葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性与子宫血流动力学的影响

目的:探讨葛根黑苏汤联合通元针法对顽固性薄型子宫内膜患者黄体中期子宫内膜容受性(ER)与子宫血流动力学的影响。方法:选择顽固性薄型子宫内膜患者84例为研究对象,随机分为两组。对照组接受阿司匹林治疗,观察组在对照组基础上给予葛根黑苏汤联合通元针法治疗,两组疗程均为3个月经周期。记录两组治疗前后中医症侯积分的变化,在阴道超声下观察黄体中期的子宫内膜厚度、容积与血流情况,并比较两组治疗前后子宫内膜分型与子宫内膜血流分型、子宫动脉血流参数。比较两组临床疗效,治疗后的经期行经时间、妊娠成功率和妊娠患者受孕时间。结果:与治疗前比较,两组治疗后各个单项中医证候积分与总积分均明显降低(P<0.05),且观察组治疗后的上述积分均低于对照组(P<0.05)。两组治疗后子宫内膜厚度、容积均增大,子宫内膜血流收缩期峰值流速/舒张末期流速(S/D)降低,且观察组治疗后的上述指标均优于对照组(P<0.05)。两组治疗后子宫内膜分型与血流分型均有明显改善,且观察者改善情况优于对照组(P<0.05)。两组治疗后平均子宫动脉血流搏动指数(mPI)、阻力指数(mRI)和平均血流收缩期峰值流速/舒张末期流速(mS/D)均明显降低,且观察组上述指标均低于对照组(P<0.05)。观察组治疗总有效率为81.0%,明显高于对照组的61.9%(P<0.05)。观察组治疗后的经期行经时间、受孕时间短于对照组,而妊娠率高于对照组(P<0.05)。结论:葛根黑苏汤联合通元针法能够显著减轻顽固性薄型子宫内膜患者临床症状,改善子宫内膜厚度、容积与形态,并提高子宫血流灌注,从而有利于改善ER及子宫血流动力学,提高妊娠率。

Effects of Gegen Heisu decoction combined with Tongyuan acupuncture on mid-luteal phase endometrial receptivity and uterine hemodynamics in patients with refractory thin endometrium infection

Objective:To study effects of Gegen Heisu decoction combined with Tongyuan acupuncture on mid-luteal phase endometrial receptivity(ER)and uterine hemodynamics in patients with refractory thin endometrium infection.Methods:A total of 84 patients with refractory thin endometrium were randomly divided into two groups.The control group received aspirin treatment,and the observation group received Gegen Heisu decoction combined with Tongyuan acupuncture on the basis of the control group,and the treatment course of both groups was 3 menstrual cycles.Record the changes of TCM syndrome scores before and after treatment in the two groups,observe the thickness,volume and blood flow of the endometrium in the mid-luteal phase under vaginal ultrasound,and compare the endometrial typing and endometrial blood flow typing,Uterine artery blood flow parameters.The clinical efficacy,menstrual duration,pregnancy success rate and conception time of pregnant patients were compared between the two groups.Results:Compared with before treatment,the individual TCM syndrome scores and the total scores of the two groups were significantly reduced after treatment(P<0.05).And the above points in the observation group after treatment were all lower than those in the control group(P<0.05).The thickness and volume of the endometrium in the two groups increased after treatment,and the peak systolic velocity/end-diastolic velocity(S/D)of endometrial blood flow decreased,and the above indicators in the observation group were better than those in the observation group after treatment(P<0.05).Endometrial typing and blood flow typing in the two groups were significantly improved after treatment,and the improvement of the observer was better than that of the control group(P<0.05).The average uterine artery pulsatility index(mPI),resistance index(mRI)and average blood flow peak systolic velocity/end diastolic velocity(mS/D)in the two groups after treatment were significantly lower,and the observation group above The indicators were lower than those in the control group(P<0.05).The total effective rate of the observation group was 81.0%,which was significantly higher than that of the control group 61.9%(P<0.05).After treatment,the menstrual period and conception time of the observation group were shorter than those of the control group,while the pregnancy rate was higher than that of the control group(P<0.05).Conclusion:Gegen Heisu decoction combined with Tongyuan aupuncture can significantly relieve clinical symptoms of patients with refractory thin endometrium,improve endometrial thickness,volume and shape,and improve uterine blood perfusion,which is beneficial to improve ER and uterine hemodynamics to improve pregnancy rates.