益气升提法干预治疗盆腔器官脱垂的临床研究

目的:通过补中益气汤配合聚丙烯网片盆底重建术综合治疗盆腔器官脱垂(POP)的方法,分析益气升提法干预治疗盆腔器官脱垂的作用及对手术效果的影响。方法:选择符合盆腔器官脱垂Ⅱ度及其以上诊断标准的气虚患者为观察对象,将患者随机分为中药加手术组34例和单纯手术组34例。术中取阴道壁组织采用免疫组化比较Ⅰ型、Ⅲ型胶原纤维变化,并于术后6个月随访,对术后各项指标及中医症候评分的变化进行评估。结果:①POP两组患者气虚积分、分级、总疗效、复发率、并发症比较,中药加手术组优于单纯手术组(P<0.05);②中药加手术组的Ⅰ、Ⅲ胶原阳性细胞灰度值与单纯手术组比较,差异有显著性(P<0.05)。结论:①手术配合中药综合治疗本病,疗效优于单纯手术;②中药加手术组对盆腔器官脱垂的总疗效及临床观察指标有明显的优势,益气升提法治疗POP提高了手术效果,显示了中西医结合治疗盆腔器官脱垂的优越性,可在临床推广应用。

Clinical research on benefiting vital energy and lifting treatment applied in treating pelvic organ prolapse

Objection:To analyze the effect of benefiting vital energy and lifting treatment on pelvic organ prolapse and its influence to operation,by using Buzhong Yiqi Decoction and reconstructing pelvic floor.Methods:Chose those patients with Ⅱ degree pelvic organ prolapse and deficiency of vital energy as the subject to observe.Randomly divided the patients into two groups:One group consisted of 34 patients using TCM and surgical therapy simultaneously;the other group consisted of 34 patients using surgical therapy only.Took tissue from vaginal wall to adopt immunohistochemistry to compare the collagenous fiber change of typeⅠand typeⅢ.With follow-up visit 6 months after the surgery,each index and change in TCM symptoms score could be evaluated.Results:①According to the comparison of the deficiency of vital energy score of integral,classification,overall curative effect and the recurrence rate,the group with TCM plus surgical therapy was better than the group with surgical therapy only(P<0.05);②There was significant difference in comparison of I&III collagen positive cells gray values between two groups(P<0.05).Conclusion:①The group with TCM plus surgical therapy was better than the group with surgical therapy only.②The overall curative effect clinical observation index of group A had obvious advantages in the cure of pelvic organ prolapse.Benefiting vital energy and lifting treatment improved the surgical effect,which showed the advantage of combined use of Western and Chinese medical treatment in pelvic organ prolapse.Therefore,benefiting vital energy and lifting treatment can be applied to clinical application.