桂枝茯苓汤加味联合参芎葡萄糖注射液治疗陈旧性宫外孕临床研究  

Clinical study of Modified Guizhi Fuling decoction combined with Shenxiong glucose injection in the treatment of old ectopic pregnancy

作　　者：刘恒炼[1] 姜宙 夏敏[1] 秦芸 王彩霞[1] Liu Henglian;Jiang Zhou;Xia Min;Qin Yun;Wang Caixia

机构地区：[1]重庆市中医院,重庆400021 [2]青岛市妇女儿童医院生殖中心,山东青岛266000 [3]重庆市石柱县中医院,重庆409100

出　　处：《中医临床研究》2020年第18期130-133,共4页Clinical Journal Of Chinese Medicine

基　　金：重庆市社会事业与民生保障科技创新专项项目(cstc2017shmsA130099);国家中医药管理局资助项目(No.[2002]39);重庆市中医药重点学科(No.[2018]43)。

摘　　要：目的:评价桂枝茯苓汤加味联合参芎葡萄糖注射液治疗陈旧性宫外孕的疗效,观察其对输卵管的疏通作用以及治疗后宫内妊娠情况,探讨其作用机制。方法:本文采用随机对照研究将100例陈旧性宫外孕患者分为观察组和对照组,观察组给予口服中药桂枝茯苓汤加味、参芎葡萄糖注射液静脉滴注,对照组给予期待疗法。治疗前后两组进行下腹痛疼痛评分、彩超包块大小、盆腔积液深度等临床指标的比较,行输卵管碘油造影检测输卵管畅通度,治疗后随访1年,统计患者宫内妊娠率。并测定血清肿瘤坏死因子(Tumor Necrosis Factor-α,TNF-α)表达水平以及血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)表达水平。结果:两组患者治疗后下腹痛疼痛评分、彩超包块大小、盆腔积液深度均减少,观察组下降比对照组更为明显,差异有统计学意义(P <0.05);观察组治疗后输卵管通畅率、宫内妊娠率,总有效率均高于对照组(P <0.05);治疗后观察组TNF-α明显降低,VEGF明显升高,与对照组相比,差异有统计学意义(P <0.05)。结论:桂枝茯苓汤加味联合参芎葡萄糖注射液治疗陈旧性宫外孕可改善患者症状、增加输卵管通畅率、增加宫内妊娠率、减轻炎症反应、改善循环、促进血管再生、恢复输卵管功能,治疗价廉安全。Objective: To evaluate the efficacy of Modified Guizhi Fuling decoction(桂枝茯苓汤) combined with Shenxiong(参芎) glucose injection in the treatment of old ectopic pregnancy. To observe its dredge effect on fallopian tube and treatment of harem pregnancy, and to explore its mechanism. Method: In this study, 100 cases of old ectopic pregnancy were randomly divided into the observation group and the control group. The observation group was given orally modified Guizhi Fuling Decoction and Shenxiong glucose injection by intravenous drip, while the control group was given expectant therapy. Before and after treatment, the lower abdominal pain score, color Doppler ultrasound lump size, pelvic effusion depth and other clinical indicators were compared between the two groups. The tubal patency was measured by salpingography and the intrauterine pregnancy rate was calculated after 1 year follow-up. The levels of serum tumor necrosis factor TNF-alpha(TNF-α) and the expression of vascular endothelial growth factor(VEGF) were measured. Result:After treatment, the scores of lower abdominal pain, the size of color Doppler ultrasound lump and the depth of pelvic effusion of the two groups were decreased, and the decrease in the observation group was more obvious than that in the control group, the difference was statistically significant(P<0.05). The tubal patency rate and intrauterine pregnancy rate in the observation group were higher than those in the control group(P<0.05). After treatment, the levels of TNF-alpha and VEGF in the observation group were significantly lower than those in the control group(P<0.05). Conclusion:Modified Guizhi Fuling Decoction combined with Shenxiong glucose injection can relieve the symptoms of patients with old ectopic pregnancy, increase the tubal patency rate, intrauterine pregnancy rate, reduce inflammation, improve circulation, promote vascular regeneration, restore the function of fallopian tubes, treatment is inexpensive and safe.

关 键 词：陈旧性宫外孕 桂枝茯苓汤加味 参芎葡萄糖注射液 临床研究 

分 类 号：R271[医药卫生—中医妇科学]