中国中医科学院广安门医院,北京市西城区北线阁5号,100053
chenruixue2864@gamyy.cn
收稿:2023-09-13,
修回:2023-12-25,
纸质出版:2024-03-02
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秦瑜玲,隋娟,周琳等.益气活血方治疗气虚血瘀证宫腔粘连患者随机对照临床观察[J].中医杂志,2024,65(05):489-494.
QIN YuLing,SUI Juan,ZHOU Lin,et al.Yiqi Huoxue Formula (益气活血方) for Intrauterine Adhesion with Syndrome of Qi Deficiency and Blood Stasis: A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2024,65(05):489-494.
秦瑜玲,隋娟,周琳等.益气活血方治疗气虚血瘀证宫腔粘连患者随机对照临床观察[J].中医杂志,2024,65(05):489-494. DOI: 10.13288/j.11-2166/r.2024.05.009.
QIN YuLing,SUI Juan,ZHOU Lin,et al.Yiqi Huoxue Formula (益气活血方) for Intrauterine Adhesion with Syndrome of Qi Deficiency and Blood Stasis: A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2024,65(05):489-494. DOI: 10.13288/j.11-2166/r.2024.05.009.
目的
2
观察益气活血方联合手术及雌激素、孕激素序贯治疗气虚血瘀证宫腔粘连患者的临床疗效及安全性。
方法
2
选取2021年6月1日至2022年12月31日在中国中医科学院广安门医院收治的宫腔粘连患者64例,随机分为治疗组和对照组各32例,均接受宫腔镜下宫腔粘连分离术(TCRA)治疗。对照组术后予雌激素、孕激素序贯治疗,每日口服1片,前14天服雌二醇片,后14天服雌二醇地屈孕酮片。治疗组术后在对照组治疗的基础上联合益气活血方治疗,每日1剂。两组疗程均为3个月。观察两组患者临床疗效、中医证候积分、子宫内膜厚度、宫腔粘连评分、月经量积分及治疗结束3个月后的复粘率、妊娠率,并进行安全性评价。
结果
2
治疗组和对照组临床总有效率分别为90.63%、75.00%,两组临床疗效差异有统计学意义(
P
<0.05)。两组患者治疗后子宫内膜厚度、月经量均较本组治疗前增加,宫腔粘连评分、中医证候积分较治疗前明显下降(
P
<0.05或
P
<0.01)。治疗后治疗组宫腔粘连评分、中医证候积分较对照组明显下降(
P
<0.05)。治疗组术后6个月妊娠率为37.50%,高于对照组的12.50%(
P
<0.05)。治疗组复粘率为3.13%,对照组为9.38%,两组复粘率比较差异无统计学意义(
P
>0.05)。两组均未出现不良事件。
结论
2
益气活血方联合手术及雌激素、孕激素序贯治疗宫腔粘连气虚血瘀证术后患者,可促进子宫内膜恢复,增加月经量,改善患者临床症状,提高妊娠率及临床疗效,且安全性好。
Objective
2
To observe the effectivenss and safety of
Yiqi Huoxue Formula
(益气活血方) combined with surgery and sequential therapy of estrogen and progesterone for the treatment of intrauterine adhesion with syndrome of
qi
deficiency and blood stasis.
Methods
2
Sixty-four patients with intrauterine adhesions were recruited in Guang'anmen Hospital, China Academy of Chinese Medical Sciences during 1st June 2021 to 31st December 2022, and they were randomly divided into two groups, with 32 patients in each group, all receiving transcervical resection of adhesions (TCRA). The control group was treated with sequential therapy of estrogen and progesterone after surgery, taking 1 tablet orally daily, estradiol tablets for the first 14 days, and estradiol dydrogesterone tablets for the last 14 days. In the treatment group, the postoperative treatment was combined with
Yiqi Huoxue Formula
on the basis of the treatment in the control group, and 1 dose was taken daily. The treatment course of both groups was 3 months. We observed the clinical effectiveness, syndrome scores of traditional Chinese Medicine (TCM), endometrial thickness, uterine adhesion score, menstrual flow points, and the re-adhesion rate and pregnancy rate 3 months after the end of treatment of the two groups, and conducted evaluation on safety.
Results
2
The total clinical effectiveness rates of the treatment group and the control group were 90.63% and 75.00%, respectively, significantly better in the treatment group (
P
<0.05). The endometrial thickness and menstrual flow of patients in both groups increased after treatment, and the scores of uterine adhesion and TCM syndrome scores decreased significantly (
P
<0.05 or
P
<0.01). After treatment, the uterine adhesion score and TCM syndrome scores of the treatment group decreased significantly compared with the control group (
P
<0.05). The 6-month postoperative pregnancy rate in the treatment group was 37.50%, higher than the 12.50% in the control group (
P
<0.05). The re-adhesion rate was 3.13% in the treatment group and 9.38% in the control group, and the difference between the two groups was not statistically significant (
P
>0.05). No adverse events occurred in both groups.
Conclusion
2
Yiqi Huoxue Formula
combined with surgery and sequential therapy of estrogen and progesterone for treating intrauterine adhesion patients with syndrome of
qi
deficiency and blood stasis can promote endometrial recovery, increase menstrual flow, improve patients' clinical symptoms, and improve pregnancy rate, showing certain clinical effectiveness and safety.
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