中西医综合疗法对改善输卵管阻塞性不孕术后妊娠结局的临床研究

Clinical Study on the Effect of Integrated Traditional Chinese and Western Medicine Therapy on Improving Postoperative Pregnancy Outcomes of Tubal Obstructive Infertility

摘要: 目的：探讨以“清热化瘀–物理松解”为核心的中西医综合疗法，对改善湿热瘀阻型输卵管阻塞性不孕患者腹腔镜术后生殖结局的临床疗效。方法：本研究选取成都中医药大学附属医院(四川省中医院)、重庆市中医药及四川省第二中医院妇科门诊与住院部收治的60例已接受腹腔镜复通术的患者作为观察对象，将所有患者随机分配至两组：研究组(30例)接受中西医结合三联疗法，包括中药口服、中药保留灌肠及永磁旋振治疗仪治疗；对照组(30例)则接受中医二联疗法，包括中药口服与中药保留灌肠。治疗周期持续12周，评估两组患者在治疗前后的中医证候评分变化，比较其输卵管疏通率，并对治疗结束后1年内的宫内妊娠成功率进行随访统计。结果：在治疗前后，两组患者中医证候评分均较治疗前降低，差异均具有统计学意义(P < 0.05)；研究组中医证候评分改善程度、中医证候疗效总有效率、输卵管疏通率、妊娠率、宫内妊娠率均高于对照组，差异均具有统计学意义(P < 0.05)。结论：腹腔镜术后辅以清热利湿、化瘀通络为法的中西医结合综合疗法，可有效改善湿热瘀阻证候，提高输卵管远期疏通性和宫内妊娠率，为已行输卵管复通术的TOI患者术后康复提供了新思路。

Abstract: Objective: To investigate the clinical efficacy of the integrated traditional chinese and western medicine therapy centered on “clearing heat and resolving stasis-physical release” in improving the reproductive outcomes of patients with damp-heat stasis type tubal obstructive infertility after laparoscopic surgery. Methods: A total of 60 patients who had undergone laparoscopic recanalization and were admitted to the Gynecology Outpatient and Inpatient Departments of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Sichuan Provincial Hospital of Traditional Chinese Medicine), Chongqing Hospital of Traditional Chinese Medicine, and Sichuan Second Provincial Hospital of Traditional Chinese Medicine were selected as the subjects. All patients were randomly divided into two groups: The study group (30 cases) received the triple therapy of integrated traditional Chinese and Western medicine, including oral administration of traditional Chinese medicine, retention enema of traditional Chinese medicine, and treatment with a permanent magnetic rotary vibration therapeutic apparatus; the control group (30 cases) received the dual therapy of traditional Chinese medicine, including oral administration of traditional Chinese medicine and retention enema of traditional Chinese medicine. The treatment cycle lasted for 12 weeks. The changes of TCM syndrome scores before and after treatment were evaluated, the tubal recanalization rate was compared, and the intrauterine pregnancy success rate within 1 year after the end of treatment was followed up and counted. Results: Before and after treatment, the TCM syndrome scores of the two groups were lower than those before treatment, and the differences were statistically significant (P < 0.05); the improvement degree of TCM syndrome scores, total effective rate of TCM syndrome efficacy, tubal recanalization rate, pregnancy rate, and intrauterine pregnancy rate of the study group were higher than those of the control group, and the differences were statistically significant (P < 0.05). Conclusion: The integrated traditional Chinese and Western medicine therapy with the method of clearing heat and dampness, resolving stasis and unblocking collaterals after laparoscopic surgery can effectively improve the syndrome of damp-heat stasis, improve the long-term patency of fallopian tubes and the intrauterine pregnancy rate, and provide a new idea for the postoperative rehabilitation of TOI patients who have undergone tubal recanalization.