本文關鍵詞：化瘀通絡方聯合腹腔鏡手術對輸卵管性不孕患者臨床療效評價　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 輸卵管炎性不孕 腹腔鏡 中醫(yī)藥 腹腔液IL-2 子宮內膜容受性 臨床研究

【摘要】：目的:通過觀察輸卵管性不孕患者經腹腔鏡手術聯合中藥治療與單純行腹腔鏡手術治療,分析比較治療前后患者中醫(yī)癥狀、局部體征、子宮內膜容受性、妊娠率及輸卵管再通率以及術中腹腔液白介素-2的表達,為化瘀通絡中藥治療輸卵管性不孕提供理論依據,提高中西醫(yī)聯合治療輸卵管性不孕的臨床水平。方法:納入符合標準的50例輸卵管性不孕患者,隨機分為2組,治療組予中藥聯合腹腔鏡治療,對照組單純行腹腔鏡治療。治療組于術前、術后分別予中藥口服三個月,兩組術后均隨訪半年。治療前后分別對兩組患者進行安全性指標檢測、療效分析,觀察對比兩組術中腹腔液IL-2的水平高低、子宮內膜容受性的改變、癥狀體征的改善及術后妊娠率、輸卵管通暢率。結果:1.兩組患者術中腹腔液IL-2的表達有明顯差異(P0.05)。2.對兩組治療后妊娠情況隨訪后進行比較,治療組宮內64.0%,無異位妊娠;對照組宮內32.0%,并且有3例患者異位妊娠,兩組妊娠率有明顯差異(P0.05)。3.兩組術后未成功自然受孕患者輸卵管通暢情況相比,治療組術后通暢情況明顯優(yōu)于對照組(P0.05)。4.兩組分別經中西醫(yī)聯合治療、單獨西醫(yī)治療后局部體征總有效率分別為92.0%、76.0%,兩組均能改善局部體征,但治療組的降低效果更明顯(P0.05),療效更佳;兩組中醫(yī)癥狀改善情況總有效率分別為92.0%、68.0%,兩組治療對中醫(yī)癥狀均有改善作用,但治療組療效更佳(P0.05)。5.兩組治療前后子宮動脈PI、RI比較,治療組能更好的降低動脈血流阻力,提高子宮內膜容受性(P0.05),而對照組也稍有下降,但其下降幅度遠遠不及治療組。結論:化瘀通絡中藥聯合腹腔鏡可以有效降低患者腹腔液中炎癥因子IL-2的水平,降低宮腔局部血流阻力,增加灌注,改善患者子宮內膜容受性,緩解患者的臨床癥狀,恢復輸卵管正常解剖、生理功能,增加宮內妊娠率。
[Abstract]:Objective: to analyze and compare the symptoms, local signs and endometrial receptivity of patients with tubal infertility by laparoscopy combined with traditional Chinese medicine and laparoscopic surgery alone. Pregnancy rate, fallopian tube recanalization rate and intraoperative expression of interleukin-2 in peritoneal fluid provide theoretical basis for the treatment of tubal infertility with traditional Chinese medicine for removing blood stasis and dredging collaterals. Methods: 50 cases of oviduct infertility were randomly divided into two groups, the treatment group was treated with traditional Chinese medicine combined with laparoscopy. The control group was treated by laparoscopy alone. The treatment group was treated with traditional Chinese medicine orally for three months before and after operation, and the two groups were followed up for half a year. The safety indexes were detected before and after treatment, and the curative effect was analyzed. The levels of IL-2 in intraoperative celiac fluid, the changes of endometrial receptivity, the improvement of symptoms and signs and the rate of pregnancy after operation were observed and compared between the two groups. Results there was a significant difference in the expression of IL-2 in intraoperative peritoneal fluid between the two groups. The pregnancy status after treatment was compared between the two groups. In the treatment group, there was no ectopic pregnancy. There were 3 cases of ectopic pregnancy in the control group. There was significant difference in pregnancy rate between the two groups. The postoperative patency in the treatment group was significantly better than that in the control group (P 0.05). 4. The total effective rate of local signs in the two groups was 92.0% and 76.0%, respectively, after the combined treatment of traditional Chinese and western medicine. Both groups were able to improve local signs, but the effect of the treatment group was better than that of the control group (P 0.05). The total effective rate of TCM symptom improvement in the two groups was 92.0 and 68.0 respectively. However, the therapeutic effect of the treatment group was better than that of the treatment group. Compared with the uterine artery Pi RI before and after treatment, the treatment group could lower the arterial flow resistance and improve the endometrial receptivity (P0.05). The control group also slightly decreased, but its decline is far less than the treatment group. Conclusion: combined with laparoscopy can effectively reduce the level of inflammatory factor IL-2 in the peritoneal fluid of patients. Reduce local blood flow resistance, increase perfusion, improve endometrial receptivity, alleviate clinical symptoms, restore normal anatomy of fallopian tubes, physiological function, increase the rate of intrauterine pregnancy.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R711.6

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