| 摘要: |
| 目的：观察中药口服联合熏蒸治疗输卵管近端阻塞性不孕宫腹腔镜COOK导丝介入术后的临床疗效。方法：选取90 例输卵管近端阻塞性不孕宫腹腔镜COOK导丝介入术后患者，采取随机数字表法将其分为治疗组与对照组，每组各45 例。对照组术后1个月开始试孕，治疗组在对照组基础上予以化瘀消癥汤口服联合芩黄消炎洗剂熏蒸治疗，治疗3个月经周期。比较2组未妊娠患者子宫动脉阻力指数(resistance index，RI)、子宫动脉搏动指数(pulsatility index，PI)、动脉收缩期峰值流速/舒张末期血流速度值(peak systolic velocity/end diastolic velocity，S/D)及术后12个月内患者妊娠情况、未妊娠者输卵管通畅情况。结果：治疗后2组PI、RI及S/D均较术前降低，且治疗组PI、RI及S/D均低于对照组(均P＜0.05)。术后12个月内的妊娠率治疗组为68.89%（31/45），高于对照组的42.22%（19/45），差异有统计学意义（P＜0.01）。术后12个月未妊娠者，行输卵管碘油造影示治疗组至少一侧输卵管通畅率为85.71%（12/14），对照组为57.69%（15/26），再堵塞率治疗组为14.29%（2/14），对照组为42.31%（11/26），2组差异均无统计学意义（P＞0.05）。结论：输卵管近端阻塞性不孕患者经宫腹腔镜COOK导丝介入术后采用中药口服联合熏蒸治疗，能够有效改善子宫动脉血流，增加输卵管通畅率，从而有效提高临床妊娠率。 |
| 关键词: 输卵管近端阻塞性不孕 宫腹腔镜COOK导丝介入术 中药口服 中药熏蒸 妊娠率 输卵管通畅率 |
| DOI： |
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| Clinical effect of oral administration of traditional Chinese medicine combined with fumigation and steaming therapy in treatment of patients with distal tubal obstructive infertility after hysteroscopy combined with laparoscopy：An analysis of 45 cases |
| LIU Yanling,PAN Lizhen,WU Haiting |
| (Nanping People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Nanping 353000，Fujian，China) |
| Abstract: |
| Objective：To investigate the clinical effect of oral administration of traditional Chinese medicine combined with fumigation and steaming therapy in the treatment of patients with distal tubal obstructive infertility after hysteroscopy-laparoscopy combined with interventional surgery with COOK guide wire.Methods：A total of 90 patients with distal tubal obstructive infertility after hysteroscopy-laparoscopycombined with interventional surgery with COOK guide wire were enrolled and divided into treatment group and control group using a random number table，with 45 patients in each group.The patients in the control group started to try to get pregnant at 1 month after surgery，and those in the treatment group were given oral administration of HuayuXiaozheng decoction combined with fumigation and steaming therapy with Qinhuang Xiaoyan lotion for 3 menstrual cycles in addition to the treatment in the control group.The two groups were compared in terms of resistance index(RI)，pulsatility index(PI)，and peak systolic velocity/end diastolic velocity(S/D) value of the uterine artery，as well as the condition of pregnancy within 12 months after surgery and fallopian tube patency in patients without pregnancy.Results：After treatment，both groups had significant reductions in PI，RI，and S/D，and the treatment group had significantly lower values than the control group (all P＜0.05).Compared with the control group，the treatment group had a significantly higher pregnancy rate within 12 months after surgery ［68.89% (31/45 vs 42.22% (19/45)，P＜0.01］.For the patients without pregnancy within 12 months after surgery，lipiodol hysterosalpingography showed that compared with the control group，the treatment group had a significantly higher patency rate of at least one fallopian tube ［85.71% (12/14) vs 57.69% (15/26)，P＞0.05］ and a significantly lower rate of fallopian tube obstruction ［14.29%(2/14) vs 42.31%(11/26)，P＞0.05］.Conclusion：After hysteroscopy-laparoscopycombined with interventional surgery with COOK guide wire，oral administration of traditional Chinese medicine combined with fumigation and steaming therapy for patients with distal tubal obstructive infertility can effectively improve blood flow in uterine artery，increase fallopian tube patency rate，and thus improve clinical pregnancy rate. |
| Key words: distal tubal obstructive infertility hysteroscopy-laparoscopy combined with interventional surgery with COOK guide wire oral administration of traditional Chinese medicine traditional Chinese medicine fumigation and steaming therapy pregnancy rate fallopian tube patency rate |
