目的 探討桂枝茯苓膠囊聯(lián)合多西環(huán)素治療反復(fù)種植失敗慢性子宮內(nèi)膜炎患者的臨床療效。方法 選取2021年8月—2023年7月南陽市第一人民醫(yī)院生殖醫(yī)學(xué)科收治的80例反復(fù)種植失敗慢性子宮內(nèi)膜炎患者，根據(jù)治療方案的不同將入選患者分對照組和治療組，每組各40例。對照組患者口服鹽酸多西環(huán)素片，0.1 g/次，2次/d。治療組在對照組的基礎(chǔ)上口服桂枝茯苓膠囊，1粒/次，2次/d。兩組于月經(jīng)第1天開始連續(xù)治療14 d。觀察兩組的臨床療效和癥狀緩解時間，比較兩組治療前后子宮內(nèi)膜指標(biāo)和血清炎性因子指標(biāo)的變化情況。結(jié)果 治療后，治療組總有效率是82.50%，顯著高于對照組的67.50%（P＜0.05）。治療后，治療組小腹疼痛、下腹墜脹、經(jīng)期延長、月經(jīng)量多的緩解時間均顯著短于對照組（P＜0.05）。治療后，兩組子宮內(nèi)膜厚度、子宮內(nèi)膜下血流指數(shù)均較同組治療前顯著增加（P＜0.05）；且治療后，治療組子宮內(nèi)膜厚度、子宮內(nèi)膜下血流指數(shù)高于對照組（P＜0.05）。治療后，兩組白細(xì)胞介素1β（IL-1β）、血管內(nèi)皮生長因子（VEGF）、腫瘤壞死因子-α（TNF-α）、缺氧誘導(dǎo)因子1α（HIF-1α）水平均較同組治療前顯著降低（P＜0.05）；且治療后，治療組IL-1β、VEGF、TNF-α、HIF-1α水平低于對照組（P＜0.05）。結(jié)論 桂枝茯苓膠囊聯(lián)合多西環(huán)素治療慢性子宮內(nèi)膜炎具有較好的臨床療效，可有效改善患者的相關(guān)癥狀，同時降低子宮內(nèi)膜炎性反應(yīng)程度，值得臨床借鑒與應(yīng)用。

Objective To explore the effects of Guizhi Fuling Capsules combined with doxycycline in treatment of chronic endometritis. Methods A total of 80 patients with chronic endometritis after repeated implantation failure admitted to Department of Reproductive Gynecology of Nanyang First People's Hospital from August 2021 to July 2023 were selected and divided into control group and treatment group according to different treatment plans, with 40 cases in each group. Patients in the control group were po administered with Doxycycline Hyclate Tablets, 0.1 g/time, twice daily. Patients in treatment group were po administered with Guizhi Fuling Capsules on the basis of control group, 1 grain/time, twice daily. Both groups were treated continuously for 14 d starting from the first day of menstruation. The clinical efficacy and symptom remission time of two groups were observed, and the changes of endometrial indexes and serum inflammatory factors before and after treatment were compared between two groups. Results After treatment, the total effective rate of the treatment group was 82.50%, which was significantly higher than that of the control group (67.50%, P < 0.05). After treatment, the relief time of lower abdominal pain, lower abdominal distension, prolonged menstrual period and heavy menstrual volume in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, endometrial thickness and subendometrial blood flow index in 2 groups were significantly increased compared with before treatment (P < 0.05). After treatment, endometrial thickness and subendometrial blood flow index in treatment group were higher than those in control group (P < 0.05). After treatment, the levels of interleukin1β (IL-1β), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α) and hypoxia-inducing factor 1α (HIF-1α) in 2 groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, the levels of IL-1β, VEGF, TNF-α and HIF-1α in treatment group were lower than those in control group (P < 0.05). Conclusion Guizhi Fuling Capsules combined with doxycycline has good clinical efficacy in treatment of chronic endometritis, and can effectively improve the relevant symptoms of patients and reduce the degree of endometrial inflammatory reaction, which is worthy of clinical reference and application.

R984

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（聯(lián)合共建）項(xiàng)目（LHGJ20200904）