| 中药滋肾养膜方对宫腔粘连内膜修复的临床研究 |
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| 作者姓名： | 刘丽文 杨超兰 尤昭玲 |
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| 作者单位： | 长沙市第一医院妇产科, 湖南 长沙 410005,长沙市第一医院妇产科, 湖南 长沙 410005,湖南中医药大学, 湖南 长沙 410208 |
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| 基金项目： | 长沙市科技局2015年指导性科技计划项目（k15ZD023-33）。 |
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| 摘 要： | 目的 通过观察中药滋肾养膜方联合宫腔镜技术对宫腔粘连患者内膜修复的影响，探讨中药治疗宫腔粘连的临床疗效。方法 收集观察就诊于“尤昭玲教授妇科工作室”和长沙市第一医院妇科的100例宫腔粘连患者的临床病历资料，随机分为两组，对照组50例宫腔镜技术加西药（雌孕激素序贯疗法），试验组50例在对照组基础上配合中药滋肾养膜方，连续3个疗程。观测两组患者治疗疗效，月经量的恢复、中医证候的改善情况和对子宫内膜的影响。结果（1）试验组和对照组在年龄、病程长短、宫腔操作次数、流产次数和治疗前症候的比较，差异无统计学意义，具有齐同可比性；（2）试验组患者经治疗综合疗效总有效率88%要高于对照治疗组（84%），但两组差异经Radit分析，差异无统计学意义；（3）两组经治疗临床症状明显改善，差异具有统计学意义（P<0.05）；（4）两组中医证候治疗后主要症状变化比较，试验组在改善经前乳胀、神疲乏力、失眠健忘、面色萎黄或晦暗方面，明显优于对照组且有统计学意义（P<0.05），在其余症状、体征等方面，两组无统计学意义（P>0.05）；（5）对两组患者治疗后月经情况：月经周期、经期、经量、月经色质均明显改善；（6）两组治疗前后子宫内膜厚度比较，治疗后两组子宫内膜厚度均较治疗前增厚，有统计学意义（P<0.05），试验组与对照组组间比较，试验组增厚程度大于对照组，但差异无统计学意义（P>0.05）。结论 中药滋肾养膜方联合宫腔镜技术和西药治疗对宫腔粘连患者内膜修复效果好，临床疗效确切，可明显增加患者的月经量并且改善患者中医临床症状，值得推广。
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| 关 键 词： | 宫腔粘连 滋肾养膜方 宫腔粘连分离术 雌孕激素序贯疗法 |
| 收稿时间： | 2016/8/14 0:00:00 |
Clinical Study of Zishen Yangmo Decoction on Repairing Endometrium of Intrauterine Adhesions |
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| Authors: | LIU Liwen YANG Chaolan and YOU Zhaoling |
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| Institution: | Department of Obstetrics and Gynecology, the First Hospital of Changsha City, Changsha, Hunan 410005, China,Department of Obstetrics and Gynecology, the First Hospital of Changsha City, Changsha, Hunan 410005, China and Hunan University of Chinese Medicine, Changsha, Hunan 410208, China |
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| Abstract: | Objective To observe the clinical effects of TCM Zishen Yangmo Decoction combined with hysteroscopy technology on repairing endometrium of patients with intrauterine adhesions, and investigate the clinical effect of TCM on treatment of intrauterine adhesions. Methods Clinical medical records of 100 patients with intrauterine adhesions from Professor You Zhaoling''s Obstetrics and Gynecology Studio and Department Of Gynaecology of the First Hospital of Changsha were collected and observed. The patients were randomly divided into two groups, 50 cases in control group were treated with hysteroscopy technology and Western medicine (female progestogen sequential therapy), 50 cases in experimental group were given with Zishen Yangmo Decoction on the basis of the control group, for 3 consecutive periods of treatment. The recovery of menstrual quantity, the improvement of TCM symptoms and effects on the lining of the uterus of patients were observed. Results The age, course of the disease, uterine cavity operation times, abortion times and TCM symptoms in experimental group and control group were compared with that before treatment, there was no obvious difference, the result showed homogeneous comparability. (2) The total effective rate of comprehensive effect was 88% in experimental group after treatment, which was higher than that of control group(84%), the differences between two groups were analyzed by Radit, there was no statistical significance. (3) The clinical symptoms improved obviously in two groups after treatment, with statistical significance (P<0.05). (4) The experimental group showed better than control group in improving premenstrual breast bilges, fatigue, insomnia, forgetfulness of god and sallow or dull complexion after comparing the changes of main symptoms in two groups after treatment, there was obvious difference(P<0.05), the other symptoms and signs in the two groups were not statistically significant (P>0.05). (5)After treatment, the cycle, period, quantity, color and quality of menstruation were obviously improved. (6) The endometrial thickness after treatment was thicker than that before by comparing the two groups, with statistical significance (P<0.05), while the degree of thickening in experimental group was more larger than that in control group, but there was no statistically significance (P>0.05). Conclusion Zishen Yangmo Decoction combined with hysteroscopy technology and Western medicine treatment show good effects on repairing endometrium of patients with intrauterine adhesions, with exact clinical curative effect. They could obviously increase the patient''s menstrual quantity and improve TCM clinical symptoms, which is worthy of popularization. |
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| Keywords: | intrauterine adhesion Zishen Yangmo decoction intrauterine adhesions separation technique female progestogen sequential therapy |
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