经阴道超声结合超微血管成像技术评估人参滋血汤对薄型子宫内膜容受性的影响  

Evaluation of Effect of Renshen Zixue Tang on Endometrial Receptivity of Thin Endometrium by Transvaginal Three-Dimensional Ultrasound Combined with Superb Microvascular Imaging

作　　者：周婷[1] 郭俊[1] 杨柳茵 薛雯 张娟[2] 张建兴[1] ZHOU Ting;GUO Jun;YANG Liuyin;XUE Wen;ZHANG Juan;ZHANG Jianxing

机构地区：[1]广东省中医院超声科,广东广州510120 [2]广东省中医院妇科,广东广州510120

出　　处：《新中医》2021年第12期117-120,共4页New Chinese Medicine

基　　金：广东省中医药局面上项目(20181134)。

摘　　要：目的:探讨经阴道三维超声结合超微血管成像技术(SMI)评估人参滋血汤在改善薄型子宫内膜容受性方面的价值。方法:选取2020年1月—2020年7月在广东省中医院妇科门诊及生殖中心诊断为不孕症,中医证候辨证为血虚证,且经阴道三维彩超检查提示为薄型子宫内膜患者60例,服用人参滋血汤治疗3个月,利用经阴道三维超声结合SMI技术评估用药前后内膜的厚度、容积、分型、内膜血流参数及子宫动脉血流参数的变化,并进行统计学分析。结果:治疗后,子宫内膜厚度、容积明显增加,双侧子宫收缩期峰值血流速度(PSV)增高、阻力指数(RI)降低,治疗前后比较,差异均有统计学意义(P<0.05)。治疗后,SMI显示内膜血流支数增加,螺旋动脉PSV增高,RI、搏动指数(PI)、PSV/ED(S/D)均降低,治疗前后比较,差异均有统计学意义(P<0.05)。治疗前,内膜血流分型Ⅰ、Ⅱ、Ⅲ病例数分别为4、51、5例,治疗后分别为0、36、24例,治疗前后比较,差异有统计学意义(P<0.05)。治疗前,内膜A、B、C分型的病例数分别为11、27、22例,治疗后分别为8、47、5例,前后比较,差异有统计学意义(P<0.05)。结论:人参滋血汤在促进子宫内膜生长方面疗效显著,经阴道三维超声结合SMI技术可较好地评估薄型子宫内膜的血流情况及子宫内膜容受性。Objective:To discuss the value of Renshen Zixue tang on endometrial receptivity of thin endometrium assessed by transvaginal three-dimensional ultrasound combined with superb microvascular imaging(SMI).Methods:From January 2020 to July 2020,in the gynecological outpatient department and reproductive center of Guangdong Provincial Hospital of Traditional Chinese Medicine,a total of 60 cases of patients,diagnosed as infertility with blood deficiency syndrome,and showed as thin endometrium by transvaginal three-dimensional ultrasound,were treated with Renshen Zixue tang for three months.Before and after medication,the changes in thickness,volume,typing,and blood flow parameters of endometrium as well as uterine artery blood flow parameters were evaluated by transvaginal three-dimensional ultrasound combined with SMI,and statistical analysis was performed.Results:After treatment,the thickness and volume of endometrium were significantly increased when compared with those before treatment,PSV of bilateral uterus was increased,and RI was decreased,differences being significant(P<0.05).After treatment,SMI showed that blood flow parameters of endometrium and PSV of helicine arteries were increased when compared with those before treatment,and RI,PI and S/D were decreased,differences being significant(P<0.05).Before treatment,the numbers of cases of endometrial blood flow typing of I,II and III were 4,51 and 5 respectively,and after treatment,the numbers were 0,36 and 24 respectively,the difference being significant(P<0.05).Before treatment,there were 11,27 and 22 cases of endometrial A,B and C typing respectively,and 8,47 and 5 cases respectively after treatment,the difference being significant(P<0.05).Conclusion:Renshen Zixue tang has significant curative effect in promoting endometrial growth.Transvaginal three-dimensional ultrasound combined with SMI can better evaluate the blood flow and endometrial receptivity of thin endometrium.

关 键 词：薄型子宫内膜 子宫内膜容受性 人参滋血汤 经阴道三维超声 超微血管成像技术 

分 类 号：R711.7[医药卫生—妇产科学]