The Clinical Study Of Artificial Abortion Preoperative Chinese Medicine Acupoint Sticking "Inform" To Protect Postoperative Women’s Reproductive Health

BackgroundIn 1995 the World Health Organization proposed to "universal access to reproductive health by 2015" goal, so reproductive health has become a global common commitment. Numerous studies have shown that artificial abortion seriously endanger women’s reproductive health, safe abortion is an important component of reproductive health, so the research on improving the safety of artificial abortion is to protect women’s postoperation reproduction health. Family planning is the basic national policy of China, although artificial abortion was not the real purpose of family planning, but artificial abortion is contraceptive failure remedial measures, so some scholars put forward the artificial abortion will always exist in people’s life, not because of legal restrictions, the improvement of science and technology, the improvement of contraceptive measures so disappear. The world health organization pointed out that there are each year about 53 million cases of artificial abortion in the global, every day there are about 100000 to 150000 cases of artificial abortion, about one-third artificial abortion is unsafe abortions. China is the second country with high abortion rates in the world, second only to Estonia, our hospital is the urban district’s tertiary first class maternal and child health care hospital, annually there are 8000-9000 peoples require induced abortion to terminate pregnancy, therefore our hospital previous did a lot of related research in improving induced abortion of the safety aspect, accumulated a lot of experience, for the smooth conduct of this study pad set a solid foundation. Artificial abortion technique has experienced 3 major improvements, numerous studies have shown that the superconducting visual painless induced abortion is a mature technology, is a relatively safe abortion, greatly reducing the complications of artificial abortion in intraoperative and postoperative. Current in clinical practice found that the major complications of induced abortion is postoperation long-term complications, the main reason is intraoperative use the instrument to suck curet the gestational sac, damage the endometrial layer, even the myometrium layer, cause uterine cavity structure disorder. Therefore, to further improve the safety of artificial abortion need to reduce intraoperative the trauma to the uterus.By reducing probability of intraoperative uterine suction injury to achieve the aim of further protect postoperative women’s reproductive health.ObjectiveOn the basis of painless superconducting visual artificial abortion technique, to explore an effective, safe, simple and convenient method to further improve the safety of artificial abortion, to further safeguard postoperative women’s reproductive health. By preoperative Chinese medicine acupoint sticking "inform" method, make the fetus has the creaking falling trend, modeling into "ripe melon self take off" of the state, thereby reducing the artificial abortion intraoperative damage to the kidney, uterus and its context, to protect the postoperative women’s reproductive health.MethodsUsing prospective randomized clinical research method, according to the proportion of 1:1,conforming to the standard of 240 cases of the research object were randomly divided into control group and experimental group, the experimental group preoperative were applied the chinese medicine plaster sticking to Shenque, Guan Yuan, air sea, Mingmen and double sided Xuehai acupoints. by intraoperative safety assessment, damage assessment of uterus after operation, recovery assessment of uterus after operation and possible mechanism and so on, Comprehensive comparison on the two groups, evaluation abortion preoperative Chinese medicine acupoint sticking "inform" to protect postoperative reproductive health protection effect,whether has the significance of clinical application.Results1. Intraoperative safety assessment:Intraoperative analgesia, the control group with 117 cases (97.5%) markedly effective,3 cases (2.5%) effective compared with the experimental group 118 cases (98.3%) markedly effective, 2 cases (1.7%) effective, the difference was not statistically significant (P> 0.05); Suction evacuation time, the control group (104.12±10.811 S) and the experimental group (76.08+6.538 S), the difference was statistically significant (P<0.05); Intraoperative blood loss, the control group(23.08+ 5.834 ml) and the experimental group (22.96 ± 4.628 ml), the difference was not statistically significant (P> 0.05);prompted the experimental group preoperative artificial abortion Chinese medicine acupoint sticking" inform" does not affect the operation of the analgesic effect, not increased intraoperative bleeding, but more conducive to shorten suck Palace time, relatively safe.2. Damage assessment of uterus after operation:Abdominal pain within one hour after abortion, the control group with73 cases (60.8%) mild pain,41 cases (34.2%) moderate pain,6 cases (5.0%) severe pain compared with the experimental group with 77 cases (64.2%) mild pain,39 cases (32.5%) moderate pain,4 cases (3.3%)severe pain, the difference was not statistically significant (P> 0.05); Backache within one hour after abortion, the control group with42 cases (35.0%) no backache,78 cases (65.0%) backache, compared with the experimental group with 59 cases (49.2%) no backache,61 cases (50.8%) backache, the difference was statistically significance (P <0.05); Postoperative vaginal bleeding time, the control group (4.93±1.772 days) and the experimental group(2.92+1.026 days), the difference was statistically significant (P<0.05); Abdominal pain within 14 days after abortion, the control group with 48 cases (40.0%) basically no,43 cases (35.8%) occasionally,20 cases (16.7%) frequently,9 cases (7.5%) continued pain compared with the experimental group with 70 cases(58.3%) basically no,31 cases (25.8%) occasionally,16 cases (13.3%) frequently,3 cases (2.5%) continued, the difference was statistically significant (P <0.05);Backache within 14 days after abortion, the control group with 38 cases (31.7%) basically no,46 cases (38.3%)occasionally,23 cases (19.2%), frequently,13 cases (10.8%) continued pain compared with the experimental group with 58cases(48.3%) basically no,39 cases (32.5%) occasionally,18 cases (15%) frequently,5 cases (4.2%)continued, the difference was statistically significant (P<0.05);prompted the experimental group preoperative artificial abortion Chinese medicine acupoint sticking" inform" can be shortened postoperative vaginal bleeding time, reduce the occurrence of backache within one hour after abortion, reduce the occurrence of abdominal pain and backache within 14 days after abortion, but neither increase nor reduce the risk of abdominal pain within one hour after abortion.3. Recovery assessment of uterus after operation:Urine pregnancy test negative rate of postoperative 14 days, the control group with 71 cases (59.2%) negative,49 cases (40.8%) weakly positive,0 cases positive compared with the experimental group with 88 cases (73.3%), negative 32 cases (26.7%) weakly positive,0 cases positive, the difference was statistically significant (P <0.05); Endometrium recovery of postoperative 14 days, the control group with57 cases(47.5%) evenly,63 cases (52.5%) uneven compared with the experimental group with 79 cases (65.8%) evenly,41 patients (34.2%) uneven, the difference was statistically significant (P<0.05); Endometrial thickness of postoperative 14 days, the control group (6.27+1.090mm) and the experimental group (6.71+0.999mm), the difference was statistical significance (P<0.05); Preoperative vaginal B-double in the uterus and accessories no exploration see cysts, postoperative 14 days the occurrence of functional ovarian cysts, the control group with16 cases(13.3%) occurrence compared with the experimental group with 5 cases (4.2%) occurrence, the difference was statistically significant (P<0.05); Preoperative usually the menstrual cycle, the control group (30.31+1.689 days) and the experimental group (30.59± 1.813 days), the difference was not statistically significant (P> 0.05), postoperative the first of menstruation recovery time, the control group (39.88±6.803 days) and the experimental group (30.28+1.911 days), the difference was statistically significant (P<0.05);the control group preoperative usually menstrual cycle (30.31±1.689 days) and postoperative the first of menstruation recovery time (39.88±6.803 days), the difference was statistically significant (P<0.05); the experimental group preoperative usually menstrual cycle(30.59 ± 1.813 days)and postoperative the first of menstruation recovery time(30.28 ± 1.911 days), the difference was statistically significant (P> 0.05); Postoperative the first of menstruation dysmenorrhea, the control group with27 cases(22.5%) no,68 cases (56.7%) mild,20 cases (16.7%) moderate,5 cases (4.2%) severe compared with the experimental group with51 cases (42.5%) no,58 cases (48.3%) mild,10 cases (8.3%) moderate,1 case (0.8%) severe, the difference was statistically significant (P<0.05); during Postoperative the second to fourth menstruation dysmenorrhea, the control group with84 cases (70.0%) no,28 cases (23.3%) mild, 8 cases (6.7%) moderate,0 cases severe compared with the experimental group with108 patients (90.0%) no,38 cases (31.7%) mild,10 cases (8.3%) moderate, severe 0 cases, the difference was statistically significant (P<0.05); During postoperative artificial abortion the second to fourth Menstruation menstrual disorders situation, the control group with 5 cases (4.1%) early menstruation,6 cases (5%) late menstruation,9 cases (7.5%) irregular menstrual cycle,11 cases (9.1%)hypomenorrhea,6cases (5%) menostaxis;4cases (3.3%) intermenstrual bleeding, including two cases hypomenorrhea who have irregular menstrual cycle; the experimental group with 3 cases(2.5%) early menstruation,3 cases (2.5%) late menstruation,3 cases (2.5%) irregular menstrual cycle,4 cases (3.3%) hypomenorrhea,4 cases (3.3%) menostaxis,2 cases (1.7%) intermenstrual bleeding, including one case hypomenorrhea who have late menstruation. The control group with 39 cases (32.5%) menstrual disorders,81 cases (67.5%) menstrual usual compared with the experimental group withl8(15.0%) cases menstrual disorders,102 cases (85.0%) menstrual usual, the difference was statistically significant (P<0.05); During postoperative four prior Menstruation endogenous reproductive tract infection, the control group with 18 cases VVC,15 cases BV, including 7 cases VVC who have BV, the experimental group with 8cases VVC,7 casesBV, including 3 cases VVC who have BV. the control group with 26 cases (21.7%) occurred endogenous reproductive tract infection compared with the experimental group with12 cases (10.0%) occurred endogenous reproductive tract infection, the difference was statistically significant (P<0.05);prompted the experimental group preoperative artificial abortion Chinese medicine acupoint sticking" inform" can increase Urine pregnancy test negative rate and promote endometrium recovery of postoperative 14 days, can more conducive to coordination postoperative endocrine, postoperative the first of menstruation recover, reduce the occurrence of postoperative dysmenorrhea, menstrual disorders and endogenous reproductive tract infections. Abortion preoperative Chinese medicine acupoint sticking "inform" can effectively prevent postoperative menstrual disorders. (relative risk (RR)= 0.426<1),and always has clinical significance (relative risk reduction (RRR)= 0.538^ 50%), and can effectively prevent postoperative endogenous reproductive tract infections. (relative risk (RR)= 0.461<1),and always has clinical significance (relative risk reduction (RRR)= 0.539≥50%).4.Before and after artificial abortion assessment the psychological status of depression and anxiety:Preoperative evaluation, the control group depression score (65.18+3.060)、anxiety score (64.31+2.513) compared with the experimental group depression score (65.04+3.041)、anxiety score (64.11 +2.586), the difference was not statistically significant (P> 0.05); Postoperative 14 days evaluation, the control group depression score (58.01 +3.523)、anxiety score (57.78+3.426)compared with the experimental group depression score (52.62+4.075), anxiety score (49.83+5.408), the difference was statistically significant (P<0.05); the control group preoperative evaluation depression score (65.18+3.060)> anxiety score (64.31+2.513) compared with postoperative 14 days evaluation depression score (58.01+3.523)、anxiety score (57.78+3.426), the difference was statistically significant (P< 0.05); the experimental group preoperative evaluation depression score(65.04+3.041), anxiety score (64.11+ 2.586) compared with postoperative 14days evaluation depression score (52.62 +4.075), anxiety score (49.83+5.408), the difference was statistically significant (P< 0.05);prompted the control group and the experimental group postoperative 14 days of depression and anxiety were significantly alleviated, but the experimental group more conducive to remission postoperative 14 days of depression and anxiety.5. Possible mechanism:Acupoint sticking before the uterine artery blood flow PI and RI, the control group PI (1.94±0.134)、RI (0.83±0.037) compared with the experimental group PI (1.93±0.112) RI (0.83±0.032), the difference was not statistically significant (P> 0.05); Acupoint sticking after, the control group PI (1.92+0.098)、RI (0.83±0.022) compared with the experimental group PI (1.61±0.104) RI (0.67±0.082), the difference was statistically significant (P<0.05); the control group acupoint sticking before PI (1.94±0.134)、RI (0.83±0.037) compared with acupoint sticking after PI (1.92±0.098), RI (0.83±0.022), the difference was not statistically significant (P> 0.05); the experimental group acupoint sticking before PI (1.93± 0.112)、RI (0.83±0.032) and acupoint sticking after PI (1.61± 0.104)、RI (0.67±0.082), the difference was statistically significant (P<0.05); Acupoint sticking before, two groups sac surrounding no dark areas. Acupoint sticking after, the control group showed no SAC surrounding dark areas, the experimental group with 36 cases (30.0%) appeared a sac surrounding dark areas, the difference was statistically significance (P<0.05); Acupoint sticking before, the two group all have primitive heart tube pulse;Acupoint sticking after, the primitive heart tube pulse of the control group were not disappear; the experimental group with 11 cases (9.2%) the primitive heart tube pulse disappear, the difference statistically significant (P<0.05); Acupoint sticking before, the control group PT (13.49 ±0.903 S),APTT (29.58±1.974S), Fib (3.89±0.588 g/L) compared with the experimental group PT (13.59±0.941 S), APTT (29.35±2.173 S), Fib (3.77±0.583 g/L), the difference was not statistically significant (P> 0.05); acupoint sticking after, the control group PT (13.48±0.898 S), APTT (29.77 ± 1.979 S), Fib (3.86±0.566 g/L) compared with the experimental group PT (13.49±0.883 S), APTT (29.33±2.178 S), Fib (3.77±0.568 g /L), the difference was not statistically significant (P> 0.05); prompted the experimental group Chinese medicine acupoint sticking can significantly alter the uterine artery blood flow PI and RI, increase the occurrence of sac surrounding dark areas, increase the occurrence of gestational sac primitive heart tube pulse disappeared, but not significantly affect blood coagulation.conclusionPreoperative artificial abortion Chinese medicine acupoint sticking "inform" is a safe and effective way to protect postoperative women’s reproductive health, with the characteristics of simple, convenient, cheap, effective is worthy of extensive promotion and clinical application.