温阳祛湿清解化瘀汤直肠给药对阳虚湿热瘀滞型 输卵管炎性不孕患者的临床观察  

Clinical Observation of Rectal Administration of Wenyang Qushi Qingjie Huayu Decoction on Infertility Patients with Salpingitis of Yang Deficiency and Damp-Heat Stasis

作　　者：万朝霞[1] 唐艳 张庆[1] 俞海忠[1] 刘海红[1] WAN Zhao-xia;TANG Yan;ZHANG Qing;YU Hai-zhong;LIU Hai-hong(Nantong Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nantong 226001,China)

机构地区：[1]南京中医药大学附属南通医院,江苏南通226001

出　　处：《云南中医中药杂志》2023年第9期26-31,共6页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

摘　　要：目的观察温阳祛湿清解化瘀汤直肠给药对阳虚湿热瘀滞型输卵管炎性不孕患者血清sICAM-1、TGF-β1及IL-17的影响及临床疗效。方法将60例符合输卵管炎性不孕诊断标准患者,随机分为2组。治疗组30例,对照组30例。治疗组:每于经净后3~7 d开始,予温阳祛湿清解化瘀汤持续直肠给药14 d,连续治疗3个月经周期;对照组:每于经净后3~7 d开始,予桂枝茯苓丸(方)持续直肠给药14 d,连续治疗3个月经周期。统计2组疗效、症状及体征积分、HSG通畅率、妊娠率、sICAM-1、TGF-β1及IL-17改变。结果总体疗效治疗组优于对照组(P<0.05);治疗组妊娠率优于对照组(P<0.05);2组治疗后症状、体征积分(病情程度)的改善均优于治疗前(P<0.05),组间比较,治疗后治疗组优于对照组(P<0.05);输卵管堵塞中度、轻度患者,2组治疗后HSG示输卵管通畅率均高于治疗前(P<0.05),组间比较,治疗组优于对照组(P<0.05),输卵管堵塞重度患者,2组治疗前后比较无差异(P>0.05),治疗后组间比较无差异(P>0.05);血清学指标,治疗组内,治疗后sICAM-1、TGF-β1均较治疗前显著降低(P<0.05);治疗后IL-17较治疗前显著升高(P<0.05);对照组内,上述指标没有显著变化(P>0.05);组间比较,治疗组治疗后sICAM-1、TGF-β1显著低于对照组(P<0.05),治疗组治疗后IL-17显著高于对照组(P<0.05)。结论温阳祛湿、清解化瘀汤直肠给药治疗输卵管炎性轻中度不孕具有良好疗效,其作用机制在于下调血清sICAM-1、TGF-β1及升高IL-17浓度,减少盆腔内(输卵管周围)炎性渗出物的聚集,改善纤维化,从而调节输卵管生理功能,提升自然受孕率。Objective:To observe the effect of rectal administration of Wenyang Qushi Qingjie Huayu Decoction on serum sICAM-1,TGF-β1 and IL-17 in infertility patients with salpingitis of yang deficiency and damp-heat stasis.Methods:60 infertility patients with salpingitis were randomly divided into two groups,30 cases in treatment group and 30 cases in control group.The treatment group was given rectal administration of Wenyang Qushi Qingjie Huayu Decoction for 14 days for 3 consecutive menstrual cycles starting from 3 to 7 days after menstruation and the control group was given rectal administration of Cassia-Poria Decoction for 14 days for 3 consecutive menstrual cycles starting from 3 to 7 days after menstruation.The curative effects,scores of symptoms and signs,HSG patency rate,pregnancy rate,sICAM-1,TGF-β1 and IL-17 of the two groups were analyzed.Results:The overall curative effect of the treatment group was better than that of control group(P<0.05).The pregnancy rate of the treatment group was better than that of the control group(P<0.05).The improvement of symptom and sign scores(illness degree)after treatment was better than that before treatment(P<0.05).After treatment,the treatment group was better than the control group(P<0.05).In the patients with moderate and mild fallopian tube blockage,HSG of the two groups showed that the fallopian tube patency rate after treatment was higher than before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).In the patients with severe fallopian tube blockage,there was no difference between the two groups before and after treatment(P>0.05),and there was no difference between the two groups after treatment(P>0.05).Serological indexes,sICAM-1 and TGF-β1 after treatment were significantly decreased compared with those before treatment(P<0.05)and IL-17 was significantly higher after treatment than before treatment(P<0.05).In the control group,there were no significant changes in the above indexes(P>0.05).After treatment,sICAM-1 and TGF-β1 in the

关 键 词：阳虚湿热瘀滞 输卵管性不孕 温阳祛湿清解化瘀汤 直肠给药 

分 类 号：R271.14[医药卫生—中医妇科学]