目的 探討少腹逐瘀湯輔助宮腔鏡手術(shù)治療對(duì)子宮內(nèi)膜息肉患者術(shù)后復(fù)發(fā)率的影響。方法 選擇2019年6月一2021年1月江蘇省常州市武進(jìn)中醫(yī)醫(yī)院收治的子宮內(nèi)膜息肉患者124例為對(duì)象，根據(jù)治療方法不同將患者分為對(duì)照組和試驗(yàn)組，每組各62例。對(duì)照組采用宮腔鏡手術(shù)治療，術(shù)后常規(guī)給予抗生素預(yù)防感染，并于下次月經(jīng)后半周期即月經(jīng)來潮后第15天，口服黃體酮膠囊，每次100 mg，每天2次，連續(xù)用藥15d （1個(gè)療程）。試驗(yàn)組在對(duì)照組基礎(chǔ)上加用少腹逐瘀湯，連續(xù)服用4周。用藥4周后評(píng)估患者相關(guān)指標(biāo)，并完成12個(gè)月隨訪，比較兩組癥狀消失時(shí)間、子宮內(nèi)膜厚度、血漿黏度、纖維蛋白原、月經(jīng)量，以及治療后6、12個(gè)月的妊娠率及復(fù)發(fā)率。結(jié)果 試驗(yàn)組治療后月經(jīng)量增多、倦怠無力、五心煩熱、面色晦暗及小腹疼痛癥狀消失時(shí)間均顯著短于對(duì)照組（P<0.05）；兩組治療4周后子宮內(nèi)膜厚度、血漿黏度、纖維蛋白原、月經(jīng)量均顯著低于本組治療前（P<0.05）；試驗(yàn)組治療4周后子宮內(nèi)膜厚度、血漿黏度、纖維蛋白原、月經(jīng)量均顯著低于對(duì)照組（P<0.05）；隨訪12個(gè)月，試驗(yàn)組妊娠率顯著高于對(duì)照組（P<0.05）；復(fù)發(fā)率顯著低于對(duì)照組（P<0.05）。結(jié)論 宮腔鏡手術(shù)后加用少腹逐瘀湯能顯著縮短子宮內(nèi)膜息肉患者癥狀消失時(shí)間，改善子宮內(nèi)膜厚度及血液流變學(xué)水平，可調(diào)節(jié)患者月經(jīng)量，提升患者妊娠率，降低復(fù)發(fā)率，值得推廣應(yīng)用。

Objective To investigate the clinical effect of Shaofu Zhuyu Decoction in hysteroscopic surgery for patients with endometrial polyps and its effect on postoperative recurrence rate.Methods A total of 124 patients with endometrial polyps from June 2019 to January 2021 were selected as the subjects, and they were randomly divided into two groups with 62 cases in each group.Patients in the control group were treated with hysteroscopic surgery, antibiotics were routinely given to prevent infection after operation, and Progesterone Capsules were taken orally twice a day, 100 mg each time, for 15 days(one course of treatment) in the second half of the next menstrual cycle, i.e.the 15 th day after menstruation.Patients in experimental group were treated with Shaofu Zhuyu Decoction for four weeks on the basis of the control group.After four weeks of medication, the patient's relevant indicators were evaluated and 12 months of follow-up were completed.The time of symptom disappearance, endometrial thickness, plasma viscosity, fibrinogen, menstrual volume, pregnancy rate and recurrence rate of six and 12 months after treatment were compared between the two groups.Results After treatment, the disappearance time of menstruation increased, fatigue and weakness, five heart trouble, dimmish and darkish complexion, and abdominal pain symptoms in the experi mental test groupwere significantly shorter than those in the control group(P<0.05).After four weeks of tre atment, the endometrial thickness, plasma viscosity, fibrinogen and menstrual volume of the two groups were significantly lower than those before treatment(P<0.05).After four weeks of treatment, the endometrial thickness, plasma viscosity, fibrinogen and menstrual volume in the experimental group were significantly lower than those in the control group(P<0.05).After 12 months of follow-up, the pregnancy rate in the experimental group was significantly higher than that in the control group(P<0.05), and the recurrence rate was significantly lower than that of the control group(P<0.05).Conclusion The addition of Shaofu Zhuyu Decoction after hysteroscopy can significantly shorten the time of symptom disappearance in patients with endometrial polyps, improve the thickness of endometrium and the level of hemorheology, regulate the menstrual volume of patients, increase the pregnancy rate of patients, and reduce the recurrence rate, which is worth popularizing.

R984

江蘇省蘇州高新區(qū)人民醫(yī)院院管科研項(xiàng)目（SYSD2015065）