中国医院用药评价与分析2025，Vol.25Issue(12)：1425-1429,5.DOI:10.14009/j.issn.1672-2124.2025.12.003
桂枝茯苓汤灌肠联合宫腔灌注对慢性子宫内膜炎患者IVF-ET助孕结局、子宫内膜微生态的影响
Exploration on Effects of Guizhi Fuling Decoction Enema Combined with Intrauterine Perfusion on Pregnancy Outcome,Endometrial Microecology in IVF-ET of Patients with Chronic Endometritis
摘要
Abstract
OBJECTIVE:To probe into the effects of Guizhi Fuling decoction enema combined with intrauterine perfusion on pregnancy outcome and endometrial microecology in vitro fertilization-embryo transfer(IVF-ET)of patients with chronic endometritis.METHODS:Totally 120 patients with chronic endometritis who underwent IVF-ET in the Reproductive Medicine Center of the hospital from Jan.2023 to Jan.2024 were extracted to be divided into the intrauterine perfusion group and traditional Chinese medicine enema group according to the random number table method,with 60 cases in each group.Both groups received conventional antibiotic treatment.Patients in the intrauterine infusion group received granulocyte colony-stimulating factor intrauterine infusion treatment,while the traditional Chinese medicine enema group was given enema treatment with Guizhi Fuling decoction based on the intrauterine infusion group.A total of 3 infusions were performed.The clinical efficacy,traditional Chinese medicine syndrome scores,assisted reproductive outcomes,CD138 expression in endometrial tissue,endometrial microecological conditions,and endometrial immune microenvironment[tumor necrosis factor α(TNF-α),interleukin-4(IL-4),and interleukin-1β(IL-1β)]of two groups were compared.RESULTS:The total effective rate of traditional Chinese medicine enema group was 91.67%(55/60),significantly higher than that 76.67%(46/60)of intrauterine perfusion group,with statistically significant differences(P<0.05).After treatment,the scores of traditional Chinese medicine syndromes and total score in both groups were significantly lower than those before treatment,and the traditional Chinese medicine enema group were significantly lower than the intrauterine perfusion group,with statistically significant differences(P<0.05).The clinical pregnancy rate and live birth rate in the traditional Chinese medicine enema group were respectively 78.33%(47/60)and 71.67%(43/60),higher than those of the intrauterine perfusion group[61.67%(37/60)and 53.33%(32/60)],the differences were statistically significant(P<0.05).After treatment,the number of CD138 cells in both groups decreased compared with those before treatment,and the traditional Chinese medicine enema group was lower than the intrauterine perfusion group,with statistically significant differences(P<0.05).After treatment,the positive proportion of pathogenic microorganisms in the traditional Chinese medicine enema group was 11.67%(7/60),lower than 30.00%(18/60)in the intrauterine perfusion group,with statistically significant differences(P<0.05).After treatment,the levels of serum TNF-α and IL-1β in both groups decreased significantly compared with those before treatment,while the level of serum IL-4 significantly increased compared with those before treatment;the levels of serum TNF-α and IL-1β in the traditional Chinese medicine enema group were significantly lower than those in the intrauterine perfusion group,and the level of IL-4 was significantly higher in the traditional Chinese medicine enema group than that in the intrauterine perfusion group,the differences were statistically significant(P<0.05).CONCLUSIONS:Guizhi Fuling decoction enema combined with intrauterine perfusion can help to improve the clinical efficacy of patients with chronic endometritis,enhance the success rate of embryo transfer and the live-birth rate after IVF-ET,as well as improve the endometrial microecology and alleviate endometrial immune-inflammation.关键词
桂枝茯苓汤/中药灌肠/宫腔灌注/慢性子宫内膜炎/体外受精-胚胎移植术Key words
Guizhi Fuling decoction/Traditional Chinese medicine enema/Intrauterine perfusion/Chronic endometritis/In vitro fertilization-embryo transfer分类
医药卫生引用本文复制引用
ZHOU Xue,ZHAO Jing,LING Xiufeng,ZHAO Chun,DING Hui..桂枝茯苓汤灌肠联合宫腔灌注对慢性子宫内膜炎患者IVF-ET助孕结局、子宫内膜微生态的影响[J].中国医院用药评价与分析,2025,25(12):1425-1429,5.基金项目
国家自然科学基金资助项目(No.82371670) （No.82371670）
江苏省妇幼健康研究会课题(No.JSFY202203) （No.JSFY202203）
