加味生化汤联合芬吗通及透明质酸钠凝胶预防人工流产术后宫腔粘连临床研究
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R714.21

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Clinical Study on Modified Shenghua Decoction Combined with Femoston and Sodium Hyaluronate Gel for Preventing Intrauterine Adhesion After Artificial Abortion
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    摘要:

    目的:观察加味生化汤联合芬吗通及透明质酸钠凝胶预防人工流产术后宫腔粘连(IUA) 血瘀肾 虚证的临床疗效。方法:选择2023年7月—2024年11月在平湖市妇幼保健院治疗的126例人工流产术患者, 按照随机数字表法分为西药组、中药组及联合组各42例。西药组采用芬吗通及透明质酸钠凝胶治疗,中药组 采用加味生化汤治疗,联合组在西药组基础上联合加味生化汤治疗。3组均治疗1个月,术后随访3个月。比 较3组治疗前后的中医证候评分、性激素水平,术后随访3个月的月经恢复情况、IUA发生率,治疗后的子宫 内膜厚度,治疗期间不良反应发生率。结果:治疗后,3组面色苍白、小腹疼痛、神疲懒言、阴道出血评分均 较治前降低(P<0.05),联合组面色苍白、小腹疼痛、神疲懒言、阴道出血评分均低于西药组、中药组(P< 0.05);西药组面色苍白、小腹疼痛、神疲懒言、阴道出血评分与中药组比较,差异均无统计学意义(P> 0.05)。术后随访3个月,联合组月经恢复情况优于西药组、中药组,联合组IUA发生率低于西药组、中药组, 差异均有统计学意义(P<0.05)。治疗后,联合组子宫内膜厚于西药组、中药组,差异均有统计学意义(P< 0.05)。3组雌二醇(E2) 均较治疗前升高,孕激素(P)、尿促卵泡素(FSH)、黄体生成素(LH) 均较治疗前 降低,联合组E2水平高于西药组、中药组,P、LH水平均低于西药组、中药组,差异均有统计学意义(P< 0.05)。3组间FSH水平比较,差异无统计学意义(P>0.05)。3组间不良反应发生率比较,差异无统计学意义 (P>0.05)。结论:加味生化汤联合芬吗通及透明质酸钠凝胶预防人工流产术后IUA血瘀肾虚证疗效好,可缓 解术后症状,促进月经恢复,降低IUA发生率,且安全性好。

    Abstract:

    Abstract:Objective:To observe the clinical effect of the combination use of modified Shenghua Decoction and Femoston and Sodium Hyaluronate Gel on preventing intrauterine adhesion(IUA)with syndrome of blood stasis and kidney deficiency after artificial abortion. Methods:A total of 126 patients who received artificial abortion and treated at Pinghu Women and Children's Hospital from July 2023 to November 2024 were selected and divided into the western medicine group,the Chinese medicine group and the combination group according to the random number table method, with 42 cases in each group. The western medicine group was treated with Femoston and Sodium Hyaluronate Gel,the Chinese medicine group was treated with modified Shenghua Decoction, and the combination group was additionally treated with modified Shenghua Decoction on the basis of the treatment in the western medicine group.All three groups were treated for one month, and followed up for three months after the surgery. The traditional Chinese medicine syndrome scores and sex hormone levels before and after treatment,the menstrual recovery status and the incidence rate of IUA during the three-month follow-up after surgery, as well as the endometrial thickness after treatment were compared among the three groups, The incidence of adverse reactions during treatment were respectively compared among the three groups. Results:After treatment,the scores of pale complexion,lower abdominal pain,lassitude in speech and vaginal bleeding in the three groups were decreased when compared with those before treatment(P<0.05); the above four scores in the combination group were lower than those in the western medicine group and the Chinese medicine group(P<0.05);there were no significant differences being found in the comparisons of above four scores between the western medicine group and the Chinese medicine group(P>0.05). During the three-month follow-up after surgery,the menstrual recovery status in the combination group was better than that in the western medicine group and the Chinese medicine group. The incidence rate of IUA in the combination group was lower than that in the western medicine group and the Chinese medicine group, with differences being significant(P<0.05). After treatment, the endometrial thickness in the combination group was greater than that in the western medicine group and the Chinese medicine group, with differences being significant(P<0.05).The levels of estradiol(E2)in the three groups were elevated when compared with those before treatment,and the levels of progesterone(P),urinary follicle stimulating hormone(FSH)and luteinizing hormone(LH)were reduced when compared with those before treatment(P<0.05). The E2 level in the combination group was higher than that in the western medicine group and the Chinese medicine group, and the levels of P and LH were lower than those in the western medicine group and the Chinese medicine group, differences being significant(P<0.05).There was no significant difference being found in the comparison of FSH level and incidence of adverse reactions among the three groups(P>0.05). Conclusion:The combination use of modified Shenghua Decoction and Femoston and Sodium Hyaluronate Gel has a good curative effect on preventing IUA with syndrome of blood stasis and kidney deficiency after artificial abortion,which can relieve the postoperative symptoms, promote the menstrual recovery,and reduce the incidence of IUA with good safety.

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闫琪,姜彦.加味生化汤联合芬吗通及透明质酸钠凝胶预防人工流产术后宫腔粘连临床研究[J].新中医,2025,57(17):21-26

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  • 在线发布日期: 2025-09-05
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