腹腔镜术联合道地通管汤治疗输卵管阻塞性不孕的临床研究

目的观察腹腔镜术联合道地通管汤灌肠、口服治疗输卵管阻塞性不孕的疗效。方法 160例输卵管阻塞性不孕患者按随机数字表法分为观察组和对照组各80例,两组均行腹腔镜下输卵管整复术,观察组术后给予道地通管汤一号方口服,二号方保留灌肠,对照组仅单纯手术治疗。比较两组受孕情况。结果随访2年,观察组受孕率为68.8%（55/80）,明显高于对照组的43.8%（35/80）,两组比较差异有统计学意义（P〈0.05）,其中观察组宫内受孕率为63.8%（51/80）明显高于对照组的27.5%（22/80）,两组比较差异有统计学意义（P〈0.05）;观察组疗效好于对照组（P〈0.05）。术后半年观察组未怀孕者43例,输卵管通畅62条（72.1%）,通而不畅16条（18.6%）,不通畅8条（15.9%）;对照组未怀孕者63例,输卵管通畅56条（44.4%）,通而不畅20条（15.9%）,不通畅50条（39.7%）;观察组输卵管通畅情况明显好于对照组（P〈0.05）。结论道地通管汤联合腹腔镜术治疗输卵管阻塞性不孕,能有效改善盆腔局部血液循环,促进炎症吸收和粘连的纤维组织松解,利于输卵管管腔功能恢复,提高宫内受孕率。

Clinical Research of Laparoscopy Combining with Daodi Tongguan Decoction on Oviduct Obstructive Infertility

Objective To observe the clinical effect of Herb Retention-enema plus oral administration of Daodi Tongguan Decoction on oviduct obstructive infertility after laparoscopy.Methods 160 cases of oviduct obstructive infertility patients were randomly divided into observation group and control group with 90 patients each.All patients were treated with laparoscopy,observation group were treated with orally Daodi Tongguan DecoctionⅠand Daodi Tongguan DecoctionⅡ retention-enema.Pregnant rates were compared between the two groups.Results Two groups were followed up for 2 years,the pregnant rates were 68.8%（55/80）in observation group,43.8%（35/80）in control group,respectively there was significant difference between the two groups（P〈0.05）.The intrauterine pregnancies rates were 63.8%（51/80）in observation group,27.5%（22/80）in control group,there was significant difference between the two groups（P〈0.05）.The clinical effect of observation group was better than that of control group（P〈0.05）.The HSG result of non-pregnant patients that had been treated for six months showed that there were 43 and 63 non-pregnant patients in observation group and control group,the recanalization rates were 72.1%（62） and 44.4%（56）,the partially blocking rates were 18.6%（16）and 15.9%（20）,the blocking rates were 15.9%（16）and 39.7%（50）in observation group and control group respectively.The tubal patency of observation group was better than that of the control group（P〈0.05）.Conclusion In treating oviduct obstructive infertility,laparoscopy combining with Daodi Tongguan Decoction can effectively improve local blood circulation in pelvic.By this way,absorption of inflammation and debonding of the adhesive fibrous tissue can be both promoted.It was proved to be helpful to restore physiological function of fallopian tube lumen,and then promote the intrauterine pregnancies rates.