盆腔炎方联合中药保留灌肠治疗输卵管阻塞性不孕宫腔镜术后临床研究
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摘要
目的:观察在常规用药干预后采用盆腔炎方联合中药保留灌肠治疗输卵管阻塞性不孕宫腔镜术后患者的疗效。方法:选择92例输卵管阻塞性不孕患者作为观察对象,随机分为观察组和对照组各46例,2组患者均行宫腔镜手术治疗,术毕予乳酸左氧氟沙星氯化钠注射液等治疗,观察组在术后给予盆腔炎方口服联合中药保留灌肠治疗,比较2组患者治疗前后的中医症状体征评分、炎症因子[白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)]水平,统计治疗后的疗效及随访12个月的妊娠情况。结果:治疗后,观察组总有效率95.65%,高于对照组的80.43%,差异有统计学意义(P <0.05)。2组舌脉、白带、下腹胀痛评分均较治疗前降低,观察组3项评分均低于对照组,差异均有统计学意义(P <0.01)。2组IL-6、IL-8、TNF-α水平均较治疗前降低,观察组3项指标值均低于对照组,差异均有统计学意义(P <0.01)。随访12个月,观察组妊娠率58.70%,对照组妊娠率32.61%,2组比较,差异有统计学意义(P <0.05)。结论:在常规用药干预后采用盆腔炎方联合中药保留灌肠治疗输卵管阻塞性不孕宫腔镜术后患者,可有效减轻慢性炎症反应,改善临床症状及预后,疗效确切。
Objective:To observe the curative effect of the application of Penqiangyan prescription combined with Chinese herbal retention enema for patients with oviduct obstructive infertility after hysteroscopic surgery after routine medication intervention.Methods:Selected 92 cases of patients with oviduct obstructive infertility as observation subjects,and randomly divided them into the observation group and the control group,46 cases in each group. Patients in the two groups were given hysteroscopic surgery and then levofloxacin lactate sodium chloride injection after surgery. The observation group was given the oral application of Penqiangyan prescription combined with Chinese herbal enema after surgery. Compared Chinese medicine symptom scores and the changes of inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor α(TNF-α)] in the two groups before and after treatment,and recorded the curative effect after treatment and the pregnancy after 12 months of follow-up. Results:After treatment,the total effective rate was 95.65% in the observation group,being higher than that of 80.43% in the control group,difference being significant(P < 0.05). The scores of tongue image and pulse condition,vaginal discharge and lower abdominal pain in the two groups were decreased when compared with those before treatment;these three scores in the observation group were lower than those in the control group, differences being significant(P < 0.01). The levels of IL-6, IL-8 and TNF-α in the two groups were decreased when compared with those before treatment; these three indexes in the observation group were lower than those in the control group,differences being significant(P < 0.01). After 12 months of follow-up, the pregnancy rate was 58.70% in the observation group and32.61% in the control group, compared the two groups, difference being significant(P < 0.05). Conclusion: After hysteroscopic surgery, the application of Penqiangyan prescription combined with Chinese herbal retention enema after the routine medication intervention for patients with oviduct obstructive infertility can effectively reduce chronic inflammation and improve clinical symptoms and prognosis. It has obvious curative effect.
Objective:To observe the curative effect of the application of Penqiangyan prescription combined with Chinese herbal retention enema for patients with oviduct obstructive infertility after hysteroscopic surgery after routine medication intervention.Methods:Selected 92 cases of patients with oviduct obstructive infertility as observation subjects,and randomly divided them into the observation group and the control group,46 cases in each group. Patients in the two groups were given hysteroscopic surgery and then levofloxacin lactate sodium chloride injection after surgery. The observation group was given the oral application of Penqiangyan prescription combined with Chinese herbal enema after surgery. Compared Chinese medicine symptom scores and the changes of inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor α(TNF-α)] in the two groups before and after treatment,and recorded the curative effect after treatment and the pregnancy after 12 months of follow-up. Results:After treatment,the total effective rate was 95.65% in the observation group,being higher than that of 80.43% in the control group,difference being significant(P < 0.05). The scores of tongue image and pulse condition,vaginal discharge and lower abdominal pain in the two groups were decreased when compared with those before treatment;these three scores in the observation group were lower than those in the control group, differences being significant(P < 0.01). The levels of IL-6, IL-8 and TNF-α in the two groups were decreased when compared with those before treatment; these three indexes in the observation group were lower than those in the control group,differences being significant(P < 0.01). After 12 months of follow-up, the pregnancy rate was 58.70% in the observation group and32.61% in the control group, compared the two groups, difference being significant(P < 0.05). Conclusion: After hysteroscopic surgery, the application of Penqiangyan prescription combined with Chinese herbal retention enema after the routine medication intervention for patients with oviduct obstructive infertility can effectively reduce chronic inflammation and improve clinical symptoms and prognosis. It has obvious curative effect.
引文
[1]汤锶锶,刘恒炼,夏敏.腹腔镜术后联合中医药治疗输卵管炎性不孕的研究进展[J].重庆医学,2018,47(6):840-842.
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[9]辛喜艳,李东,李赛,等.“辨体-辨病-辨证诊疗模式”在辅助生殖技术中的应用[J].中华中医药杂志,2017,32(9):3942-3945.
[10]陈志霞.中药灌肠治疗盆腔炎性疾病的文献评价与Meta分析[J].中国临床医生杂志,2016,44(7):95-98.
[11]刘恒炼,翁双燕,张园,等.中药多途径辅助治疗对输卵管炎性不孕患者的疗效及血清炎症因子的影响[J].中国中西医结合杂志,2016,36(9):1034-1037.
[12] Y譈CEL B,DEMIREL E,KELEKCI S,et al.Hysteroscopic evaluation of tubal peristaltic dysfunction in unexplained infertility[J].J Obstet Gynaecol, 2018, 38(4):511-515.
[13]卫爱武,王少博.四联外治法结合理气活血汤对气滞血瘀型输卵管炎性不孕的疗效观察[J].辽宁中医杂志,2015,42(8):1434-1435.
[2]马飞,马畅,王小云.桂枝茯苓胶囊辅助治疗输卵管阻塞性不孕的临床疗效及对TNF-α的影响[J].辽宁中医杂志,2017,44(8):1670-1672.
[3]郭玉娟,王睿丽,朱兆领,等.二次造影在评价输卵管通畅性方面的价值[J].中国临床医学影像杂志,2017,28(12):877-880.
[4]郑莜萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:247-250.
[5]龙梅,巩晓芸,万晓慧.中西医结合治疗输卵管阻塞性不孕症有效性和安全性的系统评价[J].中国全科医学,2015,18(25):3089-3095.
[6]陈曦,刘朝晖.生殖道感染与不孕不育关系的研究进展[J].中国妇产科临床杂志,2016,17(6):565-567.
[7] LI H,ZHANG M,QIANG Y,et al. Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency[J].Comput Assist Surg(Abingdon),2017,22(sup1):93-99.
[8]李俊箐,李祥云.输卵管性不孕的诊疗研究进展[J].中华中医药学刊,2015,33(11):2661-2665.
[9]辛喜艳,李东,李赛,等.“辨体-辨病-辨证诊疗模式”在辅助生殖技术中的应用[J].中华中医药杂志,2017,32(9):3942-3945.
[10]陈志霞.中药灌肠治疗盆腔炎性疾病的文献评价与Meta分析[J].中国临床医生杂志,2016,44(7):95-98.
[11]刘恒炼,翁双燕,张园,等.中药多途径辅助治疗对输卵管炎性不孕患者的疗效及血清炎症因子的影响[J].中国中西医结合杂志,2016,36(9):1034-1037.
[12] Y譈CEL B,DEMIREL E,KELEKCI S,et al.Hysteroscopic evaluation of tubal peristaltic dysfunction in unexplained infertility[J].J Obstet Gynaecol, 2018, 38(4):511-515.
[13]卫爱武,王少博.四联外治法结合理气活血汤对气滞血瘀型输卵管炎性不孕的疗效观察[J].辽宁中医杂志,2015,42(8):1434-1435.