中药治疗气滞血瘀型输卵管炎性不孕的临床疗效分析及实验研究

发布时间：2018-07-11 17:04

本文选题：膈下逐瘀汤加减方 + 输卵管通液术　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:1、通过临床观察和随访,研究口服膈下逐瘀汤加减方结合输卵管通液术治疗气滞血瘀型输卵管炎性不孕的临床疗效。2、通过观察气滞血瘀型输卵管炎性不孕模型大鼠的部分宏观特征、输卵管组织形态、血液流变学、肿瘤坏死因子(TNF-α)及受孕率的变化,探讨膈下逐瘀汤加减方治疗气滞血瘀型输卵管炎性不孕的机制。方法:1、气滞血瘀型输卵管炎性不孕患者30例,给予膈下逐瘀汤加减方口服结合输卵管通液术,1个月为1个疗程,治疗3个疗程,观察患者的中医证候、体征、输卵管通畅度的改善情况。半年后电话随访,观察受孕率。2、SD雌性大鼠48只,随机分为正常组、模型组、中药组、康妇炎组,除正常组外,其他组采用细菌接种联合多因素刺激复制气滞血瘀型输卵管炎性不孕动物模型。造模成功后,中药组给予膈下逐瘀汤加减方灌服,康妇炎组灌服康妇炎悬液,模型组、正常组灌服同等剂量的纯净水,连续28天。观察大鼠部分宏观特征、输卵管组织形态学变化、血液流变学指标及输卵管TNF-α的表达。与雄性大鼠合笼饲养,观察各组受孕率。结果:1、与治疗前相比较,治疗后患者的中医证候、体征、输卵管通畅度均有明显改善,差异有统计学意义(P0.05)。2、妊娠数17例,妊娠率为56.67%。3、模型组大鼠符合气滞血瘀型输卵管炎性不孕的病理特征和中医证候特点。4、与模型组相比,各用药组血液流变学指标均有不同程度改善,以中药组最佳。5、模型组输卵管组织中TNF-α表达明显升高,各治疗组均有不同程度降低。6、与正常组相比,模型组受孕率显著降低,其他各组均有不同程度改善,中药组为最佳。结论:1、膈下逐瘀汤加减方结合输卵管通液术能明显改善气滞血瘀型输卵管炎性不孕患者的中医证候、体征、输卵管通畅度。2、膈下逐瘀汤加减方结合输卵管通液术能有效提高气滞血瘀型输卵管炎性不孕患者的妊娠率。3、膈下逐瘀汤加减方能改善气滞血瘀型输卵管炎性不孕大鼠的体征和输卵管的结构、功能。4、膈下逐瘀汤加减方能明显改善气滞血瘀型输卵管炎性不孕大鼠血液流变学的各项指标。5、膈下逐瘀汤加减方能有效抑制气滞血瘀型输卵管炎性不孕大鼠输卵管上皮细胞TNF-α的表达。6、膈下逐瘀汤能提高气滞血瘀型输卵管炎性不孕大鼠的受孕率。
[Abstract]:Objective: 1, through clinical observation and follow-up, To study the clinical curative effect of Gexia Zhuyu decoction combined with tubal fluid therapy on tubal inflammatory infertility of qi stagnation and blood stasis type. By observing some macroscopic features and tubal tissue morphology of rats with Qi-stagnation and blood-stasis type salpingitis infertility, the clinical effect of Gexia Zhuyu decoction on tubal inflammation infertility was studied. The changes of hemorheology, tumor necrosis factor (TNF- 伪) and pregnancy rate were studied. Methods 30 cases of tubal inflammatory infertility with qi stagnation and blood stasis type were treated with Gexia Zhuyu decoction orally combined with salpingocele operation, one month as a course of treatment, three courses of treatment, observing the TCM syndromes and signs of the patients. Improvement of tubal patency. After half a year's telephone follow-up, 48 SD female rats were randomly divided into normal group, model group, traditional Chinese medicine group, Kangfuyan group, except normal group. The other groups were treated with bacterial inoculation combined with multiple factor stimulation to establish the model of oviduct inflammatory infertility with qi stagnation and blood stasis. After the model was successfully made, the traditional Chinese medicine group was given Gexia Zhuyu decoction, the Kangfuyan group was infused with Kangfuyan suspension, the model group and the normal group were given the same dose of pure water for 28 days. The macroscopical features, histomorphology, hemorheology and the expression of TNF- 伪 in the tubal were observed. The pregnant rate of each group was observed by feeding in cage with male rats. Results compared with before treatment, the TCM syndromes, signs and patency of fallopian tubes were significantly improved after treatment. The difference was statistically significant (P0.05) .2The number of pregnancies was 17 cases. The pregnancy rate was 56.67. 3. The model group accorded with the pathological characteristics and TCM syndrome characteristics of tubal inflammatory infertility with Qi stagnation and blood stasis. Compared with the model group, the hemorheological indexes of each medication group were improved to some extent. The expression of TNF- 伪 in the oviducts of the model group was significantly higher than that in the control group, and the expression of TNF- 伪 in the oviducts of the model group was significantly increased. The pregnant rate of the model group was significantly lower than that of the normal group, and that of the other groups was better than that of the traditional Chinese medicine group. Conclusion: the combination of Wei 1, GE Xia Zhuyu decoction and salpingostomy can obviously improve the syndrome and signs of the patients with Qi-stagnation and blood-stasis type of salpingitis infertility. The unobstructed degree of fallopian tube. 2. The decoction of removing blood stasis under the diaphragm combined with the operation of tubal fluid can effectively improve the pregnancy rate of the infertile patients with tubal inflammation of qi stagnation and blood stasis type. The decoction of removing blood stasis under the diaphragm can improve the infertility of fallopian tube inflammation of qi stagnation and blood stasis type. The signs of the rat and the structure of the fallopian tube, Function. 4. The decoction of removing blood stasis under the diaphragm can obviously improve the indexes of hemorheology of the rats with tubal inflammation of Qi stagnation and blood stasis type. 5. The decoction of removing blood stasis under the diaphragm can effectively inhibit the transfusion of oocytes in the rats with inflammatory infertility of fallopian tube of qi stagnation and blood stasis type. The expression of TNF- 伪 in epithelial cells of tube. 6. Gexia Zhuyu decoction could improve the pregnancy rate of rats with tubal inflammatory infertility of qi stagnation and blood stasis type.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.14

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