Effect on Treatment of Addition and Subtraction Therapy of Zhuyu Zhixuetang to Chronic Endometritis with Syndrome of Qi Deficiency and Blood Stasis

Ji-hong ZHANG; Yuan-huan XIONG; Xu-qing LUO; Jiao-jie CHEN; Jun-hui SHAO; Cheng-ying GONG

doi:10.13422/j.cnki.syfjx.20201033

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Effect on Treatment of Addition and Subtraction Therapy of Zhuyu Zhixuetang to Chronic Endometritis with Syndrome of Qi Deficiency and Blood Stasis

更新时间：2021-12-03

- Effect on Treatment of Addition and Subtraction Therapy of Zhuyu Zhixuetang to Chronic Endometritis with Syndrome of Qi Deficiency and Blood Stasis
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 2, Pages: 110-115(2021)
- 作者机构：
  
  1.新余市妇幼保健院，江西新余 338025
  2.江西省人民医院，南昌 330012
  3.江西中医药大学附属医院，南昌 330004
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20201033
  CLC： R289;R711;R711.32
- Received：13 June 2020，
  
  Published Online：27 July 2020，
  
  Published：20 January 2021
- 稿件说明：
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张继红,熊员焕,罗序清等.逐瘀止血汤加减治疗慢性子宫内膜炎气虚血瘀证的疗效观察[J].中国实验方剂学杂志,2021,27(02):110-115.

ZHANG Ji-hong,XIONG Yuan-huan,LUO Xu-qing,et al.Effect on Treatment of Addition and Subtraction Therapy of Zhuyu Zhixuetang to Chronic Endometritis with Syndrome of Qi Deficiency and Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(02):110-115.
张继红,熊员焕,罗序清等.逐瘀止血汤加减治疗慢性子宫内膜炎气虚血瘀证的疗效观察[J].中国实验方剂学杂志,2021,27(02):110-115. DOI： 10.13422/j.cnki.syfjx.20201033.

ZHANG Ji-hong,XIONG Yuan-huan,LUO Xu-qing,et al.Effect on Treatment of Addition and Subtraction Therapy of Zhuyu Zhixuetang to Chronic Endometritis with Syndrome of Qi Deficiency and Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(02):110-115. DOI： 10.13422/j.cnki.syfjx.20201033.

摘要

目的

评价逐瘀止血汤加减对慢性子宫内膜炎（CE）气虚血瘀证患者妊娠结局的影响及对免疫炎症因子的调节作用。

方法

将144例患者随机按数字表法分为观察组和对照组各72例。观察组脱落、失访4例，剔除2例，完成66例；对照组脱落、失访3例，剔除5例，完成65例。两组均给予抗感染治疗14 d。对照组口服妇科千金片，6片/次，3次/d。观察组内服逐瘀止血汤加减，1剂/d。两组疗程均为3个月，并随访6个月。记录治疗前后月经经量、经期和周期变化情况；进行治疗前后宫腔镜和阴道彩色多普勒超声检查，评价子宫内膜形态、子宫内膜容受性（CP）［子宫内膜厚度、阻力指数（RI），搏动指数（PI）和血流指数（FI）］等，并进行子宫内膜病理检查；进行治疗前后气虚血瘀证评分；检测治疗前后月经血白细胞介素-1

（IL-1

），IL-6和肿瘤坏死因子-

（TNF-

）水平和外周血测T淋巴亚群（CD3

，CD4

，CD8

）水平；随访记录妊娠情况和流产情况。进行安全性评价。

结果

治疗后观察组经量、经期、周期和月经完全正常率均高于对照组（

0.05）；观察组子宫内膜厚度和FI均高于对照组（

0.01），RI和PI均低于对照组（

0.01）；观察组月经血IL-1

，IL-6和TNF-

水平均低于对照组（

0.01）；观察组CD3

，CD4

水平和CD4

/ CD8

均高于对照组（

0.01），CD8

水平低于对照组（

0.01）；在6个月随访期间，观察组妊娠率46.97%（31/66），高于对照组的27.69%（18/65）（

=5.197，

0.05）；观察组子宫内膜形态疗效总有效率为96.97%（64/66），高于对照组的86.15%（56/65）（

=4.981，

0.05）；观察组子宫内膜病理组织疗效总有效率为95.45%（63/66），高于对照组的84.62%（55/65）（

=4.304，

0.05）；观察组综合临床疗效总有效率为93.94%（62/66），高于对照组的81.54%（55/65）（

=4.696，

0.05）；两组治疗期间均未发现与中药相关不良反应。

结论

逐瘀止血汤加减治疗CE气虚血瘀证患者，可调经月经、减轻临床症状，改善宫腔镜下内膜形态，调节全身和局部的免疫炎症反应，提高了CP，从而改善了妊娠结局，有着较好的综合疗效，且安全。

Abstract

Objective

To discuss clinical effect of Zhuyu Zhixuetang to chronic endometritis （CE） with syndrome of Qi deficiency and blood stasis and to study improvement effect to pregnancy outcome.

Method

One hundred and forty-four patients were randomly divided into two groups， patients in control group were 72 cases and in observation group were 72 cases. In control group， 66 patients completed the therapy because of 4 falling off or missing visit and 2 eliminated， and in observation group， 65 patients completed the therapy because of 3 falling off or missing visit and 5 eliminated. In two groups. anti-infection treatment was gicen to patients. Patients in control group got Fuke Qianjin Pian， 6 tablets/time， 3 times/day. Patients in observation group got Zhuyu Zhixuetang， 1 dose/day. The treatment was continued for 3 months and the follow up was recorded for 6 months. Before and after treatment， changes of menstrual volume， period and cycle were recorded. And hysteroscopy and color Doppler ultrasound of vagina were made， and endometrial morphology and endometrial receptivity were evaluated ［endometrial thickness， resistance index （RI）， pulsation index （PI） and blood flow index （FI）］ were evaluated， and pathology of endometrial were tested. And scores of syndrome of Qi deficiency and blood stasis were graded， levels of interleukin-1

（IL-1

）， IL-6 and tumor necrosis factor-

（TNF-

） and T-lymphoid subsets （CD3

， CD4

， CD8

） in peripheral blood were measured. Pregnancy and miscarriage were recorded and the safety was evaluated.

Result

After treatment， menstrual volume， menstrual period， cycle and complete normal rate of menstruation in observation group were all higher than those in control group （

0.05）. Endometrial thickness and FI were more than those in control group （

0.01）， RI and PI were lower than RI and PI in control group （

0.01）. And compared with control group， levels of IL-1

， IL-6， TNF-

and CD8

were less （

0.01）. And levels of CD3

， CD4

and CD4

/ CD8

were higher than the data in control group （

0.01）. During 6 months follow-up， pregnancy rate in observation group was 46.97% （31/66） was higher than 27.69% （18/65） in control group （

=5.197，

0.05）. Total effective rate of endometrial morphology was 96.97% （64/66） higher than 86.15% （56/65） in control group （

=4.981，

0.05）. Total effective rate endometrial pathology was 95.45% （63/66） higher than 84.62% （55/65） in control group （

=4.304，

0.05）. Total effective rate of comprehensive clinical effect was 93.94% （62/66） higher than 81.54% （55/65） in control group （

=4.696，

0.05）. There was no adverse reactions related to traditional Chinese medicine.

Conclusion

Zhuyu Zhixuetang can regulate menstruation， relieve clinical symptoms， improve endometrial morphology under hysteroscopy， regulate systemic and local immune inflammatory response， improve CP， thus improve pregnancy outcome， with better comprehensive effect and safety.

关键词

Keywords

references

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