世界中医药

目的：探讨生化汤加减对难治性宫内膜组织残留影响性。方法：选取2018年1月至2019年4月淮北市中医医院收治的因流产致使难治性宫内膜组织残留患者114例作为研究对象，按照住院号单双平均分为对照组和观察组，每组57例，均予以宫腔镜治疗，对照组加益母草颗粒治疗，观察组加生化汤加减治疗，均治疗10 d。观察治疗前和治疗10 d后子宫内膜厚度、生命质量、血液流变学、血流动力学、子宫内膜基质金属蛋白酶-9（MMP-9）、特异性组织抑制物-1（TIMP-1）变化并比较。结果：1)2组治疗10 d后子宫内膜厚度、宫腔残留面积、中医证候积分、血绒毛膜促性腺激素（β-HCG）、疼痛视觉模拟评分（VAS评分）较治疗前均显著降低，生命质量评分较治疗前显著升高（P<0.05），且观察组均显著优于对照组（P<0.05）。2）2组治疗10 d后全血高切黏度（HS）、红细胞刚性指数（IR）、血浆黏度（PV）、红细胞比容（Hct）、红细胞聚集指数（RF）、红细胞电泳时间（EFT）较治疗前均显著降低（P<0.05），且观察组均显著低于对照组（P<0.05）。3）2组治疗10 d后阻力指数（RI）、搏动指数（PI）、子宫三径较治疗前显著下降，子宫动脉收缩期峰值流速（PSV）较治疗前显著升高（P<0.05），且观察组显著优于对照组（P<0.05）。4）2组治疗10 d后MMP-9、TIMP-1较治疗前均显著下降（P<0.05），且观察组显著优于对照组（P<0.05）。5）观察组治愈率、有效率为68.42%、31.58%，显著高于对照组的50.88%、42.1%，比较差异有统计学意义（P<0.05）。结论：生化汤加减可改善难治性宫内膜组织残留子宫内膜厚度，促进子宫血液循环，抑制组织新生，提高生命质量。

English Summary:

To investigate the effect of Shenghua Decoction on refractory endometrial tissue residues. Methods:A total of 114 patients admitted to Huaibei Hospital of Traditional Chinese Medicine from January 2018 to April 2019 with intractable endometrial tissue remnants due to abortion were selected as the research objects and were divided a control group and an observation group, with 57 cases in each group, according to the average score of hospitalization. They were treated by hysteroscopy. The control group was treated with Yimucao Granules, and the observation group was treated with Shenghua Decoction for 10 days. The changes of endometrial thickness, quality of life, hemorheology, hemodynamics, matrix metalloproteinase-9 (MMP-9) and tissue inhibitor-1 (TIMP-1) were observed and compared before and 10 days after treatment. Results:1)After 10 days of treatment, the endometrial thickness, residual area of uterine cavity, traditional Chinese medicine syndrome score, serum chorionic gonadotropin (β-HCG), pain visual analogue score (VAS score) of the 2 groups were significantly lower than those before treatment, and the quality of life score was significantly higher than that before treatment (P<0.05), and the study group was significantly better than the control group (P<0.05). 2) After 10 days of treatment, the blood high shear viscosity (HS), erythrocyte rigidity index (IR), plasma viscosity (PV), hematocrit (Hct), erythrocyte aggregation index (RF) and erythrocyte electrophoresis time (EFT) of the 2 groups were significantly lower than those of the control group (P<0.05), and the observation group was significantly lower than those of the control group (P<0.05). 3) The resistance index (RI), pulsatility index (PI) and uterine diameter of the 2 groups decreased significantly after 10 days of treatment, and the peak systolic velocity (PSV) of uterine artery increased significantly after treatment (P<0.05), and the observation group was significantly better than the control group (P<0.05). 4) The levels of MMP-9 and TIMP-1 decreased significantly after 10 days of treatment in both groups (P<0.05), and the observation group was significantly better than the control group (P<0.05). 5) The cure rate and effective rate of the observation group were 68.42% and 31.58%, which were significantly higher than those of the control group (50.88% and 42.1%, respectively), and the difference was statistically significant (P<0.05). Conclusion:Modified Shenghua Decoction can improve the thickness of residual endometrium in refractory endometrium tissue, promote uterine blood circulation, inhibit tissue regeneration and improve the quality of life.

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