| Objective:Explore fecal calcium protein of thin endometrium spleen deficiency of objective evaluation,observation spleen by ogata,type of pixu(spleen deficient)thin endometrium thickness and the influence of fecal calcium who protein.Methods:1.Case source: retrospective collection of patients diagnosed with thin Endom-etrium who visited the tutor’s clinic in the affiliated hospital of chengdu university of traditional Chinese medicine from March 2019 to January 2020.2.Diagnostic criteria: the diagnostic criteria for thin endometrium were formulated according to practical reproductive medicine [12] and combined with clinical practice(the middle luteal stage after ovulation,namely 7 days after ovulation,with endometrial thickness <8mm by ultrasound).The criteria for diagnosis of spleen deficiency syndrome of traditional Chinese medicine are formulated according to the gynecology of traditional Chinese medicine(3rd edition,2018)and the clinical guidelines for new Chinese medicines(2002 edition).3.Patients meeting the diagnostic criteria for thin endometrium were divided into the thin endometrium(spleen deficiency syndrome)group and the thin endometrium(no spleen deficiency syndrome)group according to the manifestations of spleen deficiency syndrome such as loose stool after the exclusion of the contraindications such as acute inflammation of uterus and digestive tract or severe organic diseases.The thin endometrium(spleen-deficiency syndrome)group and the group without spleen-deficiency group were tested for fecal calcium guard protein before taking medicine and enema and after elimination of detection contraindications.Fecal test samples were collected(detection method: colloidal gold immunochromatography;The detection kit and supporting instrument source: xiamen weizheng biotechnology co.,LTD.)were used to compare the detection value of fecal calcium protectin in two groups of patients,and objectively evaluate the relationship between spleen deficiency syndrome and fecal calcium protectin level in patients with thin endometrium.The infrared thermal imaging scanning system(adt-yl100 A or HIR2000)was used to collect the heat metabolism data of the observation sites of ascending colon,descending colon,uterus,lower abdomen,dorsum pulse,temple,foot,heart,brain and eye,etc.,to observe the infrared heat metabolism level of patients with thin endometrium(spleen deficiency syndrome).4.Thin endometrium(spleen deficiency)patients to accept mentor the spleen by ogata(born of prescription: astragalus root,Fried Fried atractylodes,malt,poria cocos12 the spleen and stomach,yiqi whipped blood of traditional Chinese medicine)treatment,after the menstrual clean start medication,to stop drug next time menstruation,stay on at least two menstrual cycles,daily 1 agent,3 times a day,200 ml each time,half an hour after the meal warm clothing.Collection of spleen deficiency group of patients before and after treatment clinical observation indexes,including the effect of TCM syndrome score,ultrasonic testing(instrument: Madison SONOACE X6 or HITACHI EUB ultrasound instrument,probe 5.0 MHz)afterovulation middle luteal endometrium thickness,fecal calcium protein levels and infrared thermal imaging observation location(uterus,lower abdomen,du meridian,CV 8,foot,ascending colon,descending colon,heart,brain,eye)thermal metabolism data.5.Efficacy evaluation criteria: according to the guidelines for clinical research of new medicine of traditional Chinese medicine,the efficacy evaluation criteria of TCM syndromes are divided into cure,effective,obvious and ineffective.The apparent effect was that the syndrome score value was reduced by ≥70% and the symptoms were significantly improved.Effective means that the syndrome score value is reduced by ≥30% and the symptoms are improved.Invalid means that the syndrome score value is reduced by < 30%,and the symptoms are not significantly improved.The remaining observation indexes were effective if the difference before and after treatment was statistically significant.Excel was used to record the data,SPSS 26.0software was used for statistical analysis of the data,and the clinical efficacy of jianpi linxu prescription was evaluated according to the statistical analysis results.Results:1.A total of 75 patients with thin endometrium meeting the diagnostic criteria were included,37 in the thin endometrium(spleen deficiency syndrome)group and38 in the thin endometrium(no spleen deficiency syndrome)group.It was observed that 3 patients in the thin endometrium(spleen deficiency syndrome)group had fecal calcium guard protein level < 15 g/g,accounting for 8.1%.There were 10 patients with 15-30 g/g,accounting for 27%.There were 11 patients with 30-45 g/g,accounting for 29.7%.There were 8 patients with 45-60 g/g,accounting for 21.6%.5patients with > 60 g/g,accounting for 13.5%;In the spleen deficiency syndrome group,91.9% of the patients had > 15 g/g fecal calcium protective protein,and 64.8%of the patients had > 30 g/g.In the thin endometrium group(without spleen deficiency syndrome),19 patients with fecal calcium guard protein level < 15 g/g accounted for50%.There were 16 patients with 15-30 g/g,accounting for 42.1%.0 patients with30-45 g/g;There were 3 patients with 45-60 g/g,accounting for 7.9%.> 60 patients with g/g.The proportion of patients with fecal calcium guard protein < 30 g/g in the group without spleen-deficiency syndrome was 92.1%,while the proportion of patients with > 30 g/g was less,accounting for only 7.9%.The difference of fecal calprotectin level between the two groups was statistically significant(P<0.05).The correlation between fecal calprotectin level and fecal frequency of the two groups of patients was analyzed.The correlation between fecal calprotectin level and fecal frequency was significantly positive(P<0.05,correlation coefficient r>0).2.The median mean calorific value of ascending colon in patients with thin endometrium(spleen-deficiency syndrome)group was 30.2(30,30.3)℃,lower than that in patients without spleen-deficiency syndrome group was 30.4(30.2,30.5)℃,and the difference in the mean calorific value of ascending colon between the two groups was statistically significant(P<0.05).The mean caloric value of ascending colon in patients with thin endometrium(spleen deficiency syndrome)after treatment was higher than that before treatment,and the median value after treatment was30.5(30.2,30.5)higher than that before treatment was 30.3(30.0,30.5).The differenceof the mean caloric value of ascending colon before and after treatment was statistically significant(P<0.05).3.A total of 37 cases of thin endometrium(spleen deficiency syndrome)were evaluated before and after taking the medicine,of which 2 cases(5.40%)were significantly effective.Effective 28 cases,accounting for 75.68%;7 cases were invalid,accounting for 18.92%;The total effective number was 30,accounting for81.08%.Among them,32 patients underwent ultrasound examination before and after treatment,and the endometrial thickness increased after treatment compared with that before treatment.The median endometrial thickness was 0.5(0.5,0.6)cm before treatment and 0.7(0.5,0.8)cm after treatment,and the difference in endometrial thickness before and after treatment was statistically significant(P<0.05).Among them,30 patients completed fecal calcitonin detection before and after treatment,and11 patients with fecal calcitonin level <15 g/g increased after treatment compared with those before treatment,accounting for a 36.7% increase.The number of patients with 15-30 g/g increased by 1 compared with that before treatment,accounting for an increase of 3.4%.The number of patients with 30-45 g/g decreased by 5,accounting for 16.6%.The number of patients with 45-60 g/g was 4 less than that before treatment,accounting for a 13.3% decrease.Patients with >60 g/g decreased by 3cases after treatment compared with those before treatment,accounting for 10%reduction.The fecal calprotectin levels of patients in the thin endometrium(spleen deficiency syndrome)group decreased to different degrees after treatment,and the difference before and after treatment was statistically significant(P<0.05).Conclusion:1.Fecal calprotectin is an effective method to evaluate spleen deficiency syndrome of thin endometrium,and it can be used as one of the objective evaluation indexes for spleen strengthening and spleen regulating.2.Strengthening the spleen and connecting the thread can reduce the level of fecal calprotectin in patients with spleen deficiency syndrome of thin endometrium,improve the caloric value of ascending colon to regulate the intestinal function,and improve the endometrium thickness to regulate menstruation and facilitate pregnancy. |
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