厚胞汤联合人工周期预防TCRA术后再粘连的作用

目的探讨厚胞汤联合人工周期疗法预防宫腔粘连分离术(TCRA)后再粘连的作用。方法选取中重度宫腔粘连患者40例,TCRA术后随机分为对照组和观察组各20例。对照组予人工周期治疗,观察组予厚胞汤联合人工周期治疗,比较两组临床疗效、宫腔粘连评分、超声下内膜指标、雌激素受体(ER)表达水平。结果对照组总有效率80.00%,观察组总有效率85.00%,两组疗效差异有统计学意义(P<0.05);两组治疗后粘连评分均较治疗前下降,差异有统计学意义(P<0.05);治疗后观察组粘连评分低于对照组,差异有统计学意义(P<0.05);两组治疗后内膜厚度、容积、内膜下血流均较治疗前增加,差异有统计学意义(P<0.05);治疗后观察组内膜厚度和容积高于对照组,差异有统计学意义(P<0.05);两组治疗后内膜上R表达均较治疗前下降,差异有统计学意义(P<0.05)。结论TCRA术后使用厚胞汤联合人工周期治疗,能增加内膜厚度、容积及内膜下血流,下调子宫内膜ER表达,提高子宫内膜容受性,对预防术后再粘连有一定疗效。

The effect of Houbao Decoction combined with artificial cycle on prevention of re-adhesion after transcervical resection of adhesion

Objective To investigate the effect of Houbao Decoction combined with hormone therapy preventing re-adhesion after transcervical resection of adhesion.Methods Forty patients with moderate-to-severe intrauterine adhesion underwent transcervical resection of adhesion were randomly divided into 2 groups after operation(20 each group):the hormonal therapy group and the combined treatment group.Both groups received hormonal therapy after operation wltile the combined treatment group also received Houbao Decoction.The clinical efficacy,adhesion degree,endometrial ultrasound indexes and Estrogen Receptor(ER)were compared between two groups.Results The clinical efficacy rate in the hormonal therapy group was 80.00%while the combined group was 85.00%.Adhesion scores were significantly induced in both groups(P<0.05)and the score of the combined treatment group was lower than the hormonal therapy group after treatment(P<0.05).The endometrial thickness,blood flow and endometrial volume all improved in both groups(P<0.05)and the endometnal thickness and volume of the combined treatment group was significantly superior to the hormonal therapy group after treatment(P<0.05).The expression of ER on the endometrium decreased significantly in both groups after treatment(P<0.05).Conclusion Houbao Decoction combined with hormone therapy has certain effect of preventing re-adhesion after TCRA by increasing the endometrial thickness,volume and blood flow,down-regulating the expression levels of ER and improving the endometrial receptivity.