柴穿通任合剂辅助宫腔镜下输卵管再通术治疗肝郁气滞型输卵管阻塞性不孕症  

Clinical study of Chaichuan Tongren Mixture supplemented with hysteroscopic recanalization for the patients with tubal obstructive infertility of liver depression and qi stagnation type

作　　者：李海滨[1] 谭芳[2] 游燕[2] 秦爱华[3] Li Haibin;Tan Fang;You Yan;Qin Aihua(Department of Pharmacy,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin 541002,China;Department of Preparation Room,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin 541002,China;Department of Gynecology,Guilin Municipal Hospital of Traditional Chinese Medicine,Guilin 541002,China)

机构地区：[1]桂林市中医医院药剂科,桂林541002 [2]桂林市中医医院制剂室,桂林541002 [3]桂林市中医医院妇科,桂林541002

出　　处：《国际中医中药杂志》2022年第5期507-511,共5页International Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生厅科技研究计划课题(GZYZ-10-33)。

摘　　要：目的评价柴穿通任合剂辅助宫腔镜下输卵管再通术治疗肝郁气滞型输卵管阻塞性不孕症的临床疗效。方法将符合入选标准的2018年8月-2020年6月本院60例肝郁气滞型输卵管阻塞性不孕症患者,采用随机数字表法分为观察组31例、对照组29例。对照组行宫腔镜下输卵管再通术,观察组在对照组基础上加服柴穿通任合剂。2组均治疗4个月,随访12个月。分别于治疗前后进行中医证候评分,采用全自动生化分析仪检测前列腺素E(2 prostaglandin E2,PGE2),ELISA法检测血清TNF-α、CRP、IL-6水平。观察治疗后患者输卵管通畅情况,并于随访结束后记录妊娠情况,评价临床疗效。结果观察组总有效率为96.8%(30/31)、对照组为75.9%(22/29),2组比较差异有统计学意义(χ^(2)=4.01,P<0.01)。观察组治疗后乳房胀痛、月经不调、经色紫黯、腰骶胀痛评分及总分低于对照组(t值分别为17.69、21.67、20.89、14.67、18.20,P值均<0.001)。观察组治疗后血清PGE[(265.31±6.73)ng/L比(87.10±8.85)ng/L,t=10.78]、TNF-α[(6.90±0.71)ng/L比(11.35±1.23)ng/L,t=17.30]、CRP[(2.47±0.25)mg/L比(5.10±0.52)mg/L,t=25.23]、IL-6[(12.38±1.26)ng/L比(30.16±3.15)ng/L,t=29.05]水平低于对照组(P<0.01)。观察组治疗后输卵管通畅总有效率为96.8%(30/31)、对照组为79.3%(23/29),2组比较差异有统计学意义(χ^(2)=4.43,P<0.01)。随访结束后,观察组妊娠率为71.0%(22/31)、对照组为44.8%(13/29),2组比较差异有统计学意义(χ^(2)=4.21,P<0.01)。结论柴穿通任合剂辅助宫腔镜下输卵管再通术可降低肝郁气滞型输卵管阻塞性不孕症患者的炎性细胞因子水平,提高妊娠率。Objective To evaluate the efficacy of Chaichuan Tongren Mixture supplemented with hysteroscopic recanalization in the treatment of tubal obstructive infertility of liver depression and qi stagnation type.Methods A total of 60 patients with tubal obstructive infertility of liver depression and qi stagnation type who met the inclusion criteria were selected,between August 2018 and June 2020,and they were divided into the observation group with 31cases and the control group with 29 cases,according to the random number table method.The control group was treated with hysteroscopic recanalization,while the observation group was given Chaichuan Tongren Mixture on the basis of the control group.Both groups were treated for 4 months and followed up for 12 months.TCM syndromes were scored before and after treatment,and prostaglandin E2(PGE2)was detected by fully automatic biochemical analyzer and levels of TNF-α,CRP and IL-6 were measured by ELISA.The tubal patency of patients after treatment was observed,the pregnancy status was recorded after the end of follow-up and the clinical efficacy was evaluated.Results The total effective rate was 96.77%in the observation group and that in the control group was 75.86%(χ^(2)=4.01,P<0.01).The scores of breast distending pain,irregular menstruation,dark purple menstrual flow and lumbosacral pain in the observation group after treatment were significantly lower than those in the control group(t values were 17.69,21.67,20.89,14.67,18.20,respectively,all Ps<0.001).After treatment,the levels of serum PGE2,TNF-α,CRP,and IL-6 were significantly lower in the observation group than those in the control group[(65.31±6.73)ng/L vs.(87.10±8.85)ng/L,t=10.78;(6.90±0.71)ng/L vs.(11.35±1.23)ng/L,t=17.30;(2.47±0.25)mg/L vs.(5.10±0.52)mg/L,t=25.23;(12.38±1.26)ng/L vs.(30.16±3.15)ng/L,t=29.05](P<0.01).After treatment,there was statistical significance in the total effective rate of tubal patency of 96.8%(30/31)in the observation group compared to 79.3%(23/29)in the control group(χ^(2)=4.43

关 键 词：不育 女性 输卵管阻塞 柴穿通任合剂 宫腔镜 炎性介质 

分 类 号：R711.6[医药卫生—妇产科学]