输卵管再通术联合中药及理疗治疗阻塞性不孕临床效果研究

Clinical study on application of fallopian tube recanalization plus traditional Chinese medicine and physiotherapy in treating obstructive infertility

摘要:

目的 探讨输卵管再通术联合中药及理疗治疗梗阻性不孕的临床效果。方法 选取2016年1月—2018年2月邢台市人民医院收治的126例阻塞性不孕患者，采用随机数字表法分成观察组和对照组，每组63例。所有患者均择期行输卵管再通术治疗，对照组术后予以常规处理，观察组则在此基础上于术后首次月经干净后3 d以自拟抗炎通管汤（中药保留灌肠）+理疗治疗。比较两组的临床疗效、术后受孕情况、输卵管通畅情况、血清肿瘤坏死因子（TNF-α）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）水平、不良反应及并发症。结果 观察组总有效率为95.2%（60/63），对照组为79.4%（50/63），观察组总有效率高于对照组（P <0.05）。观察组术后1年内受孕率为71.4%（45/63），对照组为52.4%（33/63），观察组受孕率高于对照组（P <0.05）。术后1年，观察组未妊娠者输卵管通畅率高于对照组（P <0.05）。术后3个月，观察组血清TNF-α、IL-1、IL-6水平降低幅度大于对照组（P <0.05）。两组均未见与术后治疗相关的明显不良事件，术后均无子宫内膜或输卵管损伤、阴道流血及感染等严重并发症发生。结论 输卵管再通术联合中药及理疗治疗阻塞性不孕有助于维持患者术后输卵管的通畅，提高受孕率，减轻血清TNF-α、IL-1、IL-6等炎症因子反应，整体疗效确切。

Abstract:

Objective To explore the clinical efficacy of fallopian tube recanalization (FTR) plus traditional Chinese medicine and physiotherapy on obstructive infertility.Methods The subjects of this study, 126 patients with obstructive infertility admitted in our hospital from January 2016 to February 2018, were divided into observation group (n = 63) and control group (n = 63) on the basis of random number table. Besides FTR applied to all patients, the control group was administrated with conventional treatment after the operation, while the observation group was treated with Zini Kangyan Tongguan Decoction (Chinese medicine retention enema) combined with physiotherapy on the base of the control group. The clinical efficacy, postoperative pregnancy, tubal patency, serum levels of inflammatory factors, adverse reactions, and complications were compared between the two groups.Results The total effective rate was 95.2% (60/63) in the observation group and 79.4% (50/63) in the control group. The total effective rate in the observation group was higher than that in the control group (P < 0.05). The pregnancy rate of the observation group was 71.4% (45/63) in one year after operation, and that of the control group was 52.4% (33/63), and the pregnancy rate of the observation group was higher than that of the control group (P < 0.05). One year after operation, the non-pregnant tubal patency in the observation group was significantly better than that of the control group (P < 0.05). Three months after operation, the improvement of the serum levels of TNF-α, IL-1, IL-6 in the observation group were significantly better than that in the control group (P < 0.05). No severe side effect appeared in two group, such as endometrial or fallopian tube damage, vaginal bleeding or infection.Conclusion FTR combined with traditional Chinese medicine and physiotherapy in the treatment of obstructive infertility is helpful to maintain the patency of fallopian tube, improve the pregnancy rate, and alleviated the inflammatory reaction of serum TNF-α, IL-1, IL-6 and other inflammatory factors, with exactly overall effect.