生殖医学杂志

目的探讨四联外治疗法对湿热瘀阻型输卵管阻塞性不孕患者的临床效果以及对白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的影响。方法选取我院2016年7月至2017年7月湿热瘀阻型输卵管阻塞性不孕患者272例,随机数字表法分为对照组(n=136)与研究组(n=136)。对照组采取中药口服治疗,研究组采用四联外治法(永磁旋振治疗仪、中药离子导入、穴位注射、中药直肠滴入)结合中药口服治疗。观察治疗前后患者IL-6、TNF-α水平和输卵管通畅情况,以及随访治疗后半年内妊娠情况。结果研究组治愈率(输卵管双侧通畅,伞端无粘连)显著高于对照组(60.29%vs.19.12%,P<0.05),总有效率亦显著高于对照组(85.29%vs.61.76%,P<0.05);治疗前两组血清IL-6、TNF-α水平间无显著差异(P>0.05),疗程结束后两组IL-6、TNF-α水平均较治疗前降低,且研究组血清IL-6、TNF-α水平显著低于对照组(P<0.05);治疗后研究组妊娠时间显著短于对照组[(2.68±1.35)月vs.(3.71±1.18)月,P<0.05),临床妊娠率显著高于对照组(60.29%vs.19.12%,P<0.05)。结论四联外治能提高湿热瘀阻型输卵管阻塞性不孕症患者的输卵管复通率、减轻炎性因子对输卵管壁的伤害,改善临床妊娠率。

Objective:To investigate the clinical effect of tetralogy external therapy on infertility with damp-heat ecchymosis and tubal obstruction and its effect on the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α).Methods:A total of 272 infertile patients with damp-heat ecchymosis in our hospital from July 2016 to July 2017 were selected and randomly divided into two groups:control group(n=136) and study group(n=136).The patients in control group were treated with traditional Chinese medicine orally,while the patients in study group was treated with tetralogy external therapy(permanent magnet rotary vibration therapy,Chinese medicine iontophoresis,acupoint injection,rectal drip of Chinese medicine)combined with traditional Chinese medicine oral therapy.The levels of IL-6 TNF-αand the patency of fallopian tube were observed and compared before and after treatment.Results:The cure rate of the study group was significantly higher than that of the control group(60.29% vs.19.12%)(P<0.05),and the total effective rate in study group was also significantly higher than that of the control group(85.29%vs.61.76%)(P<0.05).There were no significant differences in the levels of serum IL-6 and TNF-αbetween the two groups before treatment(P>0.05).The levels of serum IL-6 and TNF-αafter treatment were significantly lower than those before treatment in both groups(P<0.05).The pregnancy time after treatment in the study group was significantly shorter than that in the control group[(2.68±1.35) months vs.(3.71±1.18) months](P<0.05),and the clinical pregnancy rate in the study group was significantly higher than that in the control group(60.29%vs.19.12%)(P<0.05).Conclusions:Tetralogy external therapy can improve the recanalization rate of fallopian tube in infertile patients with damp-heat stasis type oviduct obstruction,reduce the damage of inflammatory factors to the fallopian tube wall,and increase the clinical pregnancy rate.