宫腔粘连宫腔镜征象与中医证素相关性研究

目的探讨宫腔粘连(IUA)宫腔局部征象与中医证素的相关性。方法选择2016年9月-2019年2月福建中医药大学附属第二人民医院妇科住院IUA患者,观察宫腔镜下宫腔微观征象,采用证素辨证分析IUA患者证素分布特点,研究IUA宫腔局部征象与中医证素的关系。结果164例IUA患者病位证素按频数高低依次为胞宫、肾、脾、肝、胃,病性证素按频数高低依次为血瘀、气滞、气虚、阳虚、血虚、阴虚、痰、热、湿、动血、寒。IUA子宫内膜不同颜色、子宫内膜血管不同颜色与形态患者的证素分布差异有统计学意义(P<0.05)。在宫腔粘连程度不同分级上,肝、脾、肾、血瘀、气滞、气虚、阳虚、血虚、阴虚证素分布比较差异有统计学意义(P<0.05)。结论宫腔镜下子宫内膜颜色、子宫内膜血管颜色及形态、粘连程度等局部征象与中医证素有关,可为IUA局部望诊提供依据。

Study on Correlation Between Signs of Uterine Cavity under Hysteroscopy and TCM Syndrome Elements in Intrauterine Adhesion

Objective To explore the correlation between signs of uterine cavity and TCM syndrome elements in intrauterine adhesion(IUA).Methods IUA patients in gynecology department of the Second People’s Hospital affiliated to Fujian University of Traditional Chinese Medicine from September 2016 to February 2019 were selected.The microscopic signs of uterine cavity under hysteroscopy were observed,and the distribution characteristics of TCM syndrome elements in IUA patients were analyzed by using syndrome element differentiation,so as to study the correlation between local signs of uterine cavity of IUA and TCM syndrome elements.Results Distribution feature of TCM syndrome elements of disease location among 164 IUA patients with frequency in descending order was:uterus,kidney,spleen,liver,and stomach.Distribution features of syndrome elements of disease nature of IUA with frequency in descending order was:blood stasis,qi stagnation,qi deficiency,yang deficiency,blood deficiency,yin deficiency,phlegm,heat,dampness,bleeding,and cold.There was statistical significance in distribution of syndrome elements in different endometrial color,endometrial blood vessel color and morphological(P<0.05).In different degrees of adhesion,there was statistical significance in distribution of syndrome elements of liver,spleen,kidney,blood stasis,qi stagnation,qi deficiency,yang deficiency,blood deficiency and yin deficiency(P<0.05).Conclusion The color of endometrium,the color and shape of endometrial blood vessels,the degree of adhesion under hysteroscopy are related to TCM syndrome elements,which can be used as the local observation data of IUA.