摘要
目的观察中药灌肠配合电针治疗薄型子宫内膜型不孕症的临床疗效及对子宫内膜螺旋动脉血流参数的影响。方法将60例薄型子宫内膜型不孕症患者按照随机数字表法分为2组。对照组30例在月经周期第5 d开始口服雌二醇片/雌二醇地屈孕酮片红片;治疗组30例在对照组治疗基础上采用中药灌肠配合电针治疗。月经周期第10 d开始监测卵泡,待卵泡≥18 mm时,停止治疗,排卵后指导合房(输卵管堵塞者予试管移植),同时给予地屈孕酮片治疗14 d。2组均连续治疗3个月经周期,治疗期间如受孕者停止治疗。比较2组治疗前后子宫内膜螺旋动脉收缩期峰值血流速度(PSV)、阻力指数(RI)、搏动指数(PI)、子宫内膜厚度、形态类型,并统计疗效及妊娠率。结果治疗组总有效率83.3%,对照组总有效率36.7%,治疗组疗效优于对照组(P<0.05)。治疗组治疗后子宫内膜螺旋动脉PSV升高,RI、PI均降低(P<0.05),且改善均优于对照组(P<0.05);对照组治疗前后PSV、RI、PI无明显变化(P>0.05)。治疗后2组子宫内膜厚度均增厚(P<0.05),治疗后2组组间子宫内膜厚度比较差异无统计学意义(P>0.05)。治疗后治疗组A型子宫内膜比例升高(P<0.05),C型子宫内膜比例降低(P<0.05);且治疗组治疗后A型子宫内膜比例高于对照组(P<0.05),C型子宫内膜比例低于对照组(P<0.05)。治疗期间及随访3个月内,治疗组妊娠率36.7%,对照组妊娠率16.7%,治疗组妊娠率高于对照组(P<0.05)。结论中药灌肠配合电针治疗可有效改善薄型子宫内膜型不孕症患者子宫内膜螺旋动脉血流参数,改善子宫内膜局部血运,增加子宫内膜厚度及改善内膜形态,提高了子宫内膜容受性,进而提高了妊娠率。
Objective To observe the clinical effect of enema with Chinese medicine and electroacupuncture on thin endometrial infertility and its effect on the blood flow parameters of endometrial spiral artery. Methods 60 cases of thin endometrial infertility were randomly divided into two groups according to the random number table method. 30 cases in control group took estradiol tablet/red estradiol diprotoprostone tablet on the 5 th day of menstrual cycle. 30 cases in treatment group were treated by enema with Chinese medicine and electroacupuncture on the basis of the control group. At the 10 th day of menstrual cycle, the follicles were monitored. When the follicles were ≥18 mm, the treatment was stopped. After ovulation, the patients with fallopian tube obstruction were treated with test tube transplantation and didroxyprogesterone tablets for 14 days. The two groups were treated for three menstrual cycles, and if pregnant during the treatment, the treatment was stopped. The peak systolic blood flow velocity(PSV), resistance index(RI), pulsatility index(PI), endometrial thickness and shape type of spiral endometrial artery were compared before and after treatment between the two groups. The curative effect and pregnancy rate were analyzed. Results The total effective rate was 83.3% in treatment group and 36.7% in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, in the treatment group, PSV was increased, RI and PI were decreased(P<0.05), and the improvement was better than that in the control group(P<0.05). There was no significant change in PSV, RI and PI before and after treatment in the control group(P>0.05). The thickness of endometrial in both groups was increased after treatment(P<0.05). There was no significant difference in endometrial thickness between the two groups(P>0.05). After treatment, the proportion of type A endometrial in the treatment group was increased(P<0.05), while type C endometrial was decreased(P<0.05);the proportion of type A endometrial in the treatment group was higher than that in the control group(P<0.05), and the proportion of type C endometrial was lower than that in the control group(P<0.05). During the treatment and three months follow-up, the pregnancy rate of the treatment group was 36.7%, and that of the control group was 16.7%. The pregnancy rate of the treatment group was higher than that of the control group(P<0.05). Conclusion Enema with Chinese medicine and electroacupuncture can effectively improve the parameters of endometrial spiral artery blood flow, improve the local blood flow of endometrial, increase the thickness and shape of endometrial, improve the endometrial receptivity, and then improve the pregnancy rate.
作者
潘荣
王丽旻
刘秀英
PAN Rong;WANG Limin;LIU Xiuying(Department of Traditional Chinese Medicine,Dalian Maternal and Child Health Hospital,Dalian,Liaoning 116013)
出处
《河北中医》
2019年第9期1326-1330,共5页
Hebei Journal of Traditional Chinese Medicine
基金
2017年大连市中医药相关科学研究计划项目(编号:17Z1012)
关键词
不育
女(雌)性
子宫内膜
灌肠
中药疗法
电针
Infertility,female
Endometrial
Enema
Chinese medicine therapy
Electroacupuncture
作者简介
潘荣(1980-),女,副主任中医师,硕士。研究方向:中西医结合治疗不孕症。
