微创医学

目的观察输卵管再通术结合中医药治疗输卵管阻塞性不孕症的临床疗效，并探讨应用中药的作用机理。方法选取180例输卵管阻塞性不孕症患者作为研究对象，随机分成3组，每组60例。第1组行输卵管再通术结合中药治疗，第2组行输卵管再通术，第三组使用中药治疗。观察各组患者治疗后的输卵管再通有效率、妊娠率和输卵管再粘连率。结果（1）第1组有效率为81.7%，第2组有效率为78.3%，第3组有效率为56.7%。第1、2组与第3组间有效率差异有统计学意义（P＜0.05）。（2）术后随访1年，各组怀孕数占输卵管再通数的比例，3组分别为65.3%、53.2%、64.7%，虽然各组间差异无统计学意义，但使用中药组内的怀孕比例高于单纯输卵管再通组。（3）术后1年内，输卵管再粘连病例第1组5例、第2组12例、第3组5例，再粘连率分别为10.2%、25.5%、14.7%，第1组和第2组之间差异有统计学意义（P＜0.05）。结论介入性输卵管再通术可以提高输卵管再通有效率，中药治疗可以降低输卵管再通术后再粘连率，并有助于术后患者的怀孕，两种治疗手段可以配合使用。

ObjectiveTo observe the clinical curative effect of fallopian tube recanalization combined with traditional Chinese medicine and to explore the mechanism of traditional Chinese medicine in the treatment of tubal obstructive infertility.MethodWe selected 180 patients with tubal obstructive infertility and randomly divided them into 3 groups, each group contained 60 subjects. The subjects of the first group received treatment of fallopian tube recanalization combined with traditional Chinese medicine, the second group received fallopian tube recanalization alone, and the third group received traditional Chinese medicine alone. Then we observed the success rate of each group according to their fallopian tube patency rate, pregnancy rate and fallopian tube readhesion formation rate.Result(1) The success rate of the first group was 81.7%, while that of the second group was 78.3%, and 56.7% for the third group. There was a significant difference between the first group and the third group, as well as the second group and the third group (P＜0.05). (2) One year’s followup after treatment showed the pregnancy rate (defined as numbers of pregnancy over numbers of successful recanalization procedures) of the first, second, and third group were 65.3%, 53.2% ,and 64.7% ,respectively. Although there was no significant difference between these 3 groups, the pregnancy rate of the combination group was higher than that of the group which applied recanalization procedure alone. (3) One year after treatment, there were 5 fallopian tube readhesion cases in the first group, 12 cases in the second group, and 5 cases in the third group, the readhesion rate was 10.2%, 25.5%, and 14.7%, respectively. There was a significant difference between the first group and the second group (P＜0.05).ConclusionInterventional fallopian tube recanalization can increase the rate of patency of occluded fallopian tube, while traditional Chinese medicine can decrease postoperational tubal readhesion formation rate and facilitate pregnancy. The two treatments can be combined to treat tubal obstructive infertility.