目的 探讨桂枝茯苓胶囊联合多西环素治疗反复种植失败慢性子宫内膜炎患者的临床疗效。方法 选取2021年8月—2023年7月南阳市第一人民医院生殖医学科收治的80例反复种植失败慢性子宫内膜炎患者，根据治疗方案的不同将入选患者分对照组和治疗组，每组各40例。对照组患者口服盐酸多西环素片，0.1 g/次，2次/d。治疗组在对照组的基础上口服桂枝茯苓胶囊，1粒/次，2次/d。两组于月经第1天开始连续治疗14 d。观察两组的临床疗效和症状缓解时间，比较两组治疗前后子宫内膜指标和血清炎性因子指标的变化情况。结果 治疗后，治疗组总有效率是82.50%，显著高于对照组的67.50%（P＜0.05）。治疗后，治疗组小腹疼痛、下腹坠胀、经期延长、月经量多的缓解时间均显著短于对照组（P＜0.05）。治疗后，两组子宫内膜厚度、子宫内膜下血流指数均较同组治疗前显著增加（P＜0.05）；且治疗后，治疗组子宫内膜厚度、子宫内膜下血流指数高于对照组（P＜0.05）。治疗后，两组白细胞介素1β（IL-1β）、血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）、缺氧诱导因子1α（HIF-1α）水平均较同组治疗前显著降低（P＜0.05）；且治疗后，治疗组IL-1β、VEGF、TNF-α、HIF-1α水平低于对照组（P＜0.05）。结论 桂枝茯苓胶囊联合多西环素治疗慢性子宫内膜炎具有较好的临床疗效，可有效改善患者的相关症状，同时降低子宫内膜炎性反应程度，值得临床借鉴与应用。

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

河南省医学科技攻关计划（联合共建）项目（LHGJ20200904）