辨证施行宫腔注药治疗输卵管性不孕临床观察  

Clinical observation of treating tubal infertility with uterine cavity drugs injection based on syndrome differentiation

作　　者：孟凤云 易蕾 MENG Feng-yun;YI Lei(Nanning Hospital of Traditional Chinese Medicine in Guangxi Zhuang Autonomous Region,Nanning,530014,China)

机构地区：[1]广西壮族自治区南宁市中医医院

出　　处：《山西中医》2018年第3期19-21,46,共4页Shanxi Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生和计划生育委员会青年基金项目(编号:z2016569)

摘　　要：目的:观察辨证施行宫腔注药治疗输卵管性不孕的临床疗效。方法:纳入符合标准的93例患者随机分为3组,中药组根据不同证型分别采用丹参或红花注射液宫腔注药,西药组采用地塞米松+庆大霉素+生理盐水混合液宫腔注药,中西药组首先灌注药物为庆大霉素8万μ+地塞米松+生理盐水混合液共10 m L,其次灌注丹参注射液或红花注射液10 m L,每个月经周期2~3次为1个疗程,共治疗2个疗程,后续予监测排卵,随访1年。对比治疗前后三组患者中医证候积分及局部体征积分、1年内的妊娠情况及未妊娠患者治疗前后的输卵管通畅度。结果:中西药组、中药组、西药组1年内宫内妊娠率分别为65.62%、40.00%、46.42%,三组间比较差异具有统计意义学(P<0.05)。治疗后三组中医证候积分及体征积分均降低,中西药组优于中药组及西药组,差异有统计学意义(P<0.05)。经χ~2检验,中西药组治疗后输卵管通畅性与治疗前比较差异有统计学差异(P<0.05),中西药组优于中药组及西药组。结论:针对不同证型输卵管性不孕,根据辨证选用不同属性的活血化瘀药物联合西药施行序贯宫腔注药术,可持久保持输卵管通畅度,改善盆腔微环境,提高宫内妊娠率,降低异位妊娠率及流产率。Objective:To observe the clinical effect of treating tubal infertility with uterine cavity drugs injection based on syndrome differentiation.Methods:93 cases of included patients met the standard were randomly divided into 3 groups.TCM group was treated respectively with uterine cavity injectiing of salvia miltiorrhiza or safflower injection according to different syndrome types;the western medicine group was treated with uterine cavity injectiing of mixed liquid from dexamethason and gentamicin as well as normal saline;the Chinese-western medicine group was treated at first with medicine perfusion of total 10 mL mixed liquid from 8U/ml gentamicin and dexamethason as well as normal saline,then with perfusion of 10 mL injection of salvia miltiorrhiza or safflower.2-3 times per menstrual cycle as 1 course of treatment,a total of 2 courses of treatment.Then the ovulation was monitored,and following-up for 1 year.TCM syndrome score,local physical sign score,pregnancy within 1 year and tubal patency of unpregnant patients before and after treatment were compared among three groups of patients before and after treatment.Results:The intrauterine pregnancy rate within 1 year in Chinese-western medicine group,TCM group and western medicine group was respectively 65.62%,40%,46.42%,and the difference compared among three groups was statistically significant(P<0.05).Compared TCM syndrome scores of patients among three groups,Chinese-western medicine group was superior to TCM group and western medicine group,the difference was statistically significant(P<0.05).Compared the tubal patency Chinese-western medicine group was superior to TCM group and western medicine group.Conclusion:In view of tubal infertility of different syndrome types and in accordance with differentially selected activating-blood and removing-stasis drugs of different attributes,to perfuse drugs into uterine cavity sequentially combined with western medicine can maintain the tubal patency enduringly,improve the micro-environment of pelvic cavity,enhance th

关 键 词：输卵管性不孕 宫腔注药 辨证论治 红花注射液 丹参注射液 

分 类 号：R711.6[医药卫生—妇产科学]