| 杨汉铭,赵宏利,陈思忆.厚胞汤加减预防宫腔粘连松解术后再粘连的临床研究[J].浙江中医药大学学报,2020,44(7):633-638. |
| 厚胞汤加减预防宫腔粘连松解术后再粘连的临床研究 |
| Clinical Study of Houbao Decoction in Prevention of Re-adhesion after Trans-cervical Resection of Intrauterine Adhesion |
| DOI：10.16466/j.issn1005-5509.2020.07.007 |
| 中文关键词: 宫腔粘连 宫腔粘连松解术 厚胞汤 再粘连 激素 子宫内膜容受性 LIF ER |
| 英文关键词: intrauterine adhesion trans-cervical resection of adhesion Houbao decoction re-adhesion hormone endometrial receptivity leukemia suppressor factor estrogen receptor |
| 基金项目:浙江省中医药科技计划项目(2015ZA154) |
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| 中文摘要: |
| [目的]探讨厚胞汤加减预防宫腔粘连松解术后再粘连的临床疗效以及对宫腔粘连患者子宫内膜容受性的影响。[方法]选取2015年1月至2015年9月于杭州市中医院确诊为宫腔粘连的患者45例，随机分为激素组、中药组和联合组，每组15例，所有患者均行宫腔镜下粘连松解术并放置球囊导尿管，激素组术后采用人工周期疗法，中药组术后以厚胞汤加减口服，联合组则联用两种治疗方法，连续治疗3个周期。观察3组患者治疗前后月经及相关症状改善的情况及内膜粘连程度，并以免疫组化法检测患者分泌期子宫内膜白血病抑制因子(leukemia suppressor factor，LIF)、雌激素受体(estrogen receptor，ER)的表达水平。[结果]3组间比较，总体疗效无差异统计学意义(P＞0.05)。3组患者治疗后中医证候评分均低于治疗前，差异有统计学意义(P＜0.05)，联合组及中药组中医证候评分均显著优于激素组(P＜0.05)。3组患者治疗后宫腔粘连程度评分均低于治疗前，差异有统计学意义(P＜0.05)，其中联合组效果最佳(P＜0.05)。3组患者治疗后子宫内膜LIF、ER表达均显著增加(P＜0.05)，联合组LIF表达增加优于激素组(P＜0.05)，而ER表达增加优于激素组和中药组(P＜0.05)。[结论]厚胞汤加减联合激素治疗可有效改善宫腔粘连患者月经及相关症状，预防宫腔粘连松解术后再粘连，并能有效上调分泌期子宫内膜LIF、ER的表达水平。 |
| 英文摘要: |
| [Objective] To investigate the clinical effect of Houbao decoction in preventing re-adhesion after trans-cervical resection of adhesion(TCRA) and endometrial capacity of patients with intrauterine adhesion(IUA).[Methods] Forty-five cases selected in Hangzhou Hospital of Traditional Chinese Medicine from Jan. to Sep. 2015 diagnosed as moderate-severe IUA were randomly divided into hormone group， Chinese medicine group and combined group， 15 cases in each group， and all of them underwent TCRA and placement of a balloon catheter. The patients in hormone group underwent artificial cycle therapy after operation， Chinese medicine group underwent modified Houbao decoction and combined group experienced two kinds of treatment for three continuous treatment cycles for three consecutive cycles. The improvement of menstruation and related symptoms and the extent of endometrial adhesion before and after treatment were observed， and the expression level of leukemia suppressor factor(LIF) and estrogen receptor(ER) in the endometrium during the secretion stage were detected by immunohistochemistry before and after treatment in the three groups.[Results] There was no statistically significant difference in overall efficacy among the three groups(P＞0.05).The TCM syndrome scores of the three groups all decreased after treatment， and the difference was statistically significant(P＜0.05). The scores of combined group and Chinese medicine group were significantly better than those of hormone group(P＜0.05). The scores of uterine adhesion degree after treatment were lower than before treatment in the three groups， with significant difference(P＜0.05)， and combined group had the best effect(P＜0.05). The levels of LIF and ER in the endometrium significantly increased after treatment in the three groups(P＜0.05)， and the increasing of LIF expression in combined group was better than that in hormone group(P＜0.05)， and the increasing of ER expression was better than that in the other two groups(P＜0.05).[Conclusion] Modified Houbao decoction combined with hormone therapy can effectively improve the menstruation and related symptoms， prevent the re-adhesion after TCRA， and effectively increase the expression levels of LIF and ER in the endometrium of patients with IUA during the secretion stage. |
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