化瘀通络方联合腹腔镜手术对输卵管性不孕患者临床疗效评价

发布时间：2018-01-12 09:10

本文关键词：化瘀通络方联合腹腔镜手术对输卵管性不孕患者临床疗效评价　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察输卵管性不孕患者经腹腔镜手术联合中药治疗与单纯行腹腔镜手术治疗,分析比较治疗前后患者中医症状、局部体征、子宫内膜容受性、妊娠率及输卵管再通率以及术中腹腔液白介素-2的表达,为化瘀通络中药治疗输卵管性不孕提供理论依据,提高中西医联合治疗输卵管性不孕的临床水平。方法:纳入符合标准的50例输卵管性不孕患者,随机分为2组,治疗组予中药联合腹腔镜治疗,对照组单纯行腹腔镜治疗。治疗组于术前、术后分别予中药口服三个月,两组术后均随访半年。治疗前后分别对两组患者进行安全性指标检测、疗效分析,观察对比两组术中腹腔液IL-2的水平高低、子宫内膜容受性的改变、症状体征的改善及术后妊娠率、输卵管通畅率。结果:1.两组患者术中腹腔液IL-2的表达有明显差异(P0.05)。2.对两组治疗后妊娠情况随访后进行比较,治疗组宫内64.0%,无异位妊娠;对照组宫内32.0%,并且有3例患者异位妊娠,两组妊娠率有明显差异(P0.05)。3.两组术后未成功自然受孕患者输卵管通畅情况相比,治疗组术后通畅情况明显优于对照组(P0.05)。4.两组分别经中西医联合治疗、单独西医治疗后局部体征总有效率分别为92.0%、76.0%,两组均能改善局部体征,但治疗组的降低效果更明显(P0.05),疗效更佳;两组中医症状改善情况总有效率分别为92.0%、68.0%,两组治疗对中医症状均有改善作用,但治疗组疗效更佳(P0.05)。5.两组治疗前后子宫动脉PI、RI比较,治疗组能更好的降低动脉血流阻力,提高子宫内膜容受性(P0.05),而对照组也稍有下降,但其下降幅度远远不及治疗组。结论:化瘀通络中药联合腹腔镜可以有效降低患者腹腔液中炎症因子IL-2的水平,降低宫腔局部血流阻力,增加灌注,改善患者子宫内膜容受性,缓解患者的临床症状,恢复输卵管正常解剖、生理功能,增加宫内妊娠率。
[Abstract]:Objective: to analyze and compare the symptoms, local signs and endometrial receptivity of patients with tubal infertility by laparoscopy combined with traditional Chinese medicine and laparoscopic surgery alone. Pregnancy rate, fallopian tube recanalization rate and intraoperative expression of interleukin-2 in peritoneal fluid provide theoretical basis for the treatment of tubal infertility with traditional Chinese medicine for removing blood stasis and dredging collaterals. Methods: 50 cases of oviduct infertility were randomly divided into two groups, the treatment group was treated with traditional Chinese medicine combined with laparoscopy. The control group was treated by laparoscopy alone. The treatment group was treated with traditional Chinese medicine orally for three months before and after operation, and the two groups were followed up for half a year. The safety indexes were detected before and after treatment, and the curative effect was analyzed. The levels of IL-2 in intraoperative celiac fluid, the changes of endometrial receptivity, the improvement of symptoms and signs and the rate of pregnancy after operation were observed and compared between the two groups. Results there was a significant difference in the expression of IL-2 in intraoperative peritoneal fluid between the two groups. The pregnancy status after treatment was compared between the two groups. In the treatment group, there was no ectopic pregnancy. There were 3 cases of ectopic pregnancy in the control group. There was significant difference in pregnancy rate between the two groups. The postoperative patency in the treatment group was significantly better than that in the control group (P 0.05). 4. The total effective rate of local signs in the two groups was 92.0% and 76.0%, respectively, after the combined treatment of traditional Chinese and western medicine. Both groups were able to improve local signs, but the effect of the treatment group was better than that of the control group (P 0.05). The total effective rate of TCM symptom improvement in the two groups was 92.0 and 68.0 respectively. However, the therapeutic effect of the treatment group was better than that of the treatment group. Compared with the uterine artery Pi RI before and after treatment, the treatment group could lower the arterial flow resistance and improve the endometrial receptivity (P0.05). The control group also slightly decreased, but its decline is far less than the treatment group. Conclusion: combined with laparoscopy can effectively reduce the level of inflammatory factor IL-2 in the peritoneal fluid of patients. Reduce local blood flow resistance, increase perfusion, improve endometrial receptivity, alleviate clinical symptoms, restore normal anatomy of fallopian tubes, physiological function, increase the rate of intrauterine pregnancy.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.6

【相似文献】