祛瘀消膜汤联合温针灸对药物流产不全刮宫术后宫腔粘连、内膜纤维化及血清sFIt-1、BNIP3的影响  

Effects of Quyu Xiaomo Decoction Combined with Warm-Needling Moxibustion on Intrauterine Adhesion,Endometrial Fibrosis and Serum FIT-1 and BNIP3 After Incomplete Curettage Due to Medical Abortio After Medical Abortion with Incomplete Curettage

作　　者：陈小欢 刘秀艳[1] 孙晓吉[1] 杨冬梅[1] 吴芳 CHEN Xiaohuan;LIU Xiuyan;SUN Xiaoji;YANG Dongmei;WU Fang(Dept.of Gynecology,Qinhuangdao Hospital of Traditional Chinese Medicine,Hebei Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院妇科,河北秦皇岛066000

出　　处：《中国医院用药评价与分析》2024年第7期797-800,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省中医药科研计划项目(No.2022286);河北省秦皇岛市科学技术研究与发展计划项目(No.202101A198)。

摘　　要：目的:观察祛瘀消膜汤联合温针灸对药物流产不全刮宫术后宫腔粘连、内膜纤维化及血清Bcl2相互作用蛋白3(BNIP3)、可溶性血管内皮生长因子受体-1(sFlt-1)的影响。方法:选择2020年1月至2023年5月该院收治的药物流产不全患者96例,分组方式为随机数字表法。所有患者均给予刮宫术后常规治疗,对照组48例患者在刮宫术后给予温针灸治疗,联合组48例患者在对照组的基础上给予祛瘀消膜汤治疗。比较两组患者的临床疗效、治疗前后中医证候评分,记录腹痛持续时间、阴道出血时间和月经复潮时间,通过宫腔镜检查观察治疗后宫腔粘连发生率,检测治疗前后的血清sFIt-1、BNIP3、黄体生成素(LH)、雌激素(E2)和肿瘤坏死因子α(TNF-α)水平,通过逆转录聚合酶链反应检测子宫内膜组织基质金属蛋白酶9(MMP9)、转化生长因子β3(TGF-β3)mRNA表达水平。结果:联合组患者的总有效率为97.92%(47/48),较对照组的83.33%(40/48)更高,差异有统计学意义(P<0.05)。治疗后,联合组患者产后恶露淋漓涩滞不爽、小腹疼痛拒按、淋漓量少、色紫黯有块、脉弦涩或沉而有力、舌紫黯或边有紫点评分较对照组降低,差异均有统计学意义(P<0.05)。联合组患者腹痛持续时间、阴道出血时间和月经复潮时间短于对照组,宫腔粘连发生率低于对照组,差异均有统计学意义(P<0.05)。治疗后,联合组患者的E2水平高于对照组,LH、TNF-α水平低于对照组,BNIP3、sFlt-1水平高于对照组,MMP9、TGF-β3 mRNA表达水平低于对照组,差异均有统计学意义(P<0.05)。结论:祛瘀消膜汤联合温针灸治疗药物流产不全刮宫术后患者,可调节性激素水平,改善炎症状态,提高BNIP3、sFlt-1水平,改善子宫内膜纤维化,提升宫腔抗粘连作用,缓解病情,提高临床疗效。OBJECTIVE:To observe the effects of Quyu Xiaomo decoction combined with warm-needling moxibustion on intrauterine adhesion,endometrial fibrosis and serum Bcl2 interaction protein 3(BNIP3)and soluble vascular endothelial growth factor receptor-1(sFlt-1)after medical abortion with incomplete curettage.METHODS:Totally 96 patients with medical abortion with incomplete curettage admitted into the hospital from Jan.2020 to May 2023 were extracted to be divided into the control group and the combined group via the random number table method.All patients were given routine treatment after curettage.Forty-eight patients in the control group were given warm-needling moxibustion after curettage,and 48 patients in the combined group received Quyu Xiaomo decoction on the basis of the control group.Clinical efficacy and traditional Chinese medicine syndrome score before and after treatment were compared between two groups.The duration of abdominal pain,vaginal bleeding time and menstrual relapse time of two groups were recorded.The incidence of intrauterine adhesion was observed by hysteroscopy after treatment.Serum levels of sFIt-1,BNIP3,luteinizing hormone(LH),estrogen(E 2)and tumor necrosis fact-α(TNF-α)were measured before and after treatment,mRNA expression levels of matrix metalloproteinase 9(MMP9)and transforming growth factorβ3(TGF-β3)in endometrial tissues were detected by reverse transcriptase polymerase chain reaction(RT-PCR).RESULTS:The total effective rate of the combined group was 97.92%(47/48),higher than 83.33%(40/48)of the control group,the difference was statistically significant(P<0.05).The score of lochia dripping astringency,lower abdominal pain,less dripping volume,dark purple with clumps,astringent or heavy pulse,dark purple tongue or purple spot on the edge of the postpartum in combined group was lower than that in the control group,with statistically significant differences(P<0.05).The duration of abdominal pain,vaginal bleeding and menstrual rehydration in the combined group were shorter than thos

关 键 词：祛瘀消膜汤 温针灸 药物流产不全 刮宫术后 子宫内膜纤维化 宫腔粘连 

分 类 号：R932[医药卫生—生药学]