中药联合选择性输卵管再通治疗输卵管梗阻性不孕的临床观察

摘 要 目的：探讨分析中药联合选择性输卵管再通治疗输卵管梗阻性不孕的临床疗效。方法：回顾性病例分析，输卵管梗阻性不孕患者共120例，均行选择性输卵管造影+再通术治疗，术后其中60例常规预防感染治疗上自愿接受妇康汤口服、盆腔炎I号保留灌肠改善盆腔微循环（治疗组），另60例常规抗感染治疗并自愿不接受中药治疗（对照组）。记录输卵管梗阻部位、是否为双侧梗阻，手术成功率，受孕情况及手术相关并发症。结果：治疗组间质部(65条)、峡部梗阻(43条)且全部复通(100.0%)，壶腹部复通4条(80.0%)，伞端粘连包裹1条改为腹腔镜手术；单侧梗阻6例，双侧梗阻54例。对照组间质部(64条)、峡部梗阻(42条)全部复通(100.0%)，壶腹部（4条）复通(66.7%)，伞端阻塞2条改为腹腔镜手术；单侧梗阻7例，双侧53例。2组选择性再通成功率差异无统计学意义(x2=0.0000,P=1.0000)。随访显示，治疗组术后粘连梗阻发生率低于对照组(1.7% vs 13.3%)，而患者妊娠率治疗组高于对照组(95.0% vs 81.7%)，差异均有统计学意义(x2=4.3243, 3.9623, P=0.0376, 0.0465)。结论：中药联合选择性输卵管再通可降低输卵管梗阻术后再粘连，提高受孕率。

Clinical Observation of Chinese Medicine Combined with Selective Fallopian Tube Recanalization to Treat Fallopian Tube Obstruction Infertility

Abstract Objective: To investigate the efficacy of Chinese traditional medicine combined with selective salpingography and recanalization in treatment of tubal obstruction infertility. Method: Retrospective case analysis: 120 cases of infertility with tubal obstructive infertility were treated with selective salpingography and recanalization. Among them, 60 cases received voluntary oral administration of Fukang decoction and pelvic inflammation No. 1 enema after routine prevention of infection Improve pelvic microcirculation (treatment group), another 60 cases of conventional anti-infective treatment and voluntarily did not receive traditional Chinese medicine treatment (control group). Record the location of tubal obstruction, whether it is bilateral obstruction, surgical success rate, conception of pregnancy and surgical related complications. Result: In the treatment group, interstitial (65), isthmic obstruction (43) and all recanalization (100.0%), ampulla recanalization 4 (80.0%), and 1 umbrella-end adhesion wrap was changed to laparoscopic surgery; unilateral There were 6 cases of obstruction and 54 cases of bilateral obstruction. In the control group, interstitial (64) and isthmic obstruction (42) were all recanalized (100.0%), ampulla (4) was recanalized (66.7%), and 2 parachute obstructions were changed to laparoscopic surgery; unilateral There were 7 cases of obstruction and 53 cases of bilateral.There was no significant difference in the success rate of selective recanalization between the 2 groups (x2=0.0000, P=1.0000). Follow-up showed that the incidence of postoperative adhesion obstruction in the treatment group was lower than that in the control group (1.7% vs 13.3%), while the pregnancy rate in the treatment group was higher than that in the control group (95.0% vs 81.7%), the differences were statistically significant (x2= 4.3243, 3.9623, P=0.0376, 0.0465).Conclusion: Chinese medicine combined with selective fallopian tube recanalization can reduce re-adhesion after fallopian tube obstruction and improve the conception rate.