文献类型：期刊文献

中文题名：温阳活血方联合地屈孕酮治疗子宫内膜息肉不孕症的临床观察

英文题名：Clinical observation on the treatment of endometrial polyp infertility by Wenyang Huoxue Formula(温阳活血方)combined with dydrogesterone

作者：王玮[1];李新月[1];岳斌[2];褚翠君[2];陈元欢[2];武权生[2];吉秀家[2];张瑞芳[1];冯明霞[1];朱天垣[3]

第一作者：王玮

机构：[1]甘肃中医药大学附属医院,甘肃兰州730000;[2]甘肃中医药大学,甘肃兰州730000;[3]甘肃省妇幼保健院,甘肃兰州730050

第一机构：甘肃中医药大学第二附属医院

年份：2025

卷号：36

期号：21

起止页码：4095

中文期刊名：时珍国医国药

外文期刊名：JOURNAL OF LI-SHIZHEN TRADITIONAL CHINESE MEDICINE

收录：;北大核心:【北大核心2023】；

基金：国家自然科学基金地区项目(81760879,82260949);甘肃省中医药科研课题(GZKP-2023-17);甘肃省自然科学基金(24JRRA1016);兰州市科技发展指导性计划项目(2023-ZD-237);甘肃省高校青年博士支持项目(2025QB-070);甘肃省高等学校创新基金项目(2024A-086)。

语种：中文

中文关键词：温阳活血方;子宫内膜息肉;血流动力学;血清炎性因子;纤维化因子

外文关键词：Wenyang Huoxue Formula(温阳活血方);Endometrial polyps;Hemodynamics;Serum inflammatory factors;Fibrotic factors

摘要：目的探讨温阳活血方联合地屈孕酮对湿瘀互结型子宫内膜息肉(EP)不孕患者的疗效及子宫内膜血流灌注、炎性因子、纤维化指标的影响。方法对84例湿瘀互结型子宫内膜息肉不孕症患者,随机分为对照组、治疗组各42例。两组均予以孕激素地屈孕酮,治疗在孕激素基础上予以温阳活血方,治疗3个月经周期。以月经评分、子宫内膜厚度、复发率、妊娠率作为主要评判标准;B超主要检测子宫动脉血流动力学(PI、RI)、血清生化指标:TNF-α、IL-6、FIB、TGF-β、VEGF为次要评判标准。结果与对照组比较,观察组临床总有效率、妊娠率等明显较高,复发率显著低于对照组,且中医证候总评分明显降低(P<0.05),而对照组在停药3个月后中医证候评分未见降低(P>0.05);观察组治疗后子宫内膜厚度在治疗3个月后、停药3个月后均小于对照组且存在统计学差异(P<0.05);月经评分(PBAC)结果显示观察组低于对照组(P<0.05);子宫动脉血流动力学方面,与对照组比较,观察组治疗后PI、RI显著降低(P<0.05),而对照组治疗前后PI、RI无统计学意义;观察组治疗后血清指标TNF-α、IL-6、FIB、TGF-β、VEGF均明显降低(P<0.05)。结论湿瘀互结型子宫内膜息肉不孕患者应用温阳活血方联合地屈孕酮治疗的疗效显著,妊娠率高,复发率低,能有效改善内膜血流灌注,发挥抑制炎症及拮抗纤维化,有效改善子宫内膜容受性的作用。
Objective To explore the efficacy of Wenyang Huoxue Formula(温阳活血方,WYHXF)combined with dydrogesterone on patients with infertility due to dampness and blood stasis type endometrial polyps(EP)and its effect on endometrial blood perfusion,inflammatory factors,and fibrosis indicators.Methods A total of 84 patients with infertility due to dampness and blood stasis type EP were randomly divided into a control group and a treatment group,with 42 cases in each group.Both groups were treated with the hormone dydrogesterone,and the treatment group received WYHXF in addition to dydrogesterone for three menstrual cycles.Menstrual scoring,endometrial thickness,recurrence rate,and pregnancy rate were used as primary evaluation criteria;B ultrasound mainly detected uterine artery hemodynamics(PI,RI)and serum biochemical indicators:TNF-α,IL-6,FIB,TGF-β,VEGF as secondary evaluation criteria.Results Compared with the control group,the observation group had a significantly higher overall clinical effectiveness rate and pregnancy rate,a significantly lower recurrence rate than the control group,and a significantly lower total TCM score(P<0.05),while the control group did not see any reduction in the TCM score after 3 months of drug cessation(P>0.05);the observation group’s post-treatment endometrial thickness was smaller than the control group’s after 3 months of treatment and 3 months of drug cessation,and there was a statistically significant difference between the two groups(P<0.05);the results of the menstrual score(PBAC)showed that the observation group was lower than the control group(P<0.05);in terms of uterine artery hemodynamics,compared with the control group,the observation group had a significant decrease in PI and RI after treatment(P<0.05),whereas there was no statistically significant difference between the control group’s pre-and post-treatment PI and RI;the serum indexes of the observation group were significantly lower after treatment in the observation group in the areas of TNF-α,IL-6,FIB,TGF-β,VEGF,and VEGF.β,VEGF were significantly reduced(P<0.05).Conclusions The treatment of infertility due to dampness and blood stasis type EP with WYHXF combined with dydrogesterone is effective,with a high pregnancy rate and low recurrence rate,effectively improving endometrial blood perfusion,inhibiting inflammation and antagonizing fibrosis,thus improving endometrial receptivity.