),且热敏灸联合穴位注射组改善程度优于单纯热敏灸组与对照组(均P<0.05),热敏灸组改善情况优于对照组(均P<0.05)。结论:输卵管积水性不孕患者宫腹腔镜术后采用热敏灸联合穴位注射可以增加子宫内膜厚度,降低子宫动脉血流阻力,提高子宫内膜容受性。Objective To explore the effects of the combined therapy of heat sensitive moxibustion and acupoint injection on endometrial receptivity of hypdrosalphinx infertility in the patients after hysteroscopy and laparoscopy on the base of routine post-operative anti-inflammation. Methods A total of 210 patients of hypdrosalphinx infertility after hysteroscopy and laparoscopy were divided into a combined therapy group, a heat sensitive moxibustion group and a control group, 70 cases in each one according to the random number table. In the control group, the intravenous drip of cefoxitin sodium was adopted, and the anti-inflammation treatment was given for 1 week after operation. In the heat sensitive moxibustion group, on the basis of the treatment as the control group, the heat sensitive moxibustion was applied after vaginal bleeding stopped. The acupoints were Yaoyangguan （GV 3）, Guanyuan （CV 4）, Qihai （CV 6）, Shenshu （BL 23）, Sanyinjiao （SP 6）, Yinlingquan （SP 9） and Zigong （EX-CA1）. The acupoints were modified according to the different syndromes. In the combined therapy group, on the basis of the regimen as the heat sensitive moxibustion group, after vaginal bleeding stopped, the acupoint injection was given alternatively at bilateral Tiangong （extra, 1.0 cm inferior and bilateral to the cervix） with lidocaine 1 mL, amikacin 2 mL and salvia injection 2 mL. The treatment was given once every day, the treatment for 10 times as one course and a total of 3 courses were required. The endometrial type, thickness, uterine arterial plusatility index （PI） and resistance index （RI） were observed in the patients of each group. Results After treatment, the numbers of A-type endometrial type in the combined therapy group and the heat sensitive moxibustion group were remarkably higher than those of the control group [57.1% （40/7） vs 31.4% （22/70）, 50.0% （35/70） vs 31.4% （22/70）, both P〈0.05]. The endometrial thickness after treatment was all increased as compared with tha

关 键 词：输卵管积水性不孕 热敏灸 穴位注射 子宫内膜容受性 

分 类 号：R246.2[医药卫生—针灸推拿学]