Retrospective Research About TCM Syndromes And Recurrence Of Endometriosis Patients Perioperation Period

Endometriosis (EMS) is a common gynecopathy, whose disease incidence recent reported was 10%-15%. This disease has jumped to become "modern disease. ", which refers to the EMS endometrial glands and stroma organization (in) outside the uterus, growth, appear repeated hemorrhage, infiltration, can form nodules and bag piece, cause pain and infertility. It is a benign disease in pathology, but a similar morphology of malignant tumors grow, erosion and distant metastasis, it becomes difficult to cure, causes the serious influence of middle-aged women's health and life quality.There're six main theories concering the endometriosis's nascence. They're endometrium planting theory, lymph sending theory, coelom epithelium altering theory, immune theory, genetic theory and endocrine theory. Recently proposed domestic Lang JH. professor in the EMS endometrium determinism, "formed unique etiology. Endometriosis belonged to the catergories of "manalgia", "barrenness", "menstrual disorder" in TCM, for it havn't a corresponding name in TCM.In modern TCM, the stagnation of blood was considered to be the basic pathogency of endometriosis.There're genadotherapy, surgery, Chinese tradition medicine, etc, in treatment. Now select surgery has become the mainstream, as surgery can achieve in the diagnosis of disease and corresponding treatment.Whether medication or surgery, recurrence of common outcomes are EMS, the main influence factors are:hormone stimulation and genetic factors, the operation mode and perioperative drug treatment, etc. The highest reported recurrence of 61.5%, the recurrence rate at 36%after the surgery, which appears three months to five years after symptoms relief.In the current study, The investigation of the syndrome of TCM of endometriosis patients, lack of large sample,systematic,intensive indagation, was in incipient stage.Object iveDiscussed the TCM syndrome differentiation rules in endometriosis patients during perioperation period and their correlation of the recurrence of endometriosis after operation through retrospective investigation on 306 cases, to afford pursuant for the chinese tradition medicine during perioperative period and decrease the recurrence of endomtriosis after operation.MethodsData of 306 postoperative cases suffered from EMS were collected, whose ages were from 20 to 52. The TCM syndrome differentiation rules during perioperation period were observed. And a followup study was conducted to observe the recurrence of EMS. At last, we used retrospective cohort study to anaylse the data.ResultsThis research has surveyed with 306 patients. During follow-up,29 cases were lost, the rate for 9.48%. Among the remaining 277 cases,35 cases never review, which were eliminated in the relativity research for recurrence. 1.Of the symptoms in survey, consecutive dysmenorrhea, worsening dysmenorrhea, infertility, hypermenorrhea, prolonged menstrual period, abnormal menstruation, darkred menstrual blood and bloodclots are the most seen ones. Light dark tongue, darkred tongue, tongue with petechia and ecchymosis, venation of tongue with winding, venous strings are the most seen symptoms.2. In the distribution of pre-surgery syndromes, firstly all with blood stasis, secondly Qi stagnation and kidney deficiency are major ones. In the distribution of three days and one week post-surgery syndromes, firstly Qi deficiency, secondly blood stasis and kidney deficiency. During the period before surgery and 3 days after surgery, blood stasis, Qi stagnation and kidney deficiency evidently fall down, but Qi deficiency and blood deficiency and stagnant obviously increase. During the period after surgery for 3 days to 1 week, the distribution is almost the same, but blood stasis increase to some extent, Qi deficiency still remains as the first major syndromes.3. blood stasis based Qi stagnation, blood stasis based kidney deficiency are major syndromes in the distribution of pre-surgery type. Weakness of the spleen and stomach, weakness of both the spleen and kidney are major syndromes for the type after surgery for three days and the type after surgery for one week as well. Three days and one week after surgery, weakness of the spleen and stomach, weakness of both Qi and blood, weakness of both the spleen and kidney obviously increase compared to that before surgery. All blood stasis syndromes decrease compared to that before surgery.4. In the relativity research for recurrence, through Logistic regression analysis it point that even one of the following risky factors---yellow qualitative thick blackish, wet sputum, wet sputum and stasis before surgery are risky factors---will possibly cause recurrence, while we found out that bradymenorrhea after surgery are possibly protective factors against recurrence.Conclusion1. Blood stasis blocks chongren and baogong is the basic pathogenesis of EMS, blood stasis based Qi stagnation is the most common syndromes.2. Major pre-surgery syndromes is blood stasis based Qi stagnation, with practical syndromes as the most. Blood stasis and Qi stagnation decrease after surgery, while Qi deficiency and blood deficiency increase. The principal type of syndromes converts into the type of weakness of the spleen and stomach.3. Yellow qualitative thick blackish, wet sputum, wet sputum and stasis before surgery are risky factors will cause possible recurrence. Combining bradymenorrhea after surgery are possibly protective factors against recurrence.