| Research purposes:To explore the effect of sequential therapy of Huoxue Shugan Bushen Chinese medicine on endometrial receptivity in patients with endometriosis infertility,and to analyze the main factors affecting pregnancy after endometriosisResearch methods:Using retrospective study method,choose the patients who were admitted to Guang'an men Hospital of China Academy of Chinese Medical Sciences,Beijing Maternity Hospital affiliated to Capital Medical University,Beijing Hospital,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine,and Guangzhou University of Traditional Chinese Medicine from January 2015 to September 2017.All patients underwent laparoscopic or hysteroabdominal combined conservative surgery for infertility,were diagnosed with endometriosis,belong to the syndrome of QiZhiXueYu,and met the inclusion criteria.According to the different drugs used after surgery,they were divided into Chinese medicine group and placebo group.The traditional Chinese medicine group was treated with Huoxue Shugan Bushen Chinese medicine,and the placebo group was treated with placebo.Organize and analyze the general information and surgical data before the patient is administered and the results of pelvic ultrasound and other examinations collected during the medication,Comparison of endometrial receptivity index between the two groups before and after drug treatment,such as endometrial thickness,endometrial type,endometrial and subendocardial blood flow type,uterine artery PI and RI,endometrial PI and RI.Followed up the pregnancy and pregnancy outcomes of the two groups for 1 year.At the same time,multivariate logistic regression analysis was used to analyze the main factors affecting pregnancy after endometriosisResearch result1.A total of 172 patients with endometriosis infertility were enrolled in this study,including 86 patients in the Chinese medicine group and 86 patients in the placebo group.There were no significant differences between the two groups in age,body mass index,infertility course,occupation,educational background,infertility type,previous intrauterine operation history,previous history of endometrial polyps,intraoperative endometriosis type,r-AFS stage,fallopian tube function score,EFI score and the time of taking the medicine(P>0.05)2.Endometrial thickness:There was no significant difference in endometrial thickness between the two groups in the first month of treatment and the end of treatment(P>0.05)3.Endometrial type:There was no difference in the distribution of endometrial types between the two groups in the first month of treatment(P>0.05).At the end of treatment,the proportion of type A endometrium in the Chinese medicine group was significantly higher than that in the placebo group,while that in the B and C endometrium was significantly lower than that in the placebo group,and the difference was statistically significant(P<0.05)4.Distribution of endometrial and subendocardial blood flow:in the first month of treatment,there was no difference in the distribution of endometrium and subendometrium blood flow between the two groups(P>0.05).At the end of the treatment,the type A and type B endometrium and subendometrium of the Chinese medicine group was significantly higher than that of the placebo group,ang the type C was significantly lower than that in the placebo group,the difference was statistically significant(P<0.05)5.Uterine artery PI and RI:in the first month of treatment,there was no difference in PI and RI between the two groups(P>0.05).At the last month of treatment,the PI and RI of the Chinese medicine group were significantly lower than those in the placebo group,and the difference was statistically significant(P<0.05)6.Endometrial PI and RI:in the first month of treatment,there were no differences in PI and RI between the two groups(P>0.05).At the end of treatment month,the PI and RI of the Chinese medicine group were significantly lower than those of placebo group,and the differences were statistically significant(P<0.05)7.Pregnancy rate:one year after surgery,the total pregnancy rate of the two groups was 56.98%(98/172),the pregnancy rate of the Chinese medicine group was 67.44%(58/86),and the pregnancy rate of the placebo group was 46.51%(40/86).The pregnancy rate between the two groups was statistically significant(P<0.05).The highest rate of pregnancy in both groups was 1-6 months after surgery8.Survival rate:one year after surgery,the total survival rate of the two groups was 42.4%(73/172),the survival rate of the Chinese medicine group was 51.2%(44/86),and the live birth rate of the placebo group was 33.7%(29/86).The live birth rate between the two groups was statistically significant(P<0.05)9.Pregnancy loss rate:The total pregnancy loss rate of the two groups after surgery was 25.5%(25/98),the pregnancy loss rate of the Chinese medicine group was 24.14%(14/58),and the pregnancy loss rate of the placebo group was 27.50%(11/40).There was no significant difference between the two groups(P>0.05)10.The main factors affecting pregnancy after endometriosis:age,infertility course,previous endometrial polyp history,intraoperative r-AFS staging,EFI score,endometriosis type,postoperative combined Chinese medicine treatment are associated with pregnancy(P<0.05),infertility type,uterine operation history,fallopian tube score and pregnancy were not correlated(P>0.05).The history of endometrial polyps in the past,EFI ?7 is an independent risk factor for pregnancy,and age<30 years old,combined with Chinese medicine treatment is an independent protective factor for pregnancyResearch conclusion1.Conservative postoperative combined therapy with Huoxue Shugan Bushen Chinese medicine can significantly improve endometrial type,uterine artery and intimal blood perfusion in patients with QiZhiXueYu type endometriosis-related infertility,which can effectively improve endometrium Receptivity increases pregnancy rate,live birth rate,and does not increase pregnancy loss rate2.Age,course of infertility,previous history of endometrial polyps,r-AFS stage,EFI score,type of endometriosis,and postoperative combined traditional Chinese medicine treatment were associated with pregnancy.Age,previous history of endometrial polyps,EFI,and postoperative Chinese medicine therapy were independent factors affecting pregnancy. |
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