| Background:Endometriosis (EMs) is with the activity of endometrial tissue outside the endometrium. The ectopic endometrial may invade any part of the body, but the vast majority located in the pelvic.The most common places are the ovarian and the utero-sacral ligaments, followed by the uterus, rectum lacunae, visceral peritoneum, rectovaginal and so on. Endometriosis is a hormone-dependent diseases:the ectopic endometrial can be gradually absorbed after menopause or the removal of both ovaries; pregnancy or using the sex hormones can prevent diseases development temporarily by suppressed the ovarian function. The pathology of this disease was a benign morphologic, but the ectopic endometrial also has the ability, like a cancer to planting, erosion or distant metastasis which leads to pelvic adhesions, causing chronic pelvic pain, menstrual disorders and infertility, etc.This disease affect the young women’s health and quality of life seriously.The cause of endometriosis is unknown, Obstetrics and Gynecology experts at home and abroad have been trying to explore the pathogenesis, in order to facilitate improved treatment of this intractable disease.For that, from Sampson proposed the classical theory of blood reflux cultivation theory in1921, it has been for over80years of exploration:from cells to protein genes at the molecular level,;from hormone metabolism, adhesion invasion, angiogenesis, the growth of nerve tissue to immune system abnormalities;anther theory like the blood reflux planting theory, venous lymphaticspread theory, the body cavity metaplasia theory, induction theory, genetics and stem cells that theory have been appeared. Professor. Lang Jinghe who is an well-know experts in obstetrics and gynecology in our country proposed the "reignendometrium determinism", which is the development and complement of the traditional theory.But the cause of endometriosis remains unclear so far. It makes difficult to develop a standardized and effective treatment programs. In recent years, the incidence of this disease is rising, how to get a better treatment of endometriosis is a common issue. At present, most scholars believe that the surgical treatment of endometriosis is the primary measure.But it will be recurrence after these surgeries. Drug combination therapy with surgery is an inevitable trend of development from now on. One option is to apply GnRHa treatment after surgeries, it can be refolded to temporarily suppressovarian function which is the main way the current treatment.But it caused the attention from the obstetrics and gynecology specialist that the a series of low level estrogen problems after using the GnRHa treatment.Professor.Si Tuyi, as a academic leaders in Endometriosis specialist in our hospital,uses the integrative medicine to treat the EMT successfully.She puts forward the conclusion that the patients who gets the GnRHa treatment after surgeries is basically in kidney deficiency and blood stasis. She agrees that, when the patients get the GnRha treatment after the operations, the ovarian function has been temporarily suppressed, estrogen secretion gradually reduced, a change in the balance of the endocrine hypothalamus and the autonomic nervous systemdysfunction, which makes hot flashes, depression, insomnia, irritability and other symptoms appeared. These symptoms is caused by kidney deficiency in our traditional medicine. Before the surgery, the blood stasis deposition in the body,"Blood stasis " is the inevitable pathogenesis. It is the inevitable product of the pathological,too. It will eliminate the blood stasis during the surgery, but it will damage to the blood contact at the same time.Therefore, the blood stasis can’t disappear totally.That’s why the kidney deficiency and blood stasis can be exist at the same time. So the method to cure the EMT is tonifying the kidney, and invigorating the blood circulation. She has established the BUSHENHUOXUE prescription..Now, we set up this study are intended to further improve the assessment the efficacy and safety of BUSHENHUOXUE prescription of the low estrogen state induced by GnRHa clinical.Object ives:This study was designed to observe the ovarian endometriosis patients’ symptoms,physiological indicators, biochemical indicators and the sex hormones indicators after the short-term application of GnRHa plus bushenhuoxue prescription. In order to evaluate the clinical efficacy and safety of ovarian endometriosis after using the bushenhuoxue prescription which has improved the low estrogen state induced by GnRHa. At last, to provide a safe and effective treatment method for ovarian endometriosis and to provide a basis in determining the Chinese medicine functions in the combination therapy of traditional in endometriosis.Method:This study follows the DME principles and methods, it’s a prospective study by using a simple parallel randomized controlled clinical trials. Selecting66endometriosis patients who has underwent the laparoscopic (or open) conservative surgery in Guangdong TCM Hospital during the time from May2010to July2011, and the pathologically confirmed as ovarian endometriosis,and at the same time, to accept the GnRHa treatments. Divided these patients into the different group——the traditional Chinese medicine group and the control group. The traditional Chinese medicine group:herbs+GnRHa, It begin to Inject GnRHa in the second day the first menstrual after the surgery, The injection interval of28days, a total injection of3-pin,(optional Nuolei De3.6mg). To take the Chinese Medicine from the first injection to the last one, and to stop using herbs when the next menstrual comes. GnRH+control group:It begin to Inject GnRHa in the second day the first menstrual after the surgery. The injection interval of28days, a total injection of3-pin,(optional Nuolei De3.6mg), during this treatment, do not use any medicines about this disease. Evaluation:the symptoms occurring during the treatment, E2, Menstrual, CA125, Pregnancy, etc.Conclusion:1. The study confirmed that the low estrogen levels symptoms that occur related caused by receiving GnRHa treatment during the early stage (symptoms like: Related symptoms caused by somatic, Neuropsychiatric symptoms, Vasoconstriction-related symptoms, Urinary and reproductive system-related symptoms) should be improved.2. To compare this two groups:the traditional Chinese medicine group has a good result in the side of improving the low estrogen levels symptoms that occur related caused by receiving GnRHa treatment.3. To compare this two groups:the traditional Chinese medicine group relieves dysmenorrhea. So it indicates that the "stasis" state is improved. 4. According to the results of this study, using the bushenhuoxue prescription can improve the low estrogen state induced by GnRHa, but may not increase estrogen levels significantly. |
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