【目的】探究自拟补肾活血利水方治疗输卵管积水性不孕症患者的临床疗效。 【方法】将 70例肾虚湿瘀互结型输卵管积水性不孕症患者随机分为对照组和观察组，每组各35例。2组患者均给予宫腹腔镜微创手术治疗，在此基础上，对照组给予术后常规治疗 （包括常规使用抗生素预防感染、定期监测基础体温和复查子宫附件彩超） ，观察组在对照组的基础上给予补肾活血利水方治疗，每个月经周期服用21 d，连续用药3个月经周期。观察2组患者治疗前后输卵管评分、中医证候积分的变化情况，并评价2组患者术后3个月后的妊娠结局、未妊娠者积水复发情况及用药的安全性。 【结果】（1） 妊娠结局方面：术后3个月，观察组的总妊娠率为51.43% （18/35） ，宫内妊娠率为48.57% （17/35） ；对照组的总妊娠率为25.71% （9/35） ，宫内妊娠率为20.00% （7/35） 。组间比较 （χ2检验） ，观察组的总妊娠率及宫内妊娠率均明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （2） 输卵管评分方面：治疗后，2组患者的输卵管评分均较治疗前明显改善 （P＜0.05） ，且观察组在改善输卵管评分方面明显优于对照组，组间治疗后及差值比较，差异均有统计学意义 （P＜0.05） 。 （3） 中医证候积分方面：治疗后，2组患者的中医证候积分均较治疗前明显改善 （P＜0.05） ，且观察组在改善中医证候积分方面明显优于对照组，组间治疗后及差值比较，差异均有统计学意义 （P＜0.01） 。 （4） 未妊娠者积水复发情况方面：术后3个月，观察组的输卵管积水复发率为5.88% （1/17） ，对照组为38.46% （10/26） ，组间比较，观察组的输卵管积水复发率明显低于对照组，差异有统计学意义 （P＜0.05） 。 （5） 安全性方面：治疗期间，2 组患者均无明显不良反应情况发生，具有较高的安全性。 【结论】补肾活血利水方治疗肾虚湿瘀互结型输卵管积水性不孕症患者疗效显著，能明显提高妊娠率，减少积水复发，改善临床症状，且不良反应少，安全性高。

Objective To investigate the clinical efficacy of self-made Bushen Huoxue Lishui Prescription for the treatment of patients with infertility due to hydrosalpinx. Methods Seventy patients with infertility due to hydrosalpinx differentiated as spleen deficiency and phlegm blended with blood stasis type were randomly divided into the control group and the observation group，with 35 patients in each group. Patients in both groups were given minimally invasive surgery by using a combined hysteroscopy-laparoscopy approach， and additionally， the control group was given the postoperative routine treatment （including the use of antibiotics to prevent infections，regular monitoring of the basal body temperature，and the review of the uterine adnexa ultrasound），and the observation group was treated with Bushen Huoxue Lishui Prescription based on the treatment for the control group. The medication was performed for 21 days during a menstrual cycle，and the treatment lasted for three continuous menstrual cycle. Before and after treatment，the changes in the scores of the fallopian tube obstruction and scores of traditional Chinese medicine （TCM） syndrome in the two groups were observed. Three months after the operation，the pregnancy outcomes，the recurrence of hydrosalpinx in the non-pregnant patients，and the safety of the medication in the two groups were evaluated. Results （1） Three months after the operation，the total pregnancy rate of the observation group was 51.43%（18/35），and the intrauterine pregnancy rate was 48.57%（17/35）；in the control group，the total pregnancy rate was 25.71%（9/35） and the intrauterine pregnancy rate was 20.00%（7/35） . The intergroup comparison （by chi-square test） showed that the total pregnancy rate and intrauterine pregnancy rate of the observation group were significantly superior to those of the control group，and the differences were statistically significant （P＜0.05） . （2） After treatment，the scores of the fallopian tube obstruction in the two groups were significantly improved when compared with those before treatment （P＜0.05） ，and the improvement of tubal obstruction scores in the observation group was significantly superior to that in the control group，with statistically significant differences in the post-treatment scores and in the pre- and post-treatment score difference between the two groups（P＜0.05） . （3） After treatment， the TCM syndrome scores in the two groups were significantly improved when compared with those before treatment （P＜0.05），and the improvement of TCM syndrome score in the observation group was significantly superior to that in the control group，with statistically significant differences in the post-treatment scores and in the pre- and post-treatment score difference between the two groups （P＜0.01） . （4） Three months after the operation，the recurrence rate of hydrosalpinx in the observation group was 5.88% （1/17） ，and lower than that in the control group （38.46%，10/26） ，with statistically significant differences （P＜0.05） . （5） During the treatment，no obvious adverse reactions occurred in the two groups，and the safety was high. Conclusion Bushen Huoxue Lishui Prescription has markedly efficacy in the treatment of patients with infertility due to hydrosalpinx differentiated as spleen deficiency and phlegm blended with blood stasis type，and the prescription is effective on increasing the pregnancy rate of the patients，decreasing the recurrence of hydrosalpinx，and improving the clinical symptoms，with fewer adverse reactions and high safety.

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