Clinical Effectiveness And Mechanism Research Of Luoshi Formula Combined With Laparoscope Tresting The Infertility Caused By Stage â…¢-â…£ Endometriosis

ObjectiveThis study used Luoshi EMS formula(LSF) to treat infertile women caused by endometriosis(EM) in stage III to IV after laparoscopic operation. GnRH-a was taken as control. Observe the variation of clinical symptoms and pregnancy rate after treating; through determinating the changes of serum leptin (LEP)、monocyte chemoattractant protein-1(MCP-1) and soluble cell adhesion molecule-1(sICAM-1) before and after remedy in each group, to evaluate the relations and clinical significance of above three serum indexes with infertility caused by endometriosis(EM); research the possible pathogenesis of LSF relieving infertility caused by endometriosis.Methods30patients who were diagnosed infertility caused by endometriosis in stage III to IV after laparoscopic operation were going to be divide into two groups at random:LSF group,15cases, began to be given LSF from the first days after operation (stop taking in menstrual period and contracept during taking),30ml, three times a day, three months in all; GnRH-a group,15cases, started skin-poping GnRH-a3.6mg in a week after operation, once a month (interval of28days), tree months together. Added up symptom scores and the pregnancy rate in three months after remedy; by means of RIA and ELISA to detecting the LEP、MCP-1and sICAM-1levels in serum of all cases before and after study.Results1. Before study①The ages、BMI、dysgenesia、the staging of endometriosis、symptom scores、 chocolate cyst proportion、endometriosis operation history、LF scores、EFI scores and serum indexes of two groups had no significant differences, with comparable (all P>0.05).②There were no significant differences in serum indexes and symptom scores between EM in stage Ⅲ and Ⅳ (all P>0.05).③Symptom scores and r-AFS scores had no linear correlation(P>0.05).④The serum LEP、MCP-1and sICAM-1had no linear correlation each other before remedy (all P>0.05).⑤The r-AFS、EF and EFI had no linear correlation each other(all P>0.05).2. After studyThe pregnancy rate、curative effect of infertility and relapse rate were similar in the two groups (all P>0.05); while the time of gestation was different, LSF group was earlier than GnRH-a group (P<0.05).3. Comparison of respective group before and after remedyThe symptom scores and LEP were similar (all P>0.05); MCP-1and sICAM-1redced after treatment (all P<0.05).4. Relationships of pregnancy result and LF、EFI、r-AFSLF and EFI scores in cyophoric cases exceed nogestational; while r-AFS scores were under than nogestational (all P<0.05).The three kinds affected pregnancy result, and EF, EFI had the greater effect.Conclusion1. Clinic symptoms of infertility caused by endometriosis were not direct necessarily bound up with the extent of EM.2. Leptin leaded to EM and infertility caused by endometriosis by the way of changing the environment of abdominal cavity through MCP-1and sICAM-1.3. LSF and GnRH-a had the same curative effect at short-term infertility potency、clinical symptoms amelioration and pregnancy rate. But LFS not only had no ovarian inhibition and low side effects, but also could shorten the pregnancy time. No contraception during taking LSF, the pregnancy rate would be higher.4. The one mechanisation of Luoshi EMS formula to treat infertility caused by endometriosis maybe is dropping serum MCP-1、sICAM-1, and improving the environment of abdominal cavity.5. R-AFS could not meet the potentia generandi diagnosis of infertility caused by endometriosis completely, while LF may had better clinical value.