益气活血方治疗气虚血瘀证宫腔粘连患者随机对照临床观察  

Yiqi Huoxue Formula(益气活血方)for Intrauterine Adhesion with Syndrome of Qi Deficiency and Blood Stasis:A Randomized Controlled Trial

作　　者：秦瑜玲 隋娟 周琳 毕红[1] 陈瑞雪[1] QIN Yuling;SUI Juan;ZHOU Lin;BI Hong;CHEN Ruixue(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,100053)

机构地区：[1]中国中医科学院广安门医院,北京市100053

出　　处：《中医杂志》2024年第5期489-494,511,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82274574);中国中医科学院科技创新工程重大攻关项目(CI2021A02407);中央本级重大增减支项目(2060302)。

摘　　要：目的观察益气活血方联合手术及雌激素、孕激素序贯治疗气虚血瘀证宫腔粘连患者的临床疗效及安全性。方法选取2021年6月1日至2022年12月31日在中国中医科学院广安门医院收治的宫腔粘连患者64例,随机分为治疗组和对照组各32例,均接受宫腔镜下宫腔粘连分离术(TCRA)治疗。对照组术后予雌激素、孕激素序贯治疗,每日口服1片,前14天服雌二醇片,后14天服雌二醇地屈孕酮片。治疗组术后在对照组治疗的基础上联合益气活血方治疗,每日1剂。两组疗程均为3个月。观察两组患者临床疗效、中医证候积分、子宫内膜厚度、宫腔粘连评分、月经量积分及治疗结束3个月后的复粘率、妊娠率,并进行安全性评价。结果治疗组和对照组临床总有效率分别为90.63%、75.00%,两组临床疗效差异有统计学意义(P<0.05)。两组患者治疗后子宫内膜厚度、月经量均较本组治疗前增加,宫腔粘连评分、中医证候积分较治疗前明显下降(P<0.05或P<0.01)。治疗后治疗组宫腔粘连评分、中医证候积分较对照组明显下降(P<0.05)。治疗组术后6个月妊娠率为37.50%,高于对照组的12.50%(P<0.05)。治疗组复粘率为3.13%,对照组为9.38%,两组复粘率比较差异无统计学意义(P>0.05)。两组均未出现不良事件。结论益气活血方联合手术及雌激素、孕激素序贯治疗宫腔粘连气虚血瘀证术后患者,可促进子宫内膜恢复,增加月经量,改善患者临床症状,提高妊娠率及临床疗效,且安全性好。Objective To observe the effectivenss and safety of Yiqi Huoxue Formula(益气活血方)combined with surgery and sequential therapy of estrogen and progesterone for the treatment of intrauterine adhesion with syndrome of qi deficiency and blood stasis.Methods Sixty-four patients with intrauterine adhesions were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences during 1st June 2021 to 31st December 2022,and they were randomly divided into two groups,with 32 patients in each group,all receiving transcervical resection of adhesions(TCRA).The control group was treated with sequential therapy of estrogen and progesterone after surgery,taking 1 tablet orally daily,estradiol tablets for the first 14 days,and estradiol dydrogesterone tablets for the last 14 days.In the treatment group,the postoperative treatment was combined with Yiqi Huoxue Formula on the basis of the treatment in the control group,and 1 dose was taken daily.The treatment course of both groups was 3 months.We observed the clinical effectiveness,syndrome scores of traditional Chinese Medicine(TCM),endometrial thickness,uterine adhesion score,menstrual flow points,and the re-adhesion rate and pregnancy rate 3 months after the end of treatment of the two groups,and conducted evaluation on safety.Results The total clinical effectiveness rates of the treatment group and the control group were 90.63%and 75.00%,respectively,significantly better in the treatment group(P<0.05).The endometrial thickness and menstrual flow of patients in both groups increased after treatment,and the scores of uterine adhesion and TCM syndrome scores decreased significantly(P<0.05 or P<0.01).After treatment,the uterine adhesion score and TCM syndrome scores of the treatment group decreased significantly compared with the control group(P<0.05).The 6-month postoperative pregnancy rate in the treatment group was 37.50%,higher than the 12.50% in the control group(P<0.05).The re-adhesion rate was 3.13% in the treatment group and 9.38% in the control group,and

关 键 词：宫腔粘连 宫腔粘连分离术 益气活血方 雌激素 孕激素 妊娠率 子宫内膜 

分 类 号：R271.9[医药卫生—中西医结合]