本文選題：膈下逐瘀湯加減方 + 輸卵管通液術(shù)　； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:1、通過(guò)臨床觀察和隨訪,研究口服膈下逐瘀湯加減方結(jié)合輸卵管通液術(shù)治療氣滯血瘀型輸卵管炎性不孕的臨床療效。2、通過(guò)觀察氣滯血瘀型輸卵管炎性不孕模型大鼠的部分宏觀特征、輸卵管組織形態(tài)、血液流變學(xué)、腫瘤壞死因子(TNF-α)及受孕率的變化,探討膈下逐瘀湯加減方治療氣滯血瘀型輸卵管炎性不孕的機(jī)制。方法:1、氣滯血瘀型輸卵管炎性不孕患者30例,給予膈下逐瘀湯加減方口服結(jié)合輸卵管通液術(shù),1個(gè)月為1個(gè)療程,治療3個(gè)療程,觀察患者的中醫(yī)證候、體征、輸卵管通暢度的改善情況。半年后電話隨訪,觀察受孕率。2、SD雌性大鼠48只,隨機(jī)分為正常組、模型組、中藥組、康婦炎組,除正常組外,其他組采用細(xì)菌接種聯(lián)合多因素刺激復(fù)制氣滯血瘀型輸卵管炎性不孕動(dòng)物模型。造模成功后,中藥組給予膈下逐瘀湯加減方灌服,康婦炎組灌服康婦炎懸液,模型組、正常組灌服同等劑量的純凈水,連續(xù)28天。觀察大鼠部分宏觀特征、輸卵管組織形態(tài)學(xué)變化、血液流變學(xué)指標(biāo)及輸卵管TNF-α的表達(dá)。與雄性大鼠合籠飼養(yǎng),觀察各組受孕率。結(jié)果:1、與治療前相比較,治療后患者的中醫(yī)證候、體征、輸卵管通暢度均有明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2、妊娠數(shù)17例,妊娠率為56.67%。3、模型組大鼠符合氣滯血瘀型輸卵管炎性不孕的病理特征和中醫(yī)證候特點(diǎn)。4、與模型組相比,各用藥組血液流變學(xué)指標(biāo)均有不同程度改善,以中藥組最佳。5、模型組輸卵管組織中TNF-α表達(dá)明顯升高,各治療組均有不同程度降低。6、與正常組相比,模型組受孕率顯著降低,其他各組均有不同程度改善,中藥組為最佳。結(jié)論:1、膈下逐瘀湯加減方結(jié)合輸卵管通液術(shù)能明顯改善氣滯血瘀型輸卵管炎性不孕患者的中醫(yī)證候、體征、輸卵管通暢度。2、膈下逐瘀湯加減方結(jié)合輸卵管通液術(shù)能有效提高氣滯血瘀型輸卵管炎性不孕患者的妊娠率。3、膈下逐瘀湯加減方能改善氣滯血瘀型輸卵管炎性不孕大鼠的體征和輸卵管的結(jié)構(gòu)、功能。4、膈下逐瘀湯加減方能明顯改善氣滯血瘀型輸卵管炎性不孕大鼠血液流變學(xué)的各項(xiàng)指標(biāo)。5、膈下逐瘀湯加減方能有效抑制氣滯血瘀型輸卵管炎性不孕大鼠輸卵管上皮細(xì)胞TNF-α的表達(dá)。6、膈下逐瘀湯能提高氣滯血瘀型輸卵管炎性不孕大鼠的受孕率。
[Abstract]:Objective: 1, through clinical observation and follow-up, To study the clinical curative effect of Gexia Zhuyu decoction combined with tubal fluid therapy on tubal inflammatory infertility of qi stagnation and blood stasis type. By observing some macroscopic features and tubal tissue morphology of rats with Qi-stagnation and blood-stasis type salpingitis infertility, the clinical effect of Gexia Zhuyu decoction on tubal inflammation infertility was studied. The changes of hemorheology, tumor necrosis factor (TNF- 偽) and pregnancy rate were studied. Methods 30 cases of tubal inflammatory infertility with qi stagnation and blood stasis type were treated with Gexia Zhuyu decoction orally combined with salpingocele operation, one month as a course of treatment, three courses of treatment, observing the TCM syndromes and signs of the patients. Improvement of tubal patency. After half a year's telephone follow-up, 48 SD female rats were randomly divided into normal group, model group, traditional Chinese medicine group, Kangfuyan group, except normal group. The other groups were treated with bacterial inoculation combined with multiple factor stimulation to establish the model of oviduct inflammatory infertility with qi stagnation and blood stasis. After the model was successfully made, the traditional Chinese medicine group was given Gexia Zhuyu decoction, the Kangfuyan group was infused with Kangfuyan suspension, the model group and the normal group were given the same dose of pure water for 28 days. The macroscopical features, histomorphology, hemorheology and the expression of TNF- 偽 in the tubal were observed. The pregnant rate of each group was observed by feeding in cage with male rats. Results compared with before treatment, the TCM syndromes, signs and patency of fallopian tubes were significantly improved after treatment. The difference was statistically significant (P0.05) .2The number of pregnancies was 17 cases. The pregnancy rate was 56.67. 3. The model group accorded with the pathological characteristics and TCM syndrome characteristics of tubal inflammatory infertility with Qi stagnation and blood stasis. Compared with the model group, the hemorheological indexes of each medication group were improved to some extent. The expression of TNF- 偽 in the oviducts of the model group was significantly higher than that in the control group, and the expression of TNF- 偽 in the oviducts of the model group was significantly increased. The pregnant rate of the model group was significantly lower than that of the normal group, and that of the other groups was better than that of the traditional Chinese medicine group. Conclusion: the combination of Wei 1, GE Xia Zhuyu decoction and salpingostomy can obviously improve the syndrome and signs of the patients with Qi-stagnation and blood-stasis type of salpingitis infertility. The unobstructed degree of fallopian tube. 2. The decoction of removing blood stasis under the diaphragm combined with the operation of tubal fluid can effectively improve the pregnancy rate of the infertile patients with tubal inflammation of qi stagnation and blood stasis type. The decoction of removing blood stasis under the diaphragm can improve the infertility of fallopian tube inflammation of qi stagnation and blood stasis type. The signs of the rat and the structure of the fallopian tube, Function. 4. The decoction of removing blood stasis under the diaphragm can obviously improve the indexes of hemorheology of the rats with tubal inflammation of Qi stagnation and blood stasis type. 5. The decoction of removing blood stasis under the diaphragm can effectively inhibit the transfusion of oocytes in the rats with inflammatory infertility of fallopian tube of qi stagnation and blood stasis type. The expression of TNF- 偽 in epithelial cells of tube. 6. Gexia Zhuyu decoction could improve the pregnancy rate of rats with tubal inflammatory infertility of qi stagnation and blood stasis type.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R271.14

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