摘要
目的 观察针刺联合中药灌肠治疗湿热瘀结型输卵管性不孕的临床疗效及对患者子宫动脉血流和盆腔局部微环境的影响。方法 将68例湿热瘀结型输卵管性不孕患者按照随机数字表法分为对照组和观察组,每组34例。对照组有1例因个人原因脱落,有1例失访脱落;观察组有2例失访脱落。两组最终纳入例数均为32例。对照组予中药灌肠治疗,观察组予针刺联合中药灌肠治疗。观察两组治疗前后血清炎症因子[白介素-6(interleukin-6, IL-6)和肿瘤坏死因子(tumor necrosis factor-α, TNF-α)]、性激素[促黄体生成素(luteinizing hormone, LH)、雌二醇(estradial, E2)和促卵泡生成激素(follicle-stimulating hormone, FSH)]以及子宫动脉血流[阻力指数(pulsatility index, RI)、血管化血流指数(vascular flow index, VFI)和搏动指数(pulsatility index, PI)]的变化;比较两组输卵管疏通情况与不良反应发生情况,比较两组治疗后6个月受孕成功率。结果 治疗后,两组TNF-α、IL-6、LH、FSH、RI、PI均较治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。治疗后,两组E2和VFI均较治疗前升高(P<0.05),且观察组均高于对照组(P<0.05)。治疗后,观察组输卵管通畅率高于对照组(P<0.05);治疗后6个月,观察组受孕成功率高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 针刺联合中药灌肠治疗湿热瘀结型输卵管性不孕的疗效优于单一中药灌肠治疗,可更好地改善盆腔局部微环境,调节性激素水平,改善子宫动脉血流,提高输卵管通畅率及受孕成功率,且不良反应发生率较低。
Objective To observe the clinical efficacy of acupuncture combined with traditional Chinese medicine(TCM)enema in the treatment of tubal infertility of damp-heat and blood stasis pattern,and its effects on uterine artery blood flow and the local pelvic microenvironment.Method A total of 68 patients with tubal infertility of damp-heat and blood stasis pattern were randomly divided into a control group and an observation group,with 34 cases in each group.In the control group,1 case dropped out for personal reasons and 1 case was lost to follow-up;in the observation group,2 cases were lost to follow-up.The final number of included cases in both groups was 32.The control group received TCM enema treatment,while the observation group received acupuncture combined with TCM enema treatment.The following indicators were observed before and after treatment:serum inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],sex hormones[luteinizing hormone(LH),estradiol(E_(2)),and follicle-stimulating hormone(FSH)],and uterine artery blood flow[resistance index(RI),vascular flow index(VFI),and pulsatility index(PI)].The patency of fallopian tubes and incidence of adverse reactions were compared between the two groups.The pregnancy success rate within 6 months after treatment was also compared.Result After treatment,TNF-α,IL-6,LH,FSH,RI,and PI levels were all significantly reduced in both groups(P<0.05),and these indicators were significantly lower in the observation group than in the control group(P<0.05).After treatment,E2 and VFI levels were significantly increased in both groups(P<0.05),and the observation group showed significantly higher values than the control group(P<0.05).After treatment,the fallopian tube patency rate in the observation group was higher than that in the control group(P<0.05);within 6 months post-treatment,the pregnancy success rate in the observation group was also higher than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Acupuncture combined with TCM enema is more effective than TCM enema alone in treating tubal infertility of damp-heat and blood stasis pattern.It can better improve the local pelvic microenvironment,regulate sex hormone levels,enhance uterine artery blood flow,increase fallopian tube patency rate and pregnancy success rate,with a lower incidence of adverse reactions.
作者
王钰凡
张来举
张艳梅
徐钰雯
WANG Yufan;ZHANG Laiju;ZHANG Yanmei;XU Yuwen(Urumqi Maternal and Child Health Hospital,Urumqi 830001,China;Urumqi Hospital of Traditional Chinese Medicine,Urumqi 830099,China;Xinyuan County People’s Hospital,Ili 835899,China)
出处
《上海针灸杂志》
2025年第8期960-965,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
乌鲁木齐市妇幼保健院科技计划项目(202208)。
关键词
针刺疗法
中药灌肠
输卵管阻塞
不孕症
不育
女性
妊娠
湿热瘀结
Acupuncture therapy
Traditional Chinese medicine enema
Tubal obstruction
Infertility
Female infertility
Pregnancy
Damp-heat and blood stasis
