補(bǔ)腎活血方聯(lián)合人工周期在宮腔粘連術(shù)后的應(yīng)用效果

徐穎　邱劍萍

摘要：目的 ?評價補(bǔ)腎活血方聯(lián)合人工周期治療行宮腔粘連分離術(shù)患者的臨床療效。方法 ?選擇2016年3月～2019年12月在南京醫(yī)科大學(xué)附屬蘇州醫(yī)院進(jìn)行宮腔粘連手術(shù)的患者62例，隨機(jī)分為實(shí)驗(yàn)組和對照組，各31例，對照組給予戊酸雌二醇、地屈孕酮周期治療;實(shí)驗(yàn)組在對照組基礎(chǔ)上加用補(bǔ)腎活血方治療。比較兩組治療前后子宮內(nèi)膜厚度變化、月經(jīng)和宮腔粘連評分情況、妊娠率、活產(chǎn)率等。結(jié)果 ?治療后兩組子宮內(nèi)膜厚度均較治療前增厚，且實(shí)驗(yàn)組大于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組輕度宮腔粘連患者月經(jīng)改善效果比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;實(shí)驗(yàn)組中度、重度粘連患者月經(jīng)改善效果優(yōu)于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;實(shí)驗(yàn)組妊娠率、活產(chǎn)率均高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 ?補(bǔ)腎活血方聯(lián)合人工周期能改善宮腔粘連術(shù)后患者子宮內(nèi)膜厚度，有利于月經(jīng)恢復(fù)，提高妊娠率和活產(chǎn)率。

關(guān)鍵詞：宮腔粘連;宮腔粘連分離術(shù);補(bǔ)腎活血方;人工周期

中圖分類號：R713 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻(xiàn)標(biāo)識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2020.18.053

文章編號：1006-1959（2020）18-0159-03

Application Effect of Bushen Huoxue Prescription Combined

with Artificial Cycle after Intrauterine Adhesion

XU Ying，QIU Jian-ping

（Department of Obstetrics and Gynecology，Suzhou Hospital，Nanjing Medical University，Suzhou215000，Jiangsu，China）

Abstract：Objective ?To evaluate the clinical efficacy of Bushen Huoxue prescription combined with artificial cycles in the treatment of patients undergoing intrauterine adhesion separation.Methods ?62 patients who underwent intrauterine adhesion surgery in Suzhou Hospital of Nanjing Medical University from March 2016 to December 2019 were randomly divided into experimental group and control group， each with 31 cases. The control group was given estradiol valerate， dydrogesterone cycle treatment; the experimental group was treated with Bushen Huoxue prescription on the basis of the control group. The changes of endometrial thickness， menstrual and intrauterine adhesion scores， pregnancy rate， live birth rate， etc. were compared between the two groups before and after treatment.Results ?After treatment， the endometrial thickness of the two groups was thicker than before treatment， and the experimental group was larger than the control group， the difference was statistically significant （P<0.05）; There was no significant difference in menstrual improvement between the two groups of patients with mild intrauterine adhesions （P>0.05）; the experimental group had better menstrual improvement effects in patients with moderate and severe adhesions than the control group，the difference was statistically significant （P<0.05） ; The pregnancy rate and live birth rate of the experimental group were higher than those of the control group，the difference was statistically significant （P<0.05）.Conclusion ?The Bushen Huoxue prescription combined with artificial cycles could improve the thickness of the endometrium in patients after intrauterine adhesions， which was beneficial to the recovery of menstruation and the pregnancy rate and live birth rate.

Key words：Intrauterine adhesion;Intrauterine adhesion separation;Bushen Huoxue prescription; Artificial cycle

宮腔粘連（intrauterine adhesions，IUA）又稱阿謝曼綜合征 （ asherman syndrome），多繼發(fā)于宮腔的創(chuàng)傷性手術(shù)操作和宮腔感染，臨床上表現(xiàn)為閉經(jīng)或月經(jīng)量過少、周期性痙攣性下腹痛、繼發(fā)性不孕等[1]，是婦科常見的宮腔疾病，并且嚴(yán)重影響生育功能，在我國的發(fā)病率逐年增長。宮腔鏡下宮腔粘連分離術(shù)（transcervical resection adhesions，TCRA）是治療IUA的主要方法，可有效治療IUA，但術(shù)后易發(fā)生粘連復(fù)發(fā)[2]。因此如何改善宮腔粘連患者的預(yù)后成為臨床上關(guān)注的熱點(diǎn)問題，中醫(yī)學(xué)認(rèn)為，宮腔粘連屬本虛標(biāo)實(shí)之證，腎精不足為虛，血瘀凝滯為實(shí)，應(yīng)施以補(bǔ)腎調(diào)經(jīng)、活血化瘀[3]。本研究立足于此，對我院62例患者展開研究，旨在觀察中藥補(bǔ)腎活血方聯(lián)合雌孕激素人工周期治療宮腔粘連分離術(shù)后的效果，現(xiàn)報(bào)道如下。……