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广元市中医医院妇产科,广元 628000
赵娅君,女,39岁,硕士,主治医师。研究方向:妇科疾病的中西医诊疗。
纸质出版日期:2024-10-25,
收稿日期:2023-07-18,
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赵娅君,李标,赵伟.疏肝益肾、活血通经方联合常规西医疗法治疗宫腔粘连肝郁肾虚兼血瘀证的临床观察[J].北京中医药,2024,43(10):1200-1204.
ZHAO Yajun,LI Biao,ZHAO Wei.Clinical observation of Shugan Yishen Formula, Huoxue Tongjing Formula combined with conventional western medicine in treatment of intrauterine adhesions with liver depression, kidney deficiency, and blood stasis syndrome[J]. Beijing Journal of Traditional Chinese Medicine,2024,43(10):1200-1204.
赵娅君,李标,赵伟.疏肝益肾、活血通经方联合常规西医疗法治疗宫腔粘连肝郁肾虚兼血瘀证的临床观察[J].北京中医药,2024,43(10):1200-1204. DOI: 10.16025/j.1674-1307.2024.10.028.
ZHAO Yajun,LI Biao,ZHAO Wei.Clinical observation of Shugan Yishen Formula, Huoxue Tongjing Formula combined with conventional western medicine in treatment of intrauterine adhesions with liver depression, kidney deficiency, and blood stasis syndrome[J]. Beijing Journal of Traditional Chinese Medicine,2024,43(10):1200-1204. DOI: 10.16025/j.1674-1307.2024.10.028.
目的
2
探讨疏肝益肾、活血通经方联合常规西医疗法治疗宫腔粘连(IUA)肝郁肾虚兼血瘀证的临床效果。
方法
2
选取广元市中医医院2019年9月—2021年11月收治的104例IUA肝郁肾虚兼血瘀证患者作为研究对象,按随机数字表分为对照组和联合组。在患者月经后3~7 d内,行宫腔镜下IUA分离术。对照组术后第2天给予戊酸雌二醇口服,3粒/次,2次/d,连续服用21 d;第11天加地屈孕酮,1粒/次,2次/d,连续服用10 d。有月经患者于经期第5天进入下个服药周期,无月经患者停药7 d后进入下个服药周期。连续治疗3个月经周期。联合组在对照组治疗基础上加服疏肝益肾、活血通经方,连续治疗3个月经周期。对比2组IUA评分、妊娠率、中医症状积分、子宫内膜厚度及月经情况、复发率及再住院率、用药安全性。
结果
2
治疗后,2组IUA评分均较治疗前降低(
P
<
0.01),且联合组低于对照组(
P
<
0.01)。术后随访1年,联合组妊娠率高于对照组,差异有统计学意义(
χ
2
=5.502,
P
=0.019)。治疗后,2组中医症状积分均较治疗前降低(
P
<
0.01),且联合组低于对照组(
P
<
0.01)。治疗后,2组子宫内膜厚度均较治疗前增加(
P
<
0.01),且联合组高于对照组(
P
<
0.01);2组月经状况评分均较治疗前降低(
P
<
0.01),且联合组低于对照组(
P
<
0.01)。联合组IUA复发率低于对照组,差异有统计学意义(
χ
2
=4.414,
P
=0.036),2组IUA再住院率比较差异无统计学意义(
P
>
0.05)。2组不良反应均轻微,无需特殊治疗即自行缓解。联合组的不良反应发生率为6.25%(3/48),对照组为2.08%(1/48),2组比较差异无统计学意义(校正
<math id="M1"><msup><mrow><mi>χ</mi></mrow><mrow><mn mathvariant="normal">2</mn></mrow></msup></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=69583141&type=
3.13266683
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=69583144&type=
3.04800010
=0.261,
P
=0.610)。
结论
2
疏肝益肾、活血通经方联合常规西医疗法能有效减轻IUA肝郁肾虚兼血瘀证患者中医症状、增厚子宫内膜、改善月经和宫颈粘连情况,且安全性高。
疏肝益肾、活血通经方宫腔粘连肝郁肾虚血瘀临床疗效安全性
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