【摘要】：目的：通過臨床實(shí)驗(yàn)研究,觀察宮腔鏡下粘連分離術(shù)后運(yùn)用中藥補(bǔ)腎化瘀法聯(lián)合補(bǔ)佳樂對(duì)宮腔操作術(shù)后宮腔粘連患者月經(jīng)量的恢復(fù)、中醫(yī)證候的改善、子宮內(nèi)膜形態(tài)、子宮動(dòng)脈血流灌注以及血清炎性因子IL-6的影響,探討中藥治療本病的臨床療效,并對(duì)其作用機(jī)理進(jìn)行初步研究。方案：將因?qū)m腔操作術(shù)后引起月經(jīng)量少且宮腔鏡檢查符合宮腔輕度-中度粘連的40例患者,隨機(jī)分為治療組20例及對(duì)照組20例,兩組均于治療前在宮腔鏡下行粘連分離術(shù),術(shù)后治療組予以補(bǔ)腎化瘀中藥聯(lián)合補(bǔ)佳樂治療,對(duì)照組單用補(bǔ)佳樂治療,治療3個(gè)月經(jīng)周期,觀察治療組及對(duì)照組經(jīng)治療后其主癥月經(jīng)情況以及相關(guān)臨床伴隨癥狀的改善,宮腔鏡下粘連程度是否改善,受損子宮內(nèi)膜恢復(fù)情況及對(duì)血清炎性因子IL-6的影響。結(jié)果：兩組經(jīng)治療后,治療組及對(duì)照組總有效率分別為90.00%、75.00%,治療組總體療效優(yōu)于對(duì)照組(P0.05)。經(jīng)治療后,治療組對(duì)主癥月經(jīng)情況的改善與對(duì)照組相比具有明顯優(yōu)勢(shì)(P0.05)。兩組患者經(jīng)治療后中醫(yī)證候較療前均有所緩解,治療組及對(duì)照組總有效率分別為90.00%、65.00%,比較具有顯著性差異(P0.05)。兩組經(jīng)治療后IUA評(píng)分較前均降低,黃體期子宮內(nèi)膜厚度較治療前均增厚,子宮動(dòng)脈血流阻力指數(shù)(RI)較治療前均降低(P0.05),但兩組間比較P0.05,不具有統(tǒng)計(jì)學(xué)意義。治療后兩組患者子宮動(dòng)脈血流搏動(dòng)指數(shù)(PI)較治療前無顯著性差異(P0.05),組間比較亦無統(tǒng)計(jì)學(xué)意義(P0.05)。治療后兩組患者血清IL-6均較治療前降低(P0.05),組間比較具有顯著性差異(P0.05)。結(jié)論：宮腔粘連分離術(shù)后采用補(bǔ)腎化瘀中藥聯(lián)合雌激素對(duì)治療宮腔操作術(shù)后宮腔粘連導(dǎo)致的月經(jīng)過少甚則閉經(jīng)的臨床療效肯定,分析此法可能通過增強(qiáng)機(jī)體的免疫機(jī)能,促進(jìn)盆腔器官血流循環(huán),從而加快受損內(nèi)膜的再生使其臨床癥狀改善。
[Abstract]:Objective: to observe the recovery of menstrual volume, the improvement of TCM syndrome and the shape of endometrium in patients with uterine cavity adhesion after hysteroscopic adhesion separation with the method of tonifying the kidney and removing blood stasis combined with BujiaLe, and observing the recovery of menstrual volume, the improvement of TCM syndrome and the shape of endometrium in patients with uterine cavity adhesion after hysteroscopic surgery. The effects of uterine artery perfusion and serum inflammatory factor IL-6 were studied to explore the clinical efficacy and mechanism of traditional Chinese medicine (TCM) in the treatment of the disease. Methods: 40 patients with mild to moderate adhesion were randomly divided into two groups: treatment group (n = 20) and control group (n = 20). The two groups were divided into two groups: before treatment, they were separated by hysteroscopy under hysteroscopy, and were divided into two groups: the treatment group (n = 20) and the control group (n = 20). The patients in the treatment group were treated with traditional Chinese medicine for tonifying kidney and removing blood stasis combined with Jiaxe, while the control group were treated with Bujiaxe only for 3 months. The main symptoms and menstruation of the treatment group and the control group were observed after treatment, as well as the improvement of the related clinical concomitant symptoms. Whether the degree of adhesion under hysteroscopy was improved, the recovery of damaged endometrium and the effect on serum inflammatory factor IL-6. Results: after treatment, the total effective rates of the treatment group and the control group were 90.00% and 75.00%, respectively. The overall curative effect of the treatment group was better than that of the control group (P0.05). After treatment, the improvement of menstruation in the treatment group was superior to that in the control group (P0.05). The total effective rate of the treatment group and the control group were 90.00% and 65.00% respectively. There was significant difference between the two groups (P0.05). After treatment, the IUA score of the two groups was lower, the thickness of endometrium in luteal phase was thicker than that before treatment, and the resistance index of uterine artery blood flow (RI) was lower than that before treatment (P0.05), but there was no significant difference between the two groups (P 0.05). After treatment, there was no significant difference in uterine artery pulsatility index (PI) between the two groups (P0.05), and there was no significant difference between the two groups (P0.05). After treatment, the serum IL-6 of the two groups was lower than that before treatment (P0.05), and there was significant difference between the two groups (P0.05). Conclusion: the combination of traditional Chinese medicine for tonifying kidney and removing blood stasis combined with estrogen is effective in the treatment of menorrhagia and even amenorrhea caused by uterine cavity adhesion after operation of uterine cavity. This method may enhance the immune function of the body by analyzing the therapeutic effect of this method on menstrual dysmenorrhea caused by uterine cavity adhesion after operation. Promote pelvic organ blood circulation, thus accelerate the regeneration of damaged intima to improve its clinical symptoms.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.9

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王雅琴;楊菁;石華;謝青貞;吳庚香;;經(jīng)陰道三維超聲成像在宮腔粘連中的診斷價(jià)值[J];臨床超聲醫(yī)學(xué)雜志;2011年03期

2 張曉峰;苗杰;;子宮輸卵管造影術(shù)在宮腔粘連中的應(yīng)用[J];中國(guó)醫(yī)藥導(dǎo)報(bào);2012年22期

3 秦虹;張軍喜;王蕾;徐娜;李娟;;宮腔內(nèi)超聲診斷輕、中度宮腔粘連的價(jià)值探討[J];中國(guó)計(jì)劃生育和婦產(chǎn)科;2013年05期

4 Schenker JG;肖鑄瑗;;宮腔粘連征(Ascherman's syndrome)的最新評(píng)價(jià)[J];國(guó)外醫(yī)學(xué).婦產(chǎn)科學(xué)分冊(cè);1983年05期

5 榮抗美;宮腔粘連的診斷與處理[J];濱州醫(yī)學(xué)院學(xué)報(bào);1993年04期

6 王明陽;;宮腔粘連的診治現(xiàn)狀[J];中外醫(yī)療;2014年09期

7 劉漣;宮腔粘連的宮腔鏡診斷和治療[J];武漢市職工醫(yī)學(xué)院學(xué)報(bào);2000年03期

8 何曉宇,黃惠娟,宋健;宮腔鏡診治宮腔粘連合并不孕的評(píng)價(jià)[J];中國(guó)微創(chuàng)外科雜志;2002年S1期

9 汪愛兵,丁小蘭,馬萬增;宮腔鏡在宮腔粘連診斷和治療中的應(yīng)用價(jià)值[J];中國(guó)醫(yī)刊;2004年07期

10 郭寶艷;中西醫(yī)結(jié)合治療宮腔粘連58例[J];中國(guó)民間療法;2004年06期

相關(guān)會(huì)議論文 前10條

1 劉玉環(huán);夏恩蘭;趙玉婷;宋冬梅;周鳳瓊;;大劑量雌激素改善中重度宮腔粘連預(yù)后的研究[A];中華醫(yī)學(xué)會(huì)第十次全國(guó)婦產(chǎn)科學(xué)術(shù)會(huì)議婦科內(nèi)鏡會(huì)場(chǎng)（婦科內(nèi)鏡學(xué)組）論文匯編[C];2012年

2 上官雪軍;楊梅麗;張琴芳;;三種方式防止宮腔粘連分離手術(shù)后再粘連效果的臨床觀察[A];第八次全國(guó)婦產(chǎn)科學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2004年

3 成九梅;夏恩蘭;段華;;轉(zhuǎn)化生長(zhǎng)因子β1在宮腔粘連發(fā)病機(jī)制中的作用[A];第八次全國(guó)婦產(chǎn)科學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2004年

4 王慧民;;中西醫(yī)結(jié)合治療宮腔粘連的系統(tǒng)評(píng)價(jià)[A];第八屆全國(guó)中西醫(yī)結(jié)合婦產(chǎn)科學(xué)術(shù)大會(huì)論文及摘要集[C];2012年

5 張海霞;朱學(xué)平;陳芙庭;馬鑫;;經(jīng)陰道超聲三維成像在宮腔粘連診斷中的應(yīng)用價(jià)值[A];2012年浙江省超聲醫(yī)學(xué)學(xué)術(shù)年會(huì)論文集[C];2012年

6 徐開紅;;宮腔粘連的診治現(xiàn)狀[A];2012年浙江省婦產(chǎn)科學(xué)及圍產(chǎn)醫(yī)學(xué)學(xué)術(shù)年會(huì)暨《婦產(chǎn)科常見疾病規(guī)范化治療新進(jìn)展》及《圍產(chǎn)醫(yī)學(xué)熱點(diǎn)追蹤》學(xué)習(xí)班論文集[C];2012年

7 花向東;顧小燕;許鋒;張紅洋;王素敏;;200例宮腔粘連診治分析[A];中華醫(yī)學(xué)會(huì)第十次全國(guó)婦產(chǎn)科學(xué)術(shù)會(huì)議婦科內(nèi)鏡會(huì)場(chǎng)（婦科內(nèi)鏡學(xué)組）論文匯編[C];2012年

8 周鳳瓊;劉玉環(huán);夏恩蘭;宋冬梅;;結(jié)核性宮腔粘連的臨床診治分析[A];中華醫(yī)學(xué)會(huì)第十次全國(guó)婦產(chǎn)科學(xué)術(shù)會(huì)議婦科內(nèi)鏡會(huì)場(chǎng)（婦科內(nèi)鏡學(xué)組）論文匯編[C];2012年

9 董明理;;宮腔粘連的危險(xiǎn)因素分析[A];中華醫(yī)學(xué)會(huì)第十次全國(guó)婦產(chǎn)科學(xué)術(shù)會(huì)議婦科內(nèi)鏡會(huì)場(chǎng)（婦科內(nèi)鏡學(xué)組）論文匯編[C];2012年

10 王寶金;申愛榮;楊淑玲;王魯文;白樺;;宮腔粘連316例臨床療效分析[A];中華醫(yī)學(xué)會(huì)第十次全國(guó)婦產(chǎn)科學(xué)術(shù)會(huì)議婦科內(nèi)鏡會(huì)場(chǎng)（婦科內(nèi)鏡學(xué)組）論文匯編[C];2012年

相關(guān)重要報(bào)紙文章 前1條

1 程懷孟;人流后當(dāng)心宮腔粘連[N];大眾衛(wèi)生報(bào);2009年

相關(guān)博士學(xué)位論文 前3條

1 劉麗文;中藥滋腎養(yǎng)膜方對(duì)宮腔粘連內(nèi)膜修復(fù)和妊娠結(jié)局的臨床研究[D];湖南中醫(yī)藥大學(xué);2015年

2 楊茜;經(jīng)宮腔鏡宮腔粘連分離術(shù)后戊酸雌二醇應(yīng)用療效分析[D];中南大學(xué);2013年

3 林小娜;改善宮腔粘連預(yù)后的臨床和動(dòng)物實(shí)驗(yàn)研究[D];浙江大學(xué);2015年

相關(guān)碩士學(xué)位論文 前10條

1 張建潔;宮腔粘連分離術(shù)對(duì)妊娠結(jié)局的影響(附76例報(bào)道)[D];河北醫(yī)科大學(xué);2015年

2 祁鑫;陰道用芬嗎通對(duì)宮腔粘連的療效觀察[D];河北醫(yī)科大學(xué);2015年

3 杜艷芳;ER、PR和NF-κB在宮腔粘連發(fā)病機(jī)制中的意義及155例宮腔粘連的臨床分析[D];廣西醫(yī)科大學(xué);2016年

4 朱瑋;益腎養(yǎng)血調(diào)膜湯防治宮腔粘連致月經(jīng)過少（腎虛血虧型）的臨床研究[D];福建中醫(yī)藥大學(xué);2016年

5 蒙思林;重度宮腔粘連69例臨床資料回顧性分析[D];重慶醫(yī)科大學(xué);2016年

6 孫聰聰;羊膜移植預(yù)防宮腔粘連術(shù)后再粘連的研究進(jìn)展[D];重慶醫(yī)科大學(xué);2016年

7 徐雅珍;補(bǔ)腎化瘀法聯(lián)合補(bǔ)佳樂治療宮腔粘連術(shù)后的臨床研究及對(duì)外周血IL-6的影響[D];南京中醫(yī)藥大學(xué);2016年

8 汪鳳儀;宮腔粘連分離術(shù)聯(lián)合滋陰活血湯及雌孕激素序貫療法治療宮腔粘連的臨床研究[D];南京中醫(yī)藥大學(xué);2016年

9 羅舒茜;消ve調(diào)血方聯(lián)合雌孕激素序貫法治療宮腔粘連的臨床研究及對(duì)IL-6和8、VEGF、TNF-α的影響[D];南京中醫(yī)藥大學(xué);2016年

10 王嘉蕙;滋陰補(bǔ)陽方序貫聯(lián)合西藥治療宮腔粘連所致不孕的臨床研究[D];南京中醫(yī)藥大學(xué);2016年

，

本文編號(hào)：2468373