温肾活血法联合宫腹腔镜治疗输卵管性不孕的临床观察

doi:10.3760/cma.j.issn.1007-1245.2024.10.021

摘要/Abstract

摘要：

目的　探讨温肾活血法与宫腹腔镜联用对输卵管性不孕症（TI）的治疗效果。方法　选择2021年2月至2022年8月延安市中医医院收治的112例TI患者进行前瞻性研究，采用随机数字表法将患者分为两组，各56例。对照组年龄（28.18±3.13）岁，病程（3.11±0.52）个月，单侧阻塞28例，双侧阻塞9例，通而不畅19例，采用宫腹腔镜方案治疗；研究组年龄（28.54±3.27）岁、病程（3.16±0.56）个月，单侧阻塞26例，双侧阻塞10例，通而不畅20例，在对照组治疗基础上加用温肾活血法治疗。比较两组总有效率、中医证候积分、输卵管通畅情况、炎症因子水平［白细胞介素-4（IL-4）、IL-6］、卵巢功能指标［促黄体生成素（LH）、促卵泡生成素（FSH）、雌二醇（E₂）］、妊娠率及不良反应情况。采用配对样本t检验、独立样本t检验及χ²检验。结果　研究组总有效率［96.43%（54/56）］高于对照组［80.36%（45/56）］（P<0.05）；治疗后，研究组中医证候积分为（10.01±1.28）分，低于对照组（14.15±1.96）分（P<0.05）；治疗后，研究组输卵管通畅率96.43%（54/56）高于对照组82.14%（46/56），差异有统计学意义（P<0.05）；治疗后，研究组IL-4、IL-6水平分别为（5.09±0.72）ng/L、（4.62±0.63）ng/L，均低于对照组的（6.66±0.95）ng/L、（6.25±0.86）ng/L（均P<0.05）；治疗后，研究组LH、FSH水平分别为（7.42±1.21）IU/L、（5.33±0.82）IU/L，均低于对照组的（13.38±2.15）IU/L、（11.06±2.11）IU/L，E₂水平为（230.38±25.19）IU/L高于对照组的（185.57±20.23）IU/L（均P<0.05）；治疗后，研究组总妊娠率为62.50%（35/56）高于对照组42.86%（24/56），差异有统计学意义（P<0.05）；两组不良反应总发生率比较［5.36%（3/56）比8.93%（5/56）］，差异无统计学意义（P>0.05）。结论　对行宫腹腔镜手术的TI患者采用温肾活血法治疗，可有效改善患者输卵管功能，调节性激素水平，效果较为理想，临床应用价值较高。

关键词:

输卵管性不孕症, 宫腹腔镜手术, 温肾活血法, 临床疗效, 妊娠

Abstract:

Objective　To investigate the effect of tubal infertility (TI) treated with warming kidney and promoting blood circulation method combined with uterine laparoscopy. Methods　A total of 112 TI patients admitted to Yan'an Traditional Chinese Medicine Hospital from February 2021 to August 2022 were selected for a prospective study and were divided into two groups with 56 cases in each group by the random number table method. In the control group, the age was (28.18±3.13) years old, the course of disease was (3.11±0.52) months, and there were 28 cases of unilateral obstruction, 9 cases of bilateral obstruction, and 19 cases of partial obstruction. In the study group, the age was (28.54±3.27) years old, the course of disease was (3.16±0.56) months, and there were 26 cases of unilateral obstruction, 10 cases of bilateral obstruction, and 20 cases of partial obstruction. The control group was treated with uterine laparoscopy, and the study group was treated with warming kidney and promoting blood circulation method on the basis of the control group. The total effective rate, TCM syndrome score, fallopian tube patency, inflammatory factor level [interleukin-4 (IL-4) and IL-6], ovarian function indexes [luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E₂)], pregnancy rate, and adverse reactions were compared between the two groups. Paired sample t test, independent sample t test, and χ² test were used. Results　The total effective rate of the study group [96.43% (54/56)] was higher than that of the control group [80.36% (45/56)] (P<0.05). After treatment, the TCM syndrome score of the study group was (10.01±1.28) points, which was lower than that of the control group [(14.15±1.96) points] (P<0.05). After treatment, the patency rate of fallopian tube in the study group was 96.43% (54/56), which was higher than that in the control group [82.14% (46/56)], with a statistically significant difference (P<0.05). After treatment, the levels of IL-4 and IL-6 in the study group were (5.09±0.72) ng/L and (4.62±0.63) ng/L, which were lower than those in the control group [(6.66±0.95) ng/L and (6.25±0.86) ng/L] (both P<0.05). After treatment, the LH and FSH levels in the study group were (7.42±1.21) IU/L and (5.33±0.82) IU/L, which were lower than those in the control group [(13.38±2.15) IU/L and (11.06±2.11) IU/L], but the E₂ level [(230.38±25.19) IU/L] was higher than that in the control group [(185.57±20.23) IU/L] (all P<0.05). After treatment, the pregnancy rate of the study group was higher than that of the control group [62.50% (35/56) vs. 42.86% (24/56)], with a statistically significant difference (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups [5.36% (3/56) vs. 8.93% (5/56)] (P>0.05). Conclusion　The treatment of TI patients undergoing uterine laparoscopy by warming kidney and promoting blood circulation method can effectively improve their tubal function and regulate the levels of sex hormones, with ideal effect and high clinical application value.

Key words:

Tubal infertility, Uterine laparoscopy, Warming kidney and promoting blood circulation method, Clinical efficacy, Pregnancy

刘娜景瑞郭佳易.

温肾活血法联合宫腹腔镜治疗输卵管性不孕的临床观察 [J]. 国际医药卫生导报, 2024, 30(10): 1687-1692.

Liu Na, Jing Rui, Guo Jiayi.

Clinical observation on the treatment of tubal infertility with warming kidney and promoting blood circulation method combined with uterine laparoscopy [J]. International Medicine and Health Guidance News, 2024, 30(10): 1687-1692.

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