益肾活血方联合人工周期干预中、重度宫腔粘连术后的临床研究

目的：评价益肾活血方联合人工周期预防宫腔镜宫腔粘连分离术后再粘连的疗效。方法：选择2008年1月-2011年4月妇科经宫腔镜诊断为中、重度宫腔粘连患者90例，均行粘连分离术并安置宫内节育环，术后随机分为两组，治疗组45例，给予益肾活血方联合人工周期治疗，对照组45例，给予激素人工周期治疗，观察两种方法术后宫腔恢复情况、月经改善、黄体期子宫内膜厚度及随访妊娠情况。结果：治疗组患者术后宫腔再粘连者4例，总有效率91．1％，对照组患者术后宫腔再粘连者13例，总有效率71．1％，两组比较，差异有统计学意义（P〈0．05）。经治疗后两组黄体期子宫内膜厚度比较，治疗组优于对照组，差异有统计学意（P〈0．05）。随访1年患者妊娠情况，治疗组妊娠率58．3％，对照组妊娠率25．0％，差异有统计学意义（P〈0．05）。结论：益肾活血方联合人工周期是防治中、重度宫腔粘连术后再粘连的有效方法，值得临床推广。

Study on Intervention of Yishen Huoxue Decoction Combined with Artificial Cycle for Moderate or Severe Intrauterine Adhesions after Surgery

Objective： To evaluate the effects of Yishen Huoxue decoction combined with artificial cycle therapy on prevention of uterine adhesion after hysteroscopic adbesiolysis. Methods ： We selected 90 patients who were diagnosed as moderate or severe intrauterine adhesions by hysteroscopy in our hospital from January 200~ to April 2Oil. And all of the patients underwent the TCRA surgery and 1UD placement successfully. The patients were divided into two groups. Yishen Huoxue decoction combined with artificial cycle therapy was given to treatment group and artificial cycle therapy to control group. After the end of treatment, all of the patients reviewed hysteroscopy to understand uterine morphological changes, and followed up the recovery of menses, endometrial thickness and pregnancy. Results ： 3 patients had recurrence in the treatment group and 4 patients in the control group. Total effective rate of treatment group was 91. 1%, and that was 71.1% in the control group. The two groups were significantly different（ P 〈 0.05 ）. Comparison of endometrial thick- ness, the treatment group was superior to the control group. The two groups were significantly different （P 〈 0.05）. After 1 -year follow up in pregnancy, the pregnancy rate was 58.3% in treatment group,and it was 25.0% in control group. The two groups were significantly different（ P 〈 0.05 ）. Conclusion： Yishen Huoxue decoction combined with artificial cy- cle therapy is an effective method to prevent the palace cavity adhesion recurrence, and it is worthy of clinical promotion.