补肾化瘀法联合补佳乐治疗宫腔粘连术后的临床研究及对外周血IL-6的影响

发布时间：2019-04-29 16:55

【摘要】：目的：通过临床实验研究,观察宫腔镜下粘连分离术后运用中药补肾化瘀法联合补佳乐对宫腔操作术后宫腔粘连患者月经量的恢复、中医证候的改善、子宫内膜形态、子宫动脉血流灌注以及血清炎性因子IL-6的影响,探讨中药治疗本病的临床疗效,并对其作用机理进行初步研究。方案：将因宫腔操作术后引起月经量少且宫腔镜检查符合宫腔轻度-中度粘连的40例患者,随机分为治疗组20例及对照组20例,两组均于治疗前在宫腔镜下行粘连分离术,术后治疗组予以补肾化瘀中药联合补佳乐治疗,对照组单用补佳乐治疗,治疗3个月经周期,观察治疗组及对照组经治疗后其主症月经情况以及相关临床伴随症状的改善,宫腔镜下粘连程度是否改善,受损子宫内膜恢复情况及对血清炎性因子IL-6的影响。结果：两组经治疗后,治疗组及对照组总有效率分别为90.00%、75.00%,治疗组总体疗效优于对照组(P0.05)。经治疗后,治疗组对主症月经情况的改善与对照组相比具有明显优势(P0.05)。两组患者经治疗后中医证候较疗前均有所缓解,治疗组及对照组总有效率分别为90.00%、65.00%,比较具有显著性差异(P0.05)。两组经治疗后IUA评分较前均降低,黄体期子宫内膜厚度较治疗前均增厚,子宫动脉血流阻力指数(RI)较治疗前均降低(P0.05),但两组间比较P0.05,不具有统计学意义。治疗后两组患者子宫动脉血流搏动指数(PI)较治疗前无显著性差异(P0.05),组间比较亦无统计学意义(P0.05)。治疗后两组患者血清IL-6均较治疗前降低(P0.05),组间比较具有显著性差异(P0.05)。结论：宫腔粘连分离术后采用补肾化瘀中药联合雌激素对治疗宫腔操作术后宫腔粘连导致的月经过少甚则闭经的临床疗效肯定,分析此法可能通过增强机体的免疫机能,促进盆腔器官血流循环,从而加快受损内膜的再生使其临床症状改善。
[Abstract]:Objective: to observe the recovery of menstrual volume, the improvement of TCM syndrome and the shape of endometrium in patients with uterine cavity adhesion after hysteroscopic adhesion separation with the method of tonifying the kidney and removing blood stasis combined with BujiaLe, and observing the recovery of menstrual volume, the improvement of TCM syndrome and the shape of endometrium in patients with uterine cavity adhesion after hysteroscopic surgery. The effects of uterine artery perfusion and serum inflammatory factor IL-6 were studied to explore the clinical efficacy and mechanism of traditional Chinese medicine (TCM) in the treatment of the disease. Methods: 40 patients with mild to moderate adhesion were randomly divided into two groups: treatment group (n = 20) and control group (n = 20). The two groups were divided into two groups: before treatment, they were separated by hysteroscopy under hysteroscopy, and were divided into two groups: the treatment group (n = 20) and the control group (n = 20). The patients in the treatment group were treated with traditional Chinese medicine for tonifying kidney and removing blood stasis combined with Jiaxe, while the control group were treated with Bujiaxe only for 3 months. The main symptoms and menstruation of the treatment group and the control group were observed after treatment, as well as the improvement of the related clinical concomitant symptoms. Whether the degree of adhesion under hysteroscopy was improved, the recovery of damaged endometrium and the effect on serum inflammatory factor IL-6. Results: after treatment, the total effective rates of the treatment group and the control group were 90.00% and 75.00%, respectively. The overall curative effect of the treatment group was better than that of the control group (P0.05). After treatment, the improvement of menstruation in the treatment group was superior to that in the control group (P0.05). The total effective rate of the treatment group and the control group were 90.00% and 65.00% respectively. There was significant difference between the two groups (P0.05). After treatment, the IUA score of the two groups was lower, the thickness of endometrium in luteal phase was thicker than that before treatment, and the resistance index of uterine artery blood flow (RI) was lower than that before treatment (P0.05), but there was no significant difference between the two groups (P 0.05). After treatment, there was no significant difference in uterine artery pulsatility index (PI) between the two groups (P0.05), and there was no significant difference between the two groups (P0.05). After treatment, the serum IL-6 of the two groups was lower than that before treatment (P0.05), and there was significant difference between the two groups (P0.05). Conclusion: the combination of traditional Chinese medicine for tonifying kidney and removing blood stasis combined with estrogen is effective in the treatment of menorrhagia and even amenorrhea caused by uterine cavity adhesion after operation of uterine cavity. This method may enhance the immune function of the body by analyzing the therapeutic effect of this method on menstrual dysmenorrhea caused by uterine cavity adhesion after operation. Promote pelvic organ blood circulation, thus accelerate the regeneration of damaged intima to improve its clinical symptoms.
【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】：2016
【分类号】：R271.9

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