| Objective:To study the evolution of TCM syndromes of HSIL patients cured by LEEP before and after operation,and to provide guidance,theoretical guidance and scientific basis for the treatment and timely intervention of traditional Chinese medicine after LEEP,so as to promote the recovery after LEEP and prevent the residual / recurrence and progress of cervical lesions.Method:The case was from July 2018 to January 2019 in the obstetrics and gynecology clinic or inpatient department of Fujian Second People’s Hospital,which was diagnosed as HSIL and treated with LEEP for the first time.All patients after LEEP were followed up regularly(3months,6 months,12 months and 24 months after operation).At the same time,colposcopy was performed for all cases to obtain the colposcopy image representation observation data,and the four diagnostic information of TCM was collected regularly for TCM syndrome differentiation.The distribution characteristics of TCM syndromes at different time points before and after LEEP were compared,and the evolution law of TCM syndromes before and after LEEP in cured patients was further explored.It provides a research basis for TCM prevention and control of residual /recurrence after LEEP in HSIL patients,and provides a theoretical basis for traditional Chinese medicine to guide the conditioning after LEEP.Result:1.General situation study : 45 patients were aged from 24 to 67 years old,and the majority were aged from 40 to 49 years old,accounting for 31.11%.In contraceptive methods,non-barrier contraception such as intrauterine device,surgical ligation and oral contraceptives accounted for 26.67%,and non-contraception accounted for 17.78%.The proportion of first sexual life under 25 years old was 77.78%.2.Elimination cases and end-point events : 45 patients were enrolled in this study.During the follow-up,2 cases were residual in postoperative pathological returns,4 cases were involved in the gland,1 case was inconvenient for follow-up,and 1 case was complicated with uterine fibroids.The above 8 cases underwent hysterectomy after LEEP,and 1 case was found residual in pathological changes after 6 months of follow-up.These 9 cases were eliminated,and 36 cases were finally cured and followed up.3.The distribution and changes of TCM syndromes at different time points before and after LEEP in cured patients :1)Preoperative and postoperative 3 months,damp-heat syndrome,liver meridian damp-heat syndrome and spleen deficiency damp-heat syndrome were the three main syndromes,accounting for 27.78%,27.78% and 25.00 %,respectively.After 3 months,the proportion was41.67%,22.22% and 25.00%.Postoperative 6 months,damp turbidity downward injection syndrome and spleen deficiency and dampness stagnation syndrome accounted for 22.22%and 19.44%,respectively.Postoperative 12 months,there was no significant change in damp turbidity downward injection syndrome,and the proportion of spleen deficiency and dampness stagnation syndrome decreased to 16.67%.Postoperative 24 months,the common people accounted for 41.67%,spleen deficiency and yin deficiency accounted for 25.00 %and 19.44 % respectively.2)The proportion of damp-heat syndrome before operation was 27.78%,3 months after operation was 41.67%,11.11% 6 months after operation.There was no damp-heat syndrome12 months after operation,and the changes were statistically significant.3)The proportion of spleen deficiency and damp-heat syndrome before and after operation was 25.00%,which decreased to 8.33% at 6 months after operation.There was no spleen deficiency and damp-heat syndrome at 12 months and 24 months after operation,and the change was statistically significant.4)Preoperative and postoperative 3 months,there was no wet turbidity under the injection,6months and 12 months after operation accounted for 22.22%,24 months after operation accounted for only 2.78%,the change was statistically significant.5)Preoperative and postoperative 3 months,there was no spleen deficiency syndrome.The proportion of 6 months,12 months and 24 months after operation showed an upward trend,accounting for 2.78%,13.89% and 25.00%,respectively.The change was statistically significant.6)Normal people began to appear 12 months after operation,accounting for 8.33%,and41.67% 24 months after operation,with statistical difference.Conclusion:1.HSIL patients cured after LEEP treatment,the main pathogenesis after operation was as follows : accumulation of damp-heat,heat dehumidifying,dissipation of damp-heat,virtual appearance,and disease healing.2.HSIL patients cured after LEEP treatment,the evolution of TCM syndromes in patients with different TCM syndromes before and after LEEP :1)Patients with spleen deficiency damp-heat syndrome before operation,according to the spleen deficiency damp-heat syndrome-spleen dampness syndrome-spleen asthenic syndrome-average evolution after operation.2)Patients with damp-heat syndrome before operation,according to the damp-heat syndrome-wet turbidity syndrome-average evolution after operation.3)Patients with liver meridian damp heat syndrome before operation,according to the liver meridian damp heat syndrome-liver yin deficiency syndrome-average evolution after operation. |
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