中药内外合治对输卵管炎性不孕患者循环因素的影响  

The influence of TCM medicine comprehensive therapy on hemorheology factors in tubal factor infertility patients

作　　者：刘恒炼[1] 翁双燕 冯倩[1] 夏敏[1] LIU Henglian;WENG Shuangyan;Feng Qian;XIA Min

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中医临床研究》2022年第27期131-134,共4页Clinical Journal Of Chinese Medicine

基　　金：重庆市科研机构绩效激励引导专项项目[2018(17)];重庆市中医药重点学科[(2018)43];国家中医药管理局第三届国医大师传承工作室及全国名中医传承工作室(2018YFC1704104);夏敏重庆英才·创新领军人才项目[2019(2)];重庆市名老中医药专家传承工作室[2020(20)]。

摘　　要：目的:探讨中药内外合治对输卵管炎性不孕(Tubal Factor Infertility,TFI)的临床疗效及对患者循环因素的影响。方法:选取60例TFI患者,分为观察组(30例)和对照组(30例)。对照组给予腹腔镜手术治疗,观察组在腹腔镜术后联合中药内外合治方案(口服中药+中药离子导入+中药直肠滴入),连续治疗3个月。比较两组中医症状积分、临床疗效、妊娠情况及血液流变学、血流动力学、血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)、促血管生成素-2(Angiopoietin-2,Ang-2)指标。结果:治疗后,观察组症状积分均显著低于对照组,组间差异具有统计学意义(P<0.05)。观察组患者各项血液流变学指标均显著降低,与对照组的差异具有统计学意义(P<0.05)。观察组患者子宫动脉搏动指数、阻力指数及卵巢动脉搏动指数、阻力指数降低,均低于对照组,差异具有统计学意义(P<0.05)。观察组患者血清VEGF、Ang-2下降,且低于对照组,差异具有统计学意义(P<0.05)。观察组治疗有效率显著高于对照组(P<0.05)。术后随访2年,观察组宫内妊娠率高于对照组,组间差异具有统计学意义(P<0.05);两组异位妊娠率比较,差异无统计学意义(P>0.05)。结论:中药内外合治治疗TFI可显著改善患者的临床症状和体征,提高治疗效果及妊娠率,而改善血液流变性和黏滞度,降低VEGF、Ang-2水平,改善子宫、卵巢血流可能是其主要的作用机制。Objective:To evaluate the clinical efficacy of TCM medicine comprehensive therapy on tubal factor infertility(TFI),and its influences on hemorheology factors of the patients.Methods:A total of 60 cases were divided into the observation group(30 cases)and the control group(30 cases).The control group was treated by laparoscopy,and the observation group was treated by laparoscopy plus TCM medicine comprehensive therapy(oral TCM medicine plus TCM medicine retention enema and TCM medicine iontophoresis)for 3 months.Results:After treatment,the TCM symptom scores in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).The hemorheology indexes in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).The uterine artery pulsatility index and resistance index,and ovarian artery pulsatility index and resistance index in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).The levels of VEGF and Ang-2 in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).The effective rate in the observation group was significantly higher than the control group(P<0.05).After 2 years of followed-up,the intrauterine pregnancy rate in the observation group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in ectopic pregnancy between the two groups(P>0.05).Conclusion:TCM medicine comprehensive therapy on TFI can significantly ameliorate clinical symptoms,improve curative effect and pregnancy rate.Its main action mechanism may be to improve blood rheology and viscosity,reduce VEGF and Ang-2 levels,and improve uterine and ovarian blood circulation.

关 键 词：输卵管炎性不孕 中药 循环因素 

分 类 号：R271.14[医药卫生—中医妇科学]