中药综合治疗输卵管妊娠腹腔镜剖管取胚术后的临床研究

发布时间：2018-06-03 03:53

本文选题：输卵管妊娠 + 中药综合治疗　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的研究中药综合疗法("重楼血竭散"联合"盆复康汤")治疗输卵管妊娠腹腔镜剖管取胚术后的临床作用以及其对患者血清IL-2、IL-6浓度水平的影响。方法选取2014年7月至2016年3月肇庆市中医院妇产科收治的输卵管妊娠患者60例,随机分为治疗组和对照组,每组30例。两组均采用输卵管妊娠腹腔镜剖管取胚术,术后常规抗感染治疗3天。治疗组于月经来潮第7天开始内服"重楼血竭散",配合"盆复康汤"保留灌肠;对照组仅进行随访观察。观察患者治疗前后的临床表现及体征,采用中医证候评分表进行疗效评价;采用子宫输卵管造影术观察治疗后患侧输卵管的通畅情况;比较治疗前后患者血清IL-2、IL-6浓度水平情况。结果1.随访3个月,治疗组脱落病例2例,对照组脱落病例1例;两组治疗前的基线对比,差异无统计学意义(P0.05);2.治疗3个月后,治疗组的总有效率为89.2%,对照组的总有效率为65.5%,两组的总有效率比较,差异存在统计学意义(P0.05),提示治疗组的总体疗效优于对照组;3.治疗3个后,治疗组的中医证候评分为12.29±4.50分,对照组的中医证候评分为15.16±5.88分,两组的中医证候评分比较,差异存在统计学意义(P0.05),提示治疗组的中医临床症状改善程度优于对照组;4.治疗3个月后,治疗组的患侧输卵管通畅率为64.3%,对照组的患侧输卵管通畅率为37.9%,差异存在统计学意义(P0.05),提示治疗组的患侧输卵管通畅率显著高于对照组;5.治疗3个月后,治疗组的血清IL-2、IL-6浓度水平均明显低于对照组,差异存在统计学意义(P0.05)。结论中药综合疗法("重楼血竭散""联合"盆复康汤")治疗输卵管妊娠腹腔镜剖管取胚术后,可改善患者术后的临床症状,提高术后患侧输卵管的通畅率,还可以降低患者术后的血清IL-2、IL-6浓度水平,具有较好的临床效果。
[Abstract]:Objective to study the clinical effect of traditional Chinese medicine comprehensive therapy ("Chonglou Xueshou San" and "Penhukang decoction") in the treatment of oviduct pregnancy after laparoscopic tube embryo extraction and its effect on the serum level of IL-2 and IL-6 in patients with tubal pregnancy. Methods from July 2014 to March 2016, 60 cases of tubal pregnancy were randomly divided into treatment group (n = 30) and control group (n = 30). Both groups were treated with laparoscopy for embryo extraction and routine anti-infective therapy for 3 days. The treatment group began to take "Chonglou Xue Drachao San" on the 7th day of menstrual menorrhagia, combined with "Penfukang decoction" to retain enema, while the control group was followed up only. Observe the clinical manifestations and signs of patients before and after treatment, using TCM syndrome score table to evaluate the efficacy; use hysterosalpingography to observe the patency of the affected fallopian tubes; compare the serum levels of IL-2 IL-6 before and after treatment. Result 1. After 3 months follow-up, there were 2 cases of shedding in treatment group and 1 case of abscission in control group, and there was no significant difference between the two groups in baseline before treatment (P 0.05). After 3 months of treatment, the total effective rate of the treatment group was 89.2 and the total effective rate of the control group was 65.5. The difference of the total effective rate between the two groups was statistically significant (P 0.05), indicating that the total effective rate of the treatment group was better than that of the control group. After three treatments, the TCM syndrome score of the treatment group was 12.29 卤4.50, and that of the control group was 15.16 卤5.88. The difference was statistically significant (P 0.05), suggesting that the improvement of TCM clinical symptoms in the treatment group was better than that in the control group (P 0.05). After 3 months of treatment, the patency rate of the affected fallopian tube in the treatment group was 64.3 and that in the control group was 37.9. The difference was statistically significant (P 0.05), suggesting that the patency rate of the affected side in the treatment group was significantly higher than that in the control group. After 3 months of treatment, the serum levels of IL 2 and IL 6 in the treatment group were significantly lower than those in the control group, and the difference was statistically significant (P 0 05). Conclusion the clinical symptoms and patency rate of the affected fallopian tubes can be improved by the combined therapy of traditional Chinese medicine ("Chonglou Xueshou San" and "Penhukang decoction") in the treatment of tubal pregnancy after laparoscopy. It can also reduce the level of serum IL-2 and IL-6 after operation, and has good clinical effect.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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