Distribution Characteristics Of TCM Syndrome Elements Of Intrauterine Adhesion And Study On Its Relevance With Hysteroscopy Signs

Objective:To discuss the distribution characteristics of TCM syndrome elements in patients with intrauterine adhesion(IUA)by syndrome element theory,obtain the local lesion signs of IUA by hysteroscopy imaging technology and discuss the relationship between hysteroscopy and IUA syndrome elements,in the hope of providing objective criteria for standardization of TCM differentiation in IUA and providing theoretical basis for prevention and treatment of intrauterine adhesion in traditional Chinese medicine.Methods:First of all,82 patients who were diagnosed as intrauterine adhesion by hysteroscopy in the Department of Gynaecology of the Second People’s Hospital of Fujian Province from January,2018 to January,2019 were selected.Secondly,four diagnostic methods of TCM for all cases were properly collected by the same trained investigator,and the characteristics of syndrome elements were studied by referring t-o the principle of differentiation in Zhu Wenfeng’s Syndrome Element Differentiation.Finally,the subjects of study were examined by hysteroscopy by the same doctor,and the Hysteroscopy Image Superficial Characterization Syndrome Observation Questionna-ire was filled out correctly to discuss the relationship between IUA syndrome elements and hysteroscopy signs.Results:1.Distribution characteristics of IUA’s syndrome elements:(1)Distribution of disease location syndrome elements: 59 cases in uterus,accounting for 71.59%,31 cases in kidney,accounting for 37.80%,31 cases in spleen,accounting for 37.8%,29 cases in liver,accounting for 35.36%,one case in stomach,accounting for 1.21%.(2)Distribution of pathogenic factors: 52 cases in blood stasis,accounting for 63.34%,46 cases in Qi stagnation,accounting for 56.09%,40 cases in Qi deficiency,accounting for 48.78%,30 cases in Yang deficiency,accounting for 36.58%,23 cases in blood deficiency,accounting for 28.04%,5 cases in Yin deficiency,accounting for 6.09%,3 cases in dampness,accounting for 3.65%,one case in coldness,accounting for 1.21%,one case in phlegm,accounting for 4.87%,2 cases in heat,accounting for 2.43%,2 cases in blood disorder,accounting for 2.43%.2.Distribution characteristics of uterine cavity signs under IUA hysteroscopy:(1)endometrium:(1)color: 3 case in bright red,accounting for 3.65%,44 cases in light red,accounting for 53.68%,35 cases in pale,accounting for 42.68%.(2)blood vessel color: 47 cases in light red,accounting for 57.31%,35 cases in dark red,accounting for 42.68%.(3)blood vessel shape: 58 cases were small and dot-like,accounting for 70.73%,24 cases were thick with mesh appearance,accounting for 29.26%.(4)thickness: 17 cases were thick,accounting for 20.73%,30 cases with uneven thickness,accounting for 36.58%,35 cases were thin,accounting for 42.68%.(2)adhesion characteristics: 39 cases in membranous adhesion,accounting for 47.56%,2 cases in muscular adhesion,accounting for 2.43%,52 cases in fibrous adhesion,accounting for 63.41%.(3)adhesion range: 37 cases with no more than 1/4 uterine cavity,accounting for 45.12%,30 cases were between 1/4 and 3/4 uterine cavity,accounting for 36.58%,15 cases with more than 3/4 uterine cavity,accounting for 18%.3.The relationship between hysteroscopy signs and syndrome elements: IUA syndrome elements had statistical difference in endometrial color,endometrial vascular color and morphological distribution(P < 0.05),while it had no statistical difference in the nature and extent of intrauterine adhesion,as well as the distribution of endometrial thickness(P>0.05).Conclution:1.Blood stasis,Qi stagnation,Qi deficiency,Yang deficiency,blood deficiency,Yin deficiency,dampness,coldness,phlegm,heat and blood disorder can be seen in the syndrome element of disease nature of uterine adhesion,and uterus,liver,spleen,kidney and stomach can be seen in the syndrome element of disease location of uterine adhesion.Among them,blood stasis is the most common syndrome element of disease nature of intrauterine adhesion,and uterus is the most common syndrome element of disease location of intrauterine adhesion.2.The relevance between hysteroscopy signs and IUA syndrome elements:(1)The pale color of endometrium is related to kidney in syndrome element of disease location of and is related to blood stasis in syndrome element of disease nature,the light red color of endometrium is related to spleen in syndrome element of disease location and is related to blood stasis in syndrome element of disease nature,the bright red color of endometrium is related to liver in syndrome element of disease location and is related to heat in syndrome element of disease nature.(2)The light red color of endometrial vessels is related to spleen in syndrome element of disease location and is related to Qi deficiency in syndrome element of disease nature,the dark red color of endometrial vessels is related to liver in syndrome element of disease location and is related to blood stasis in syndrome element of disease nature.(3)The small and dot-like endometrial blood vessels is related to spleen in syndrome element of disease location and is related to Qi deficiency in syndrome element of disease nature,and the thick endometrial blood vessels with mesh appearance are related to liver in syndrome element of disease location and is related to Qi stagnation in syndrome element of disease nature.3.The endometrial color,endometrial vessel color and shape under hysteroscopy are related to TCM syndrome element of IUA,which can be used as a basis for local diagnosis of uterus by observation.