中药配合人工授精对子宫内膜异位症腹腔镜术后患者的疗效

目的 探讨中药配合人工授精对子宫内膜异位症腹腔镜术后患者进行巩固治疗的临床疗效.方法 将50例子宫内膜异位症腹腔镜术后患者按随机数字表法分为2组,每组25例.对照组术后采用戈舍瑞林缓释植入剂3.6 mg腹前壁注射,第28天1次,共计3次.治疗组术后进行中药综合疗法(口服中药、中药灌肠及中药外敷),连续治疗3个月.2组均予相应治疗3个月后进行人工授精.3个月后对2组患者治疗前后痛经程度缓解,糖类抗原(CA125)、子宫内膜抗体(EMAb)的变化,伴随症状(肛门坠痛、性交痛、经期延长、经量过多等),排卵、活产及流产率等情况进行比较.结果 治疗前2组患者痛经、CA125、EMAb的变化及伴随症状比较差异均无统计学意义(均P＞0.05).治疗后2组患者痛经症状及伴随症状较治疗前明显改善,血清CA125水平及EMAb阳性率较治疗前均显著下降(均P＜0.05)；2组间比较差异无统计学意义(P＞0.05).2组周期排卵率、3个人工授精周期累计妊娠率、流产率及活产率比较,差异均无统计学意义(均P＞0.05).结论 中药配合人工授精对子宫内膜异位症腹腔镜术后患者具有较理想的止痛效果,同时可以抑制异位的子宫内膜活性,缓解痛经,且无不良反应.

Efficacy of Traditional Chinese Medicine Combined with Artificial Insemination in Patients Undergoing Laparoscopic Surgery for Endometriosis

Objective To investigate the clinical efficacy of traditional Chinese medicine combined with artificial insemination in patients undergoing laparoscopic surgery for endometriosis.Methods Fifty patients who underwent laparoscopic surgery for endometriosis were randomly divided into two groups,with 25 patients in each group.Patients in control group were injected with 3.6 mg sustained release goserelin implants into anterior abdominal wall on postoperative day 28 for 3 times.Patients in treatment group were postoperatively given comprehensive therapy with traditional Chinese medicine（oral application,enema and external application） for 3 months.Artificial insemination was performed after treatment for 3 months in both groups.The relief of dysmenorrheal,changes in CA125 and EMAb levels,associated symptoms（anal pain,algopareunia,bradymenorrhea and excessive menstrual volume）,ovulation rate,live birth rate,and abortion rate were compared between the two groups.Results There were no significant differences in the degree of dysmenorrheal,changes in CA125 and EMAb levels and associated symptoms between the two groups before treatment.After treatment,the dysmenorrhea and associated symptoms were obviously improved and serum CA125 levels and positive EMAb rates were remarkably decreased（all P0.05）,but no significant differences were found between the two groups（all P0.05）.In addition,there no were obvious differences in cumulative pregnancy rate,abortion rate and live birth rate between the two groups after 3 cycles of artificial insemination（all P0.05）.Conclusion Traditional Chinese medicine combined with artificial insemination has an ideal analgesic effect in patients undergoing laparoscopic surgery for endometriosis and can inhibit ectopic endometrial activity and alleviate dysmenorrheal without adverse reactions.