通管汤内外合治法治疗输卵管性不孕症的临床观察

发布时间：2018-08-24 10:15

【摘要】：目的:通过观察通管汤口服加灌肠治疗输卵管性不孕症患者输卵管通畅情况、临床症状的改善情况、妊娠率及综合疗效,探讨通管汤内外结合治疗输卵管性不孕症的临床疗效及作用机理。方法:收集2016年1月至2017年1月在江苏省中医院妇科门诊就诊的正虚血瘀型输卵管性不孕症患者63例,随机分为中药口服组(A),中药灌肠组(B)及中药口服加灌肠组(C)。A组:通管汤,200ml,口服,1剂/日,早晚分服;B组:通管汤,200ml,灌肠,1/每晚;C组:通管汤,口服加灌肠,方法同上。经期均口服经期方,停用口服及灌肠药;4周为一个疗程,观察3个疗程。观察三组患者治疗前后输卵管通畅情况、临床症状的改善情况、妊娠率及综合临床疗效。通过spss23.0统计软件,进行数据处理,分析研究结果。结果:1、输卵管通畅情况:A组、B组、C组治疗后输卵管改善率分别为:15.00%、35.89%、64.10%,三组间比较,差异有统计学意义(P0.05)。其中,C组改善率明显优于A组和B组(P0.05);B组改善率优于A组(P0.05)。2、证候积分变化情况:三组患者的治疗后总积分均明显小于治疗前(P0.05);A组、B组、C组中医证候总有效率分别为:80.96%、90.48%、95.24%,三组间比较,差异有统计学意义(P0.05)。其中,C组总有效率明显优于A组和B组(P0.05);A组和B组之间差异无统计学意义(P0.05)。3、妊娠情况:A组、B组、C组的妊娠率分别为19.05%、14.28%、38.10%,三组间比较,差异有统计学意义(P0.05)。其中,C组妊娠率明显优于A组和B组(P0.05);A组和B组妊娠率的比较,差异无统计学意义(P0.05)。三组患者治疗后受孕时间的比较,差异均无统计学意义(P0.05)。4、综合临床疗效:A组、B组、C组的总有效率分别为76.19%、71.42%、85.71%,三组间比较,差异有统计学意义(P0.05)。其中,C组总有效率明显优于A组和B组(P0.05);A组和B组之间差异无统计学意义(P0.05)。结论:应用通管汤三种不同方法治疗输卵管性不孕症均取得显著临床疗效;通管汤口服结合灌肠疗法在输卵管通畅、中医症状改善、提高妊娠率及总有效率等方面疗效均优于单纯中药口服或单纯中药灌肠疗法。
[Abstract]:Objective: to observe the patency of fallopian tube, the improvement of clinical symptoms, the pregnancy rate and the comprehensive curative effect in the treatment of tubal infertility by oral administration of Tongguan decoction and enema. To explore the clinical effect and mechanism of Tongguan decoction in the treatment of tubal infertility. Methods: from January 2016 to January 2017, 63 cases of tubal infertility with positive deficiency and blood stasis were collected from gynecological clinic of Jiangsu Provincial traditional Chinese Medicine Hospital. They were randomly divided into (A), enema group (B) and traditional Chinese medicine plus enema group (C) .A group): Tongguan decoction (200ml), oral dose of 1 dose / day, morning and evening, group B: Tongguan decoction 200ml, enema 1 / nightly C group: Tongguo decoction, oral plus enema, methods: same as above. Every menstrual period was given orally, and the oral and enema drugs were stopped for 4 weeks as a course of treatment, and three courses of treatment were observed. The patency of fallopian tube, improvement of clinical symptoms, pregnancy rate and comprehensive clinical effect were observed before and after treatment. Through the spss23.0 statistical software, data processing, analysis of the results. Results the oviduct patency in group A and B was significantly higher than that in group B (P 0.05). The improvement rate of fallopian tube in group B was respectively 64.100.The improvement rate of fallopian tube in group B was 64.100.The difference between the three groups was statistically significant (P0.05). The improvement rate of group C was significantly better than that of group A and group B (P0.05), the improvement rate of group B was better than that of group A (P0.05). The change of syndromes integral: the total integral of three groups after treatment was significantly lower than that before treatment (P0.05) the total effective rate of TCM syndromes of group A and group B was lower than that of group C, respectively. For: 80.96, 90.48 and 95. 24, comparison between the three groups, The difference was statistically significant (P0.05). The total effective rate of group C was significantly better than that of group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). The pregnancy rate of group B was 19.05 and 14.28. The difference between the three groups was statistically significant (P0.05). The pregnancy rate of group C was significantly better than that of group A and group B (P0.05), there was no significant difference between group A and group B (P0.05). There was no significant difference in the gestation time between the three groups after treatment (P0.05). The total effective rate of group B and C was 76.19 and 71.42, respectively. The difference between the three groups was statistically significant (P0.05). The total effective rate of group C was significantly better than that of group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). Conclusion: three different methods of Tongguan decoction are effective in the treatment of tubal infertility. The effect of improving pregnancy rate and total effective rate was better than that of oral Chinese medicine alone or enema therapy of traditional Chinese medicine alone.
【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】：R271.14

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