【摘要】：目的:通過觀察通管湯口服加灌腸治療輸卵管性不孕癥患者輸卵管通暢情況、臨床癥狀的改善情況、妊娠率及綜合療效,探討通管湯內(nèi)外結(jié)合治療輸卵管性不孕癥的臨床療效及作用機理。方法:收集2016年1月至2017年1月在江蘇省中醫(yī)院婦科門診就診的正虛血瘀型輸卵管性不孕癥患者63例,隨機分為中藥口服組(A),中藥灌腸組(B)及中藥口服加灌腸組(C)。A組:通管湯,200ml,口服,1劑/日,早晚分服;B組:通管湯,200ml,灌腸,1/每晚;C組:通管湯,口服加灌腸,方法同上。經(jīng)期均口服經(jīng)期方,停用口服及灌腸藥;4周為一個療程,觀察3個療程。觀察三組患者治療前后輸卵管通暢情況、臨床癥狀的改善情況、妊娠率及綜合臨床療效。通過spss23.0統(tǒng)計軟件,進行數(shù)據(jù)處理,分析研究結(jié)果。結(jié)果:1、輸卵管通暢情況:A組、B組、C組治療后輸卵管改善率分別為:15.00%、35.89%、64.10%,三組間比較,差異有統(tǒng)計學意義(P0.05)。其中,C組改善率明顯優(yōu)于A組和B組(P0.05);B組改善率優(yōu)于A組(P0.05)。2、證候積分變化情況:三組患者的治療后總積分均明顯小于治療前(P0.05);A組、B組、C組中醫(yī)證候總有效率分別為:80.96%、90.48%、95.24%,三組間比較,差異有統(tǒng)計學意義(P0.05)。其中,C組總有效率明顯優(yōu)于A組和B組(P0.05);A組和B組之間差異無統(tǒng)計學意義(P0.05)。3、妊娠情況:A組、B組、C組的妊娠率分別為19.05%、14.28%、38.10%,三組間比較,差異有統(tǒng)計學意義(P0.05)。其中,C組妊娠率明顯優(yōu)于A組和B組(P0.05);A組和B組妊娠率的比較,差異無統(tǒng)計學意義(P0.05)。三組患者治療后受孕時間的比較,差異均無統(tǒng)計學意義(P0.05)。4、綜合臨床療效:A組、B組、C組的總有效率分別為76.19%、71.42%、85.71%,三組間比較,差異有統(tǒng)計學意義(P0.05)。其中,C組總有效率明顯優(yōu)于A組和B組(P0.05);A組和B組之間差異無統(tǒng)計學意義(P0.05)。結(jié)論:應用通管湯三種不同方法治療輸卵管性不孕癥均取得顯著臨床療效;通管湯口服結(jié)合灌腸療法在輸卵管通暢、中醫(yī)癥狀改善、提高妊娠率及總有效率等方面療效均優(yōu)于單純中藥口服或單純中藥灌腸療法。
[Abstract]:Objective: to observe the patency of fallopian tube, the improvement of clinical symptoms, the pregnancy rate and the comprehensive curative effect in the treatment of tubal infertility by oral administration of Tongguan decoction and enema. To explore the clinical effect and mechanism of Tongguan decoction in the treatment of tubal infertility. Methods: from January 2016 to January 2017, 63 cases of tubal infertility with positive deficiency and blood stasis were collected from gynecological clinic of Jiangsu Provincial traditional Chinese Medicine Hospital. They were randomly divided into (A), enema group (B) and traditional Chinese medicine plus enema group (C) .A group): Tongguan decoction (200ml), oral dose of 1 dose / day, morning and evening, group B: Tongguan decoction 200ml, enema 1 / nightly C group: Tongguo decoction, oral plus enema, methods: same as above. Every menstrual period was given orally, and the oral and enema drugs were stopped for 4 weeks as a course of treatment, and three courses of treatment were observed. The patency of fallopian tube, improvement of clinical symptoms, pregnancy rate and comprehensive clinical effect were observed before and after treatment. Through the spss23.0 statistical software, data processing, analysis of the results. Results the oviduct patency in group A and B was significantly higher than that in group B (P 0.05). The improvement rate of fallopian tube in group B was respectively 64.100.The improvement rate of fallopian tube in group B was 64.100.The difference between the three groups was statistically significant (P0.05). The improvement rate of group C was significantly better than that of group A and group B (P0.05), the improvement rate of group B was better than that of group A (P0.05). The change of syndromes integral: the total integral of three groups after treatment was significantly lower than that before treatment (P0.05) the total effective rate of TCM syndromes of group A and group B was lower than that of group C, respectively. For: 80.96, 90.48 and 95. 24, comparison between the three groups, The difference was statistically significant (P0.05). The total effective rate of group C was significantly better than that of group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). The pregnancy rate of group B was 19.05 and 14.28. The difference between the three groups was statistically significant (P0.05). The pregnancy rate of group C was significantly better than that of group A and group B (P0.05), there was no significant difference between group A and group B (P0.05). There was no significant difference in the gestation time between the three groups after treatment (P0.05). The total effective rate of group B and C was 76.19 and 71.42, respectively. The difference between the three groups was statistically significant (P0.05). The total effective rate of group C was significantly better than that of group A and group B (P0.05). There was no significant difference between group A and group B (P0.05). Conclusion: three different methods of Tongguan decoction are effective in the treatment of tubal infertility. The effect of improving pregnancy rate and total effective rate was better than that of oral Chinese medicine alone or enema therapy of traditional Chinese medicine alone.
【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】：R271.14

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