【摘要】 目的：探讨中西医结合治疗宫腔镜下宫腔粘连分离术后预防再粘连的疗效。方法：选取广西医科大学附属南宁市妇幼保健院收治的中重度宫腔粘连患者81例为研究对象，随机分为研究组(n=40)与对照组(n=41)。两组均行B超监护下宫腔镜下宫腔粘连分离术(TCRA),术后对照组予口服雌孕激素克龄蒙治疗3个月，研究组予口服雌孕激素克龄蒙+益肾调经方治疗3个月，比较术后月经改善情况、术后3个月行宫腔镜探查宫腔再次粘连情况，术后1个月及4个月B超检查子宫内膜厚度及术后1年妊娠率。结果：研究组术后月经改善占92.30%,对照组术后月经改善占85.71%,两组比较差异无统计学意义(χ~2=0.088,P>0.05);术后3个月研究组再次粘连率及再次中重度粘连发生率与对照组比较，均明显下降，差异有统计学意义(均P<0.05);研究组术后1个月及4个月子宫内膜增厚与对照组比较，均更明显，差异有统计学有意义(P<0.05);研究组术后1年内妊娠率明显高于对照组，差异有统计学意义(χ~2=5.512,P=0.019)。结论：益肾调经方联合雌孕激素克龄蒙治疗中重度宫腔粘连分离术后患者效果更佳，能够改善月经量，有利于促进子宫内膜增长，防止宫腔再粘连，显著提高患者妊娠率。更多还原

【Abstract】 Objective To investigate the effect of integrated traditional Chinese and western medicine on prevention of re adhesion after hysteroscopic separation of intrauterine adhesions.Method 81 patients with moderate to severe intrauterine adhesions were selected as the research subjects and randomly divided into study group and control group, including 40 cases in the study group and 41 cases in the control group.Both groups were treated with hysteroscopic separation of uterine adhesions under the monitoring of B-ultrasound.The control group was treated with oral estrogen and progesterone clindamole for 3 months after operation, and the study group was treated with oral estrogen and progesterone clindamole plus Yishen Tiaojing Formula for 3 months.The improvement of menstruation after operation was compared with that of hysteroscopic exploration of uterine adhesions 3 months after operation.The endometrial thickness and 1-year pregnancy rate were checked by B-ultrasound 1 month and 4 months after operation.Results Postoperative menstrual improvement accounted for 92.30% in the study group and 85.71% in the control group.There was no significant difference between the two groups(χ~2 =0.088,P >0.05); Three months after operation, the rate of re adhesion and re occurrence of moderate to severe adhesion in the study group were significantly lower than those in the control group, with statistically significant differences(P<0.05);One month and four months after operation, the endometrial thickness of the study group was significantly higher than that of the control group(P<0.05).The pregnancy rate in the study group was significantly higher than that in the control group within one year after operation(χ~2=5.512, P=0.019).Conclusion The effect of Yishen Tiaojing Recipe combined with estrogen and progesterone clenbuterol on patients with moderate to severe intrauterine adhesions after separation is better.It can not only improve the menstrual flow, but also promote the growth of endometrium, more effectively prevent the intrauterine adhesions, significantly increase the pregnancy rate of patients, which is worth popularizing更多还原