摘要
目的探讨孕通汤组方联合宫腹腔镜对盆腔输卵管性不孕症患者卵巢功能及血清免疫因子的影响。方法采用两均数比较的样本含量计算公式计算研究所需样本量,选取2017年7月—2020年6月期间河北省沧州中西医结合医院收治的血瘀型盆腔输卵管性不孕症患者160例,按随机数字表法分为对照组和观察组,每组各80例。对照组采用宫腹腔镜治疗,观察组采用孕通汤联合宫腹腔镜治疗。治疗7 d后,观察比较两组患者的中医证候积分及临床体征积分,治疗前及治疗7 d后卵巢功能指标[雌二醇(Estradiol,E_(2))、促卵泡生成激素(Follicle-stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)],血清免疫因子[CD3^(+)、CD4^(+)、CD4^(+)/CD8+、自然杀伤细胞(Natural killer cell,NK)]的变化,记录术后随访12个月内妊娠情况。结果治疗后观察组总有效率93.75%(75/80)明显高于对照组75.00%(60/80),差异有统计学意义(P<0.05)。治疗7 d后,观察组中医证候积分(6.63±1.72)分与对照组(9.24±1.86)分比较明显减少,差异有统计学意义(P<0.05)。治疗7 d后,观察组LH、FSH水平较治疗前明显降低,E_(2)水平较治疗前明显升高,差异有统计学意义(P<0.05);且观察组LH、FSH水平低于对照组,E_(2)水平高于对照组,差异有统计学意义(P<0.05)。治疗7 d后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及NK均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组高于对照组,差异有统计学意义(P<0.05)。观察组宫内妊娠率42.50%(34/80)较对照组20.00%(16/80)明显升高,差异有统计学意义(P<0.05);两组患者生化妊娠率、异位妊娠率比较,差异无统计学意义(P>0.05)。结论孕通汤组方联合宫腹腔镜手术能进一步提高盆腔输卵管性不孕症的治疗总有效率及宫内妊娠率,改善临床症状及卵巢功能,增强机体免疫功能。
Objective To explore the efficacy of Yuntong Decoction combined with hysteroscopy in the treatment of ovarian function and serum immune factors in patients with pelvic tubal infertility.Methods The sample size required for research was calculated by the formula of sample size comparison of two mean values.160 cases of pelvic tubal infertility with blood stasis admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2017 to June 2020 were selected and divided into a control group and an observation group according to the random number table method.80 cases of the control group were treated with hysteroscopy,and 80 cases of the observation group were treated with Yuntong Decoction combined with hysteroscopy.The scores of TCM syndromes and clinical signs of the two groups were compared after seven days of treatment.The changes in ovarian function indexes[estradiol(E_(2)),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)]and serum immune factors[CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and natural killer cells(NK)]were detected before and after seven days of treatment.The pregnancy situation 12 months after the operation was recorded.Results The total effective rate of the observation group after treatment was 93.75%(75/80),which was significantly higher than that of the control group 75.00%(60/80),and the difference was statistically significant(P<0.05).After seven days of treatment,the TCM syndrome score of the observation group(6.63±1.72)was significantly lower than that of the control group(9.24±1.86)(P<0.05);the levels of LH and FSH in the observation group were significantly lower than those before treatment,and the level of E_(2) was significantly higher than that before treatment(P<0.05).The levels of LH and FSH in the observation group were lower than those in the control group,and the level of E_(2) was higher than that in the control group(P<0.05).After seven days of treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and NK in the observation group were significantly high
作者
翟倩
陈秀英
吴尚青
王旭初
陈娜
杨栋宝
ZHAI Qian;CHEN Xiu-ying;WU Shang-qing;WANG Xu-chu;CHEN Na;YANG Dong-bao(Department of Gynecology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000;Department of Reproductive Medicine,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou Hebei 061000;Department of Anesthesia,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou Hebei 061000)
出处
《世界中西医结合杂志》
2023年第7期1448-1452,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河北省中医药管理局科研计划项目(2018484)。
