通管汤保留灌肠联合热敏灸治疗气滞血瘀型输卵管性不孕症的临床疗效

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中图分类号：R719.8，R614.41 文献标志码：A DOI：10.11958/20252300

Abstract：ObjectiveTo investigate theefects of Tongguandecoctionretention enemacombinedwith heat-sensitive moxibustiononinflammatoryfactors，hysterosalpingography （HSG）recanalizationrateand natural pregnancyratein patients with qi-stagnationandblood-stasis type tubalfactor infertility（TFI）.MethodsAtotalof17Opatientswithqi-stagnation andblood-stasistype TFIwere enrolledandrandomlyasigned toeitherthesurgerygroup（85cases）orthecombination group（85cases）using arandom number table.Allpatients hadproximal tubal obstructive lesionsand underwent hysteroscopic tubalcatheterizationrecanalization.Thecombination group aditionallyreceived Tongguandecoctionretention enemaand heat-sensitive moxibustion for three menstrual cycles after surgery.Changes in traditional Chinese medicine （TCM）syndrome scoresand uterine fluid inflammatory cytokine levels [interleukin （IL）-6， IL- 1β ，tumor necrosis factor- α （204号 （TNF- α ）l were compared before and afterthe intervention between groups.Secondaryoutcomes including HSG recanalization rates，naturalpregnancyrates，ectopic pregnancyrateandcomplicationratewereanalyzed.ResultsAfterinterventionoth groupsshowedreducedTCM syndrome scores （including lowerabdominal stabbing pain，menstrual bloodstasis， hypochondriac and breast distension pain，lumbosacral soreness，emotional distressand menstrual obstruction）and inflammatory cytokine levels （IL-6， IL- 1β and TNF- α ）compared with those before intervention，and the combination group was lower than those of the surgery group（ P<0.05 ）.Thecombination group demonstrated significantly higher HSG recanalization rate and natural pregnancy rate than those of the surgery group after intervention （ P<0.05 ）. There were no significant differences in ectopic pregnancy rate and total complication rate between the two groups （ P>0.05 ）. Conclusion Asanadjuncttohysteroscopictubal recanalization，Tongguan decoctionretentionenemacombinedwithheatsensitive moxibustion significantly improves TCM syndromes，reduces inflammatorycytokinesand enhances HSG recanalization and natural pregnancy ratein qi-stagnation and blood-stasis type TFI patients.

KeyWords：infertilityfemale;tubalfactorinfertity;sydromeofi-tagnationandbloodstasis;hterosalpingoaphy; Tongguan Decoction retention enema; heat-sensitive moxibustion

输卵管性不孕症（TFI是指因输卵管解剖结构或生理功能异常导致精卵结合障碍的一类病理状态，占女性不孕症的 25%～35% 。（剩余17177字）