增膜助孕汤联合针刺对肾虚血瘀型不孕症患者子宫内膜容受性的影响
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R711.6

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2018年度浙江省基础公益研究项目计划(LGF18H270002)


Effect of Zengmo Zhuyun Tang Combined with Acupuncture on Endometrial Receptivity of Patients with Infertility of Kidney Deficiency and Blood Stasis Type
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    摘要:

    目的:探讨增膜助孕汤联合针刺治疗对肾虚血瘀型不孕症患者子宫内膜容受性的影响。方法:将60 例肾虚血瘀型不孕症妇女随机分为试验组(A 组) 和对照组(B 组)。B 组用阿司匹林片治疗,A 组在阿司匹林片治疗基础上增加中药增膜助孕汤联合针刺治疗。观察2 组患者治疗前及治疗后子宫内膜厚度、内膜形态、内膜下血流及双侧子宫动脉血阻力指数(RI)、收缩末期峰值/舒张末期流速(S/D) 值、妊娠率的变化。结果:治疗前,2 组内膜厚度比较,差异无统计学意义(P>0.05)。治疗后,A组内膜厚度较B 组增厚(P<0.05)。2 组治疗后内膜较前增厚,差异有统计学意义(P<0.05)。治疗后,A 组内膜形态与B 组比较,差异有统计学意义(P<0.05),且A 组内膜A 型率较多,C 型率较少,内膜形态优于B 组。治疗后,A 组子宫内膜RI 及S/D 值较治疗前降低(P<0.05)。B 组治疗后子宫内膜RI 及S/D 值较治疗前降低(P<0.05)。A 组治疗后的子宫内膜RI 与B 组比较,差异无统计学意义(P>0.05)。A 组治疗后的子宫内膜S/D 值较B 组降低明显,差异有统计学意义(P<0.05)。治疗后,A 组双侧子宫动脉RI 及S/D 值较治疗前降低,差异有统计学意义(P<0.05)。B 组治疗后双侧子宫动脉RI 及S/D 值较治疗前降低,差异有统计学意义(P<0.05)。A 组治疗后双侧子宫动脉RI 较B 组降低,差异无统计学意义(P>0.05),A 组治疗后双侧子宫动脉S/D 值较B 组明显降低,差异有统计学意义(P<0.05)。2 组治疗后及随访半年的妊娠率比较,差异均有统计学意义(P<0.05)。结论:在使用西药阿司匹林片的基础上增加中药增膜助孕汤联合针刺疗法,能够增加肾虚血瘀型不孕症妇女子宫内膜厚度,优化内膜形态,改善子宫内膜下血流及子宫动脉下血流阻力水平,从而改善子宫内膜容受性,并提高妊娠率。

    Abstract:

    Abstract: Objective: To discuss the effect of Zengmo Zhuyun tang combined with acupuncture on endometrial receptivity of patients with infertility of kidney deficiency and blood stasis type. Methods:A total of 60 cases of female with infertility of kidney deficiency and blood stasis type were randomly divided into the experiment group(Group A) and the control group(Group B). The group B was given aspirin tablets, and the group A was additionally given Zengmo Zhuyun tang of Chinese medicine combined with acupuncture based on the treatment of the control group. Before and after treatment,the changes in endometrial thickness,endometrial morphology,indexes of subendometrial blood flow and bilateral uterine artery blood flow(values of RI and S/D),and the rate of pregnancy were observed in the two groups. Results:Before treatment, there was no significant difference being found in the comparison of endometrial thickness between the two groups(P>0.05). After treatment, endometrial thickness in Group A was increased when compared with that in Group B(P<0.05). After treatment, endometrial thickness in the two groups was increased when compared with that before treatment(P<0.05). After treatment,the comparison of endometrial morphology between the two groups showed significance in the difference (P<0.05);the percentage of type A of endometrium in Group A was more than that in Group B,the percentage of type C less,and endometrial morphology better. After treatment,there was no significant difference being found in the comparison of RI of endometrium between the two groups(P>0.05). After treatment,the decrease of S/D of endometrium in Group A was more significant than that in Group B,the difference being significant(P<0.05). After treatment,values of RI and S/D of bilateral uterine artery in Group A were decreased when compared with those before treatment, the difference being significant(P<0.05);the two values above in the Group B were decreased when compared with those before treatment,the difference being significant(P<0.05). After treatment,the value of RI of bilateral uterine artery in the Group A was decreased when compared with that in the Group B,the difference being not significant(P>0.05);the value of S/D was significantly decreased,the difference being significant(P<0.05). The comparison of the rate of pregnancy after treatment with that in a half- year follow- up between the two groups showed significance in differences(P<0.05). Conclusion: Based on aspirin tablet, the therapy of Zengmo Zhuyun tang of Chinese medicine combined with acupuncture can increase endometrial thickness of female with infertility of kidney deficiency and blood stasis type, optimize endometrial morphology, improve levels of resistance of subendometrial blood flow and uterine artery blood flow. Therefore, endometrial receptivity is improved,and the rate of pregnancy is increased.

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高楚楚,陈浩波,胡欣欣,徐道芬.增膜助孕汤联合针刺对肾虚血瘀型不孕症患者子宫内膜容受性的影响[J].新中医,2021,53(19):138-142

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  • 在线发布日期: 2021-10-09
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