补肾化瘀法对宫腔粘连患者术后VEGF的影响及临床疗效观察  

Clinical Effect of Tonifying Kidney and Removing Blood Stasis on VEGF in Patients with Post-Operative IUA

作　　者：马本玲[1] 邢艺璇 谭枚秀 戴月[1] MA Benling;XING Yixuan;TAN Meixiu;DAI Yue(The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410005, China)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005

出　　处：《中医药学报》2022年第7期74-78,共5页Acta Chinese Medicine and Pharmacology

基　　金：湖南省教育厅一般项目(18C0376)。

摘　　要：目的:观察中重度宫腔粘连患者宫腔镜下分离术后实行补肾化瘀法周期治疗的临床疗效。方法:选取2019年3月—2021年3月湖南中医药大学第二附属医院收治的82例中重度宫腔粘连患者为观察对象,按照完全随机原则分为对照组和研究组,每组41例,对照组给予雌孕激素治疗,研究组基于对照组基础上联合使用补肾化瘀中药周期治疗,对比两组治疗后效果。结果:在临床疗效方面,研究组比对照组的治疗有效率高出17.08%(P<0.05);研究组治疗后的子宫内膜厚度增加,阻力指数(PI)和搏动指数(RI)水平比对照组降低(P<0.05);研究组治疗后的全血高切黏度、全血低切黏度、卡松黏度均低于对照组,且研究组红细胞电泳时间更短(P<0.05);研究组VEGF水平均低于对照组(P<0.05),研究过程中未见与服用中药相关的不良反应。结论:中重度宫腔粘连患者行宫腔镜下宫腔粘连分离术后联合补肾活血法治疗,可增加子宫内膜厚度,促进子宫血液循环,并能调节体内纤维化因子的表达,降低宫腔粘连复发,提高临床疗效,临床实践价值较高。Objective:To observe the clinical effect of tonifying Kidney and removing blood stasis after hysteroscopic separation of moderate and severe intrauterine adhesion(IUA).Methods:82 patients with moderate and severe IUA were randomly divided into the control group and the study group,with 41 cases in each group.The control group was treated with estrogen and progesterone;on which basis,the study group was also treated with tonifying Kidney and removing blood stasis therapy.The effects of the two groups were compared.Results:In terms of clinical efficacy,the effective rate of the study group was 7.08%higher than that of the control group(P<0.05).The endometrial thickness increased and the levels of RI and PI decreased in the study group compared with those in the control group(P<0.05).The whole blood high-shear viscosity,whole blood low-shear viscosity and Carson viscosity were lower in the study group than those in the control group,and the erythrocyte electrophoresis time was shorter in the study group than that in the control group(P<0.05).The level of VEGF was lower in the study group than that in the control group(P<0.05).There were no adverse reactions related to taking Chinese medicinal during the study.Conclusion:Hysteroscopic separation of moderate and severe IUA combined with tonifying Kidney and removing blood stasis therapy can increase the thickness of endometrium,promote uterine blood circulation,regulate the expression of fibrosis factors,reduce the recurrence of IUA,improve the clinical curative effect with its high clinical practice value.

关 键 词：中重度宫腔粘连 宫腔镜下宫腔粘连分离术 补肾化瘀法 子宫内膜厚度 VEGF 

分 类 号：R271.9[医药卫生—中西医结合]