摘要
目的:观察归肾丸加减联合T管用于宫腔粘连术后的临床疗效及其对患者子宫内膜雌激素受体(ER)的影响。方法:回顾性分析92例确诊为中重度宫腔粘连并行宫腔镜下粘连松解术的患者,根据术后预防粘连措施的不同分为三组。观察组31例,T管治疗术后予以归肾丸;西药组30例,T管治疗术后予以雌孕激素序贯治疗;球囊组31例,术后予以雌孕激素序贯治疗联合Cook球囊。三组患者均治疗2个月经周期,观察治疗前后宫腔粘连评分、月经量、子宫内膜厚度、子宫内膜ER变化情况、妊娠情况等。结果:观察组总有效率为87.10%、西药组83.33%,球囊组80.65%,三组间总有效率比较,差异无统计学意义(P>0.05)。治疗后三组宫腔粘连评分均较治疗前下降,月经量积分、子宫内膜厚度、子宫内膜ER水平均较治疗前上升,差异有统计学意义(均P<0.05)。观察组与西药组在增加子宫内膜厚度方面均优于球囊组,差异有统计学意义(均P<0.05)。三组在提升月经量积分、子宫内膜ER水平、降低宫腔粘连评分方面比较,差异无统计学意义(均P>0.05)。治疗过程中三组均未出现药物过敏、子宫穿孔、感染等不良反应。结论:归肾丸加减联合T管治疗宫腔粘连术后患者,可有效预防粘连复发,增加月经量,促进子宫内膜增厚,提高子宫内膜ER水平,其总体疗效与雌孕激素序贯治疗联合球囊方案相当,且在增加子宫内膜厚度方面效果更优。
Objective:To observe clinical efficacy of modified Guishen Wan combined with T tube for postoperative intrauterine adhesion and its effect on endometrial estrogen receptor(ER).Methods:A retrospective analysis of 92 patients diagnosed with moderate to severe intrauterine adhesions underwent hysteroscopic adhesion anlysis was performed,divided into three groups according to different postoperative adhesion prevention measures.31 cases in the observation group were given modified Guishen Wan combined with T tube after operation,30 cases in the western medicine group received estrogen-progestin sequential therapy combined with T tube therapy after operation,31 cases in the balloon group received estrogen-progestin sequential therapy combined with Cook balloon therapy after operation.All the three groups were treated for 2 menstrual cycles.Before and after treatment,the intrauterine adhesion scores,menstrual flow scores,endometrial thickness,endometrial ER levels and pregnancy rate were observed.Results:The total efficiency of the observation group was 87.10%,the western medicine group 83.33%,the balloon group 80.65%,there was no significant difference in the three groups(P>0.05).After treatment,the intrauterine adhesion scores of the three groups were all significantly lower than before,and the menstrual flow scores,endometrial thickness,and endometrial ER levels of the three groups were all significantly higher than before,difference statistically significant(all P<0.05).After treatment,the intrauterine adhesion score of the three groups was decreased compared with that before treatment,the menstrual volume score,endometrial thickness and endometrial ER level were increased compared with those before treatment,differences statistically significant(all P<0.05).The observation group and the western medicine group in increasing endometrial thickness were better than those in the balloon group difference statistically significant(all P<0.05).Improving menstrual volume score,endometrial ER level and reducing uterine adhe
作者
郑维维
杜子琪
陈怡
陈慕镟
廖慧慧
ZHENG Weiwei;DU Ziqi;CHEN Yi;CHEN Muxuan;LIAO Huihui(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China)
出处
《陕西中医》
CAS
2022年第12期1729-1733,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
广州中医药大学学科研究重点建设项目(XK2019010)
张玉珍全国名老中医药专家传承工作室建设项目[粤中医办函(2017)209号]。
关键词
宫腔粘连
归肾丸
T管治疗
子宫内膜
雌激素受体
雌孕激素序贯治疗
Intrauterine adhesion
Guishen Wan
T tube treatment
Endometrium
Estrogen receptor
Estrin sequential treatment
