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目的:观察补肾活血周期治疗联合西药对宫腔粘连术后患者中医证候的改善情况及对子宫内膜厚度、子宫动脉血流的影响,探讨补肾活血周期治疗联合西药治疗本病的临床疗效及对宫腔粘连术后子宫内膜的影响。方法:将100例宫腔粘连术后患者,按随机单盲法分为中药组和对照组各50例。中药组用中药补肾活血周期治疗联合西药雌孕激素人工周期治疗,对照组单纯用西药人工周期治疗,用药3个月经周期后观察两组患者中医证候的改善情况,超声下观察对子宫内膜、子宫动脉血流的影响以及在宫腔镜下观察粘连程度的改善情况。结果:二组治疗后中医证候积分、粘连评分均较治疗前下降(P<0.05),组间比较,中药组均优于对照组(P<0.05);治疗后,中药组子宫内膜厚度明显增加,子宫内膜血流参数PI、RI均明显降低(P<0.05),组间比较,治疗后中药组子宫内膜厚度明显大于对照组(P<0.05);搏动指数PI比较,差异无统计学意义(P>0.05);阻力指数RI比较,差异有统计学意义(P<0.05)。结论:补肾活血周期治疗联合西药可降低患者的粘连评分及中医证候评分,改善子宫内膜厚度,增加子宫内膜血流,其机制可能与促进子宫内膜修复,改善子宫血流灌注量有关。
Objective: To observe the effect of Bushen Huoxue cycle combined with Western medicine on patients with intrauterine adhesions after the improvement of TCM symptoms and endometrial thickness, uterine artery blood flow to explore the clinical efficacy of the Bushenhuoxu cycle combined with western medicine in the treatment of the disease and Effect of intrauterine adhesions on endometrium. Methods: 100 cases of intrauterine adhesions patients were randomly divided into two groups according to randomized single-blind control group and control group of 50 cases. Chinese medicine group with Chinese medicine kidney and blood circulation treatment combined with Western medicine estrogen and progesterone artificial periodical treatment, the control group was treated with Western medicine artificial cycle, medication three menstrual cycles after treatment to observe the improvement of TCM syndromes, ultrasound observed under the endometrium , The effect of uterine artery blood flow and the improvement of adhesion observed under hysteroscopy. Results: The TCM syndrome score and adhesion score of the two groups were significantly lower than those before treatment (P <0.05). After treatment, the Chinese medicine group was better than the control group (P <0.05). After treatment, the thickness of the endometrium (P <0.05). After treatment, the thickness of endometrium in traditional Chinese medicine group was significantly larger than that in control group (P <0.05). The difference of PI in pulsatility index Statistical significance (P> 0.05); resistance index RI, the difference was statistically significant (P <0.05). Conclusion: Bushenhuoxue cycle combined with Western medicine can reduce the patient’s adhesion score and TCM syndrome score, improve the endometrial thickness and increase the endometrial blood flow, the mechanism may be related to the promotion of endometrial repair and improve the uterine perfusion .