Clinical Study Of Traditional Chinese Medicine Combined With Intrauterine Perfusion For Treatment Of Thin Endometrium With Kidney Deficiency And Blood Stasis

Objective: To observe the effect of traditional Chinese medicine combined with intrauterine perfusion on the expression of vascular endothelial growth factor(VEGF)and integrin β3 in endometriumof thin endometrium infertility with kidney deficiency and blood stasis type,and to discuss the effect of bushenhuoxue treatment on thin endometrium from the cytokine level,and then explore the mechanism of its action.Methods: Sixty four patients who failed after in vitro fertilization and embryo transfer(IVF-ET)and met the inclusion criteria were randomly divided into two groups:32 cases in the traditional Chinese medicine combined with intrauterine perfusion(TCM+IP)group and 32 cases in the intrauterine perfusion(IP)group.TCM+IP group takes Bushen Huoxue decoction on the 3rd day of menstruation and injected recombinant human granulocyte stimulating factor into uterine cavity at 3-5 days after menstruation,IP group only receives intrauterine injection,both groups were treated for three menstrual cycles.6 days after ovulation in the second menstrual cycle,with the informed consent of the patients,the endometrial tissue was sucked with endometrial sampler,and the expression of VEGF,integrin β3 in endometrium of the two groups was determined by immunohistochemical method.During the third menstrual cycle,freeze-thawed embryo transfer uses natural cycle to prepare intima,this cycle Bushen Huoxue decoction taked until the intimal transformation day.The changes of TCM syndromes integral and the expression of VEGF,integrin β3 in endometriumm were compared between the two groups,and then compare the endometrial thickness on the date of endoetrial transformation in transplantation cycle,the embryo implantation rate,and clinical pregnancy rate of these two groups.Results:(1)After treatment,the score of kidney deficiency and blood stasis syndrome in TCM+IP group was significantly lower than that in IP group,the difference was statistically significant(P<0.05),the score of kidney deficiency and blood stasis syndrome after treatment in TCM+IP group was significantly different from that before treatment(P<0.05),the symptoms of kidney deficiency and blood stasis were obviously improved,the score of kidney deficiency and blood stasis syndrome in IP group was decreased but compared with that before treatment,there was no significant difference(P>0.05).(2)The endometrial thickness on the date of endometrial transformation in transplantation cycle of TCM+IP group were significantly higher than those in the IP group,the difference was statistically significant(P<0.05),and the endometrial thickness of the two groups on the date of endometrial transformation in transplantation cycle was significantly different from that before treatment(P<0.05).(3)The expression of VEGF in the TCM+IP group during the endometrial implantation window was significantly higher than that in the IP group,and the difference was statistically significant(P<0.05)(4)The expression of integrin β3 in the TCM+IP group during the endometrial implantation window was significantly higher than that in the IP group,and the difference was statistically significant(P<0.05).(5)The embryo implantation rate in the TCM+IP group was higher than that in the IP group,the difference was statistically significant(P<0.05).(6)The clinical pregnancy rate in the TCM+IP group was higher than that in the IP group,the difference was statistically significant(P<0.05).Conclusion: Bushen Huoxue treatments can effectively improve patients’ endometrial thickness,and by improving the receptivity of the endometrium,patients’ clinical pregnancy rate increased significantly.Its mechanism of action may be related to the enhancement of endometrial VEGF and integrin β3 expression in the implantation window.