首页|肾虚血瘀方联合温肾促孕灸法对子宫内膜异位囊肿合并不孕症患者排卵情况、妊娠结局的影响

肾虚血瘀方联合温肾促孕灸法对子宫内膜异位囊肿合并不孕症患者排卵情况、妊娠结局的影响

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目的 观察肾虚血瘀方联合温肾促孕灸法对子宫内膜异位囊肿合并不孕症患者排卵情况、妊娠结局的影响.方法 将40 例子宫内膜异位囊肿合并不孕症患者按照随机数字表法分为 2 组,对照组 20 例予醋酸戈舍瑞林缓释植入剂治疗,治疗组20 例在对照组治疗基础上予肾虚血瘀方联合温肾促孕灸法治疗.2 组均治疗 3 个月经周期.比较2 组治疗前后中医证候评分、子宫内膜异位囊肿直径、疼痛视觉模拟评分(VAS)、卵巢功能指标[血清黄体生成激素(LH)、雌二醇(E2)、卵泡刺激素(FSH)],并统计2 组临床疗效、排卵率、排卵数量、1 年内临床妊娠率和早期流产率.结果 治疗组总有效率95.00%(19/20),对照组总有效率65.00%(13/20),治疗组临床疗效优于对照组(P<0.05).2 组治疗1、3 个疗程后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗 1、3 个疗程后均低于对照组同期(P<0.05).2 组治疗1、3 个疗程后子宫内膜异位囊肿直径、疼痛VAS均较本组治疗前降低(P<0.05),且治疗组治疗1、3 个疗程后均低于对照组同期(P<0.05).治疗组排卵率90.00%(18/20),对照组排卵率60.00%(12/20),治疗组排卵率高于对照组(P<0.05),治疗组排卵数量高于对照组(P<0.05).2 组治疗 1、3 个疗程后血清LH、FSH水平均较本组治疗前升高(P<0.05),血清E2 水平均降低(P<0.05),且治疗组治疗1、3 个疗程后血清LH、FSH水平均高于对照组同期(P<0.05),血清E2 水平低于对照组同期(P<0.05).治疗组1 年内临床妊娠率高于对照组(P<0.05),2 组 1 年内早期流产率比较差异无统计学意义(P>0.05).结论 肾虚血瘀方联合温肾促孕灸法可有效缓解子宫内膜异位囊肿合并不孕症患者腰腹疼痛、月经不调等症状,缩小囊肿直径,提高排卵率及临床妊娠率,改善卵巢指标及妊娠结局,临床疗效显著.
Effect of kidney-deficiency blood-stasisprescription combined with kidney-warming and pregnancy-promoting moxibustion on ovulation and pregnancy outcome in patients with endometriosis cyst complicated with infertility
Objective To analyze the effect of kidney-deficiency blood-stasisprescription combined with kidney-warming and pregnancy-promoting moxibustion on ovulation and pregnancy outcome in endometriosis cyst complicated with infer-tility.Methods Forty patients with endometriotic cysts and infertility were randomly divided into the control group(20 cases)and the treatment group(20 cases).All patients were treated with oxaliplatin acetate(Noride),those in the treatment group were additionally treated with kidney-deficiency blood-stasisprescription combined with kidney-warming and pregnancy-pro-moting moxibustion.Both groups were treated for 3 menstrual cycles.The traditional Chinese medicine(TCM)syndrome scores,diameter of endometriotic cysts,visual analogue scale(VAS)scores,and ovarian function indicators(serum luteinizing hormone[LH],estradiol[E2],follicle stimulating hormone[FSH])were included as comparatorsbetween two groups before and after treat-ment.The clinical efficacy,ovulation rate,ovulation number the clinical efficacy,1-year clinical pregnancy rateand early miscar-riage rate of the two groups were statistically analyzed.Results The total effective rate in the treatment group was significantly higher than that of the control group(95.00%[19/20]vs 65.00%[13/20],P<0.05).After 1 and 3 courses of treatment,the TCM syndrome dimension score,diameter of endometriosis cyst,and VAS for pain score in both groups were significantly lower than before treatment(P<0.05),and the decreases were more pronounced in the treatment group relative to the control group(P<0.05).The ovulation rate of the treatment group was significantly higher than that of the control group(90.00%[18/20]vs 60.00%[12/20],P<0.05),and the number of ovulations in the treatment group was significantly higher than that of the control group(P<0.05).After1 and3 courses of treatment,the serum levels of LH and FSH in both groups were significantly higher than those before treatment(P<0.05),while the serum levels of E2 were significantly lower(P<0.05),and there were differences in serum levels of LH,FSH and E2 between the two groups(all P<0.05).The 1-year clinical pregnancy rate in the treatment group was significantly higher than that of the control group(P<0.05),and there was no statistically significant differ-ence in 1-year early abortion rate between groups(P>0.05).Conclusion For patients with endometriotic cysts and infertility,kidney-deficiency and blood-stasis prescription combined with kidney-warming and pregnancy-promoting moxibustion can effectively relieve the symptoms of endometriosis cyst complicated with infertility,such as waist and abdomen pain,irregular menstruation.It is capable of reducing the diameter of the cyst,improving the ovulation rate and clinical pregnancy rate,impro-ving the ovarian index and pregnancy outcome,and the clinical effect is significant.

Endometriosis cystInfertilityKidney-deficiency and blood-stasis prescriptionKidney-warming and pregnancy-promoting moxibustionOvulationPregnancy Outcome

祝小欢、孙伟伟、储心乔、徐琳

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中国人民解放军联勤保障部队第908 医院健康医学科,江西 南昌 330000

中国中医科学院广安门医院妇科,北京 100053

中国中医科学院广安门医院针灸科,北京 100053

子宫内膜异位囊肿 不孕症 肾虚血瘀方 温肾促孕灸法 排卵情况 妊娠结局

中国中医科学院科技创新项目

CI2021A02401

2024

河北中医
河北省医学情报研究所,河北省中医药学会

河北中医

CSTPCD
影响因子:0.951
ISSN:1002-2619
年,卷(期):2024.46(5)