针药结合治疗气滞血瘀型输卵管炎性阻塞性不孕症的临床疗效观察

发布时间：2018-01-29 03:37

本文关键词： 温针灸桃红四物汤输卵管通液术输卵管炎性阻塞性不孕症临床疗效观察　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过温针灸、桃红四物汤联合输卵管通液术治疗气滞血瘀型输卵管炎性阻塞性不孕症的妊娠率、输卵管通畅率、中医证侯积分、局部体征积分及术后VAS评分的改善情况,评估其临床可行性、有效性及安全性。方法:收集气滞血瘀型输卵管炎性阻塞性不孕症患者60例,随机分为对照组和治疗组,每组各30例。对照组用桃红四物汤联合输卵管通液术治疗,治疗组在对照组的基础上采用温针灸治疗,两组治疗6个月经周期。治疗结束时,评价中医证侯积分、中医各主症积分、局部体征积分和VAS评分改善情况;治疗结束6个月后,评价受孕情况、双侧输卵管通畅情况及局部体征积分改善情况。结果:1.两组临床综合疗效比较两组治疗结束6个月后的临床综合疗效比较:两组均有提高,治疗组总有效率96.67%,愈显率66.67%;对照组总有效率80%,愈显率40%,两组总有效率及愈显率(输卵管通畅率)比较,差异均有统计学意义(P0.05)。2.两组治疗结束6个月后受孕情况比较两组患者治疗后6个月,治疗组受孕率50%,对照组受孕率23.33%,两组比较差异有统计学意义(P0.05)。3.两组治疗前后中医证侯积分比较两组治疗结束时,中医证侯积分较治疗前均下降,两组差异均有统计学意义(P0.01),但治疗组的下降幅度更明显,组间比较有显著性差异(P0.01)。4.两组治疗前后中医各主症积分的比较治疗前与治疗结束时中医各主症平均积分比较:下腹胀痛或刺痛积分比较,治疗组治疗前较治疗结束时有明显下降,组间比较有显著性差异(P0.01),但对照组下降幅度不明显,组内比较差异无统计学意义(P0.05);治疗组下降幅度大于对照组,组间相比有显著性差异(P0.01)。治疗结束时两组胸胁乳房胀痛积分均有所下降,两组组内比较均有显著性差异(P0.01),而治疗组下降更明显,组间比较差异有统计学意义(P0.05)。5.两组治疗前后及治疗结束6个月后局部体征积分比较治疗结束时较治疗前,两组的局部体征积分均有下降,两组组内比较均有显著性差异(P0.01),治疗组下降幅度明显大于对照组,差异有统计学意义(P0.01)。治疗结束6个月后较治疗结束时,治疗组有下降,差异有统计学意义(P0.05),对照组局部体征积分有所下降,但组内比较差异无统计学意义(P0.05);组间相比,治疗组下降幅度明显大于对照组,差异有统计学意义(P0.01)。6.两组治疗前后VAS评分的比较输卵管通液术治疗结束后40分钟较输卵管通液术结束时,两组VAS评分均下降,两组组内比较均有显著性差异(P0.01);组间相比,治疗组下降幅度明显大于对照组,差异有统计学意义(P0.05)。结论:温针灸、桃红四物汤联合输卵管通液术治疗气滞血瘀型输卵管炎性阻塞性不孕症的妊娠率和输卵管通畅率高于用桃红四物汤联合输卵管通液术治疗,且改善中医证侯积分、局部体征方面效果较佳,同时温针灸有术后镇痛作用。
[Abstract]:Objective: to treat the pregnancy rate, tubal patency rate and TCM syndrome score by warming acupuncture and moxibustion, Taohong Siwu decoction combined with tubal tubal fluid therapy for the treatment of tubal inflammatory obstructive infertility with qi stagnation and blood stasis. To evaluate the clinical feasibility, efficacy and safety of local sign score and postoperative VAS score. Methods: 60 cases of tubal inflammatory obstructive infertility with Qi stagnation and blood stasis were collected. Randomly divided into control group and treatment group, each group of 30 cases. The control group was treated with Taohong Siwu decoction combined with fallopian tube operation, and the treatment group was treated with warm acupuncture on the basis of the control group. At the end of the treatment, the improvement of TCM syndromes, main symptoms, local signs and VAS scores were evaluated. Six months after treatment, pregnancy was evaluated. Results 1. Comparison of clinical comprehensive efficacy between the two groups after 6 months of treatment: both groups were improved. The total effective rate of the treatment group was 96.677.The effective rate of the treatment group was 66.67; In the control group, the total effective rate was 80%, the more obvious rate was 40%, and the total effective rate and the healing rate (fallopian tube patency rate) were compared between the two groups. There were significant differences between the two groups after 6 months after the end of the treatment compared with the two groups of patients 6 months after treatment, the treatment group pregnancy rate 50, the control group pregnancy rate 23.33%. The difference between the two groups was statistically significant (P 0.05). Before and after treatment, the scores of TCM syndromes in the two groups were lower than those before and after treatment. The difference between the two groups was statistically significant, but the decrease was more obvious in the treatment group. There was significant difference between the two groups before and after treatment of the main symptoms of traditional Chinese medicine before and after the treatment of the average score of the main symptoms of traditional Chinese medicine comparison: lower abdominal distending pain or pain score comparison. There was a significant decrease in the treatment group before treatment than at the end of the treatment, there was a significant difference between the groups, but the decrease in the control group was not significant, there was no significant difference between the two groups (P 0.05). The decrease in the treatment group was greater than that in the control group, and there was a significant difference between the two groups. At the end of treatment, the score of breast distension and pain in both groups decreased. There was significant difference between the two groups (P 0.01), but the decrease was more obvious in the treatment group. Two groups before and after treatment and 6 months after the end of treatment compared with the end of treatment, the local signs of the two groups were decreased. There was significant difference between the two groups (P 0.01). The decrease of the treatment group was significantly larger than that of the control group (P 0.01). The difference was statistically significant 6 months after the end of treatment than at the end of the treatment. In the treatment group, the difference was statistically significant (P 0.05), and the score of local signs in the control group was decreased, but there was no significant difference between the two groups (P 0.05). Compared with the control group, the decrease of the treatment group was significantly greater than that of the control group. Comparison of VAS scores before and after treatment in the two groups, the VAS scores of the two groups decreased after 40 minutes compared with the end of salpingostomy. There was significant difference between the two groups (P 0.01). Compared with each other, the decrease of treatment group was significantly larger than that of control group, and the difference was statistically significant (P 0.05). Conclusion: warm acupuncture and moxibustion. The pregnancy rate and fallopian tube patency rate of Taohong Siwu decoction combined with fallopian tube liquid therapy were higher than that of Taohong Siwu decoction combined with fallopian tube fluid-opening operation in the treatment of oviduct inflammatory obstructive infertility with qi stagnation and blood stasis. And improve TCM syndromes score, local signs of the effect is better, at the same time warming acupuncture has postoperative analgesic effect.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.3

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