Liu Yanling, Pan Lizhen, Wang Ying
Department of Obstetrics and Gynecology, Nanping People's Hospital Affiliated to Fujian University of TCM, Nanping 353000, China.
Zhongguo Zhen Jiu. 2018 Jan 12;38(1):22-6. doi: 10.13703/j.0255-2930.2018.01.005.
To explore the effects of the combined therapy of heat sensitive moxibustion and acupoint injection on endometrial receptivity of hypdrosalphinx infertility in the patients after hysteroscopy and laparoscopy on the base of routine post-operative anti-inflammation.
A total of 210 patients of hypdrosalphinx infertility after hysteroscopy and laparoscopy were divided into a combined therapy group, a heat sensitive moxibustion group and a control group, 70 cases in each one according to the random number table. In the control group, the intravenous drip of cefoxitin sodium was adopted, and the anti-inflammation treatment was given for 1 week after operation. In the heat sensitive moxibustion group, on the basis of the treatment as the control group, the heat sensitive moxibustion was applied after vaginal bleeding stopped. The acupoints were Yaoyangguan (GV 3), Guanyuan (CV 4), Qihai (CV 6), Shenshu (BL 23), Sanyinjiao (SP 6), Yinlingquan (SP 9) and Zigong (EX-CA1). The acupoints were modified according to the different syndromes. In the combined therapy group, on the basis of the regimen as the heat sensitive moxibustion group, after vaginal bleeding stopped, the acupoint injection was given alternatively at bilateral Tiangong (extra, 1.0 cm inferior and bilateral to the cervix) with lidocaine 1 mL, amikacin 2 mL and salvia injection 2 mL. The treatment was given once every day, the treatment for 10 times as one course and a total of 3 courses were required. The endometrial type, thickness, uterine arterial plusatility index (PI) and resistance index (RI) were observed in the patients of each group.
After treatment, the numbers of A-type endometrial type in the combined therapy group and the heat sensitive moxibustion group were remarkably higher than those of the control group [57.1% (40/7) vs 31.4% (22/70), 50.0% (35/70) vs 31.4% (22/70), both <0.05]. The endometrial thickness after treatment was all increased as compared with that before treatment in each group (all <0.05). The increasing degree in the combined therapy group was better than either the heat sensitive moxibustion group or the control group (both <0.05). The improvement in the heat sensitive moxibustion group was superior to the control group (<0.05). PI and RI in the combination group and PI in the control group were decreased after treatment (all <0.05). The improvements of PI and RI in the combination group were better than those in the heat moxibustion group (both <0.05), which were superior to those in the control group (all <0.05).
In the patients of hypdrosalphinx infertility after hysteroscopy and laparoscopy, the combined therapy of heat sensitive moxibustion and acupoint injection increases endometrial thickness, reduces uterine arterial resistance and improves endometrial receptivity.
探讨在宫腔镜及腹腔镜术后常规抗炎基础上,热敏灸联合穴位注射对输卵管积水性不孕患者子宫内膜容受性的影响。
将210例宫腔镜及腹腔镜术后的输卵管积水性不孕患者按随机数字表法分为联合治疗组、热敏灸组和对照组,每组70例。对照组采用静脉滴注头孢西丁钠,术后抗炎治疗1周。热敏灸组在对照组治疗的基础上,于阴道出血停止后行热敏灸治疗。穴位选取腰阳关(GV 3)、关元(CV 4)、气海(CV 6)、肾俞(BL 23)、三阴交(SP 6)、阴陵泉(SP 9)、子宫(EX - CA1),根据不同证型进行穴位加减。联合治疗组在热敏灸组治疗方案的基础上,于阴道出血停止后交替在双侧子宫穴(extra,宫颈旁开1.0 cm、向下1.0 cm)进行穴位注射,注射药物为1 mL利多卡因、2 mL阿米卡星、2 mL丹参注射液。每天治疗1次,10次为1个疗程,共治疗3个疗程。观察各组患者的子宫内膜类型、厚度、子宫动脉搏动指数(PI)及阻力指数(RI)。
治疗后,联合治疗组和热敏灸组的A型子宫内膜例数显著高于对照组[57.1%(40/70)比31.4%(22/70),50.0%(35/70)比31.4%(22/70),均P<0.05]。各组治疗后的子宫内膜厚度均较治疗前增加(均P<0.05)。联合治疗组的增加幅度优于热敏灸组和对照组(均P<0.05)。热敏灸组的改善情况优于对照组(P<0.05)。联合治疗组治疗后的PI和RI及对照组的PI降低(均P<0.05)。联合治疗组PI和RI的改善情况优于热敏灸组(均P<0.05),热敏灸组优于对照组(均P<0.05)。
对于宫腔镜及腹腔镜术后的输卵管积水性不孕患者,热敏灸联合穴位注射可增加子宫内膜厚度,降低子宫动脉阻力,提高子宫内膜容受性。