| Objective:By comparing the expression of serum inflammatory factors and CD56+ expression of endometrial in patients with chronic endometritis(chronicendometritis,CE)of kidney deficiency and blood stasis before and after treatment,this paper discusses the possible mechanism of Bushen Huoxue decoction from the point of view of immunology,and evaluates the effect of Bushen Huoxue decoction on clinical efficacy and pregnancy outcome of CE patients with kidney deficiency and blood stasis,so as to provide theoretical evidence for the treatment of CE with traditional Chinese medicine.Methods:A total of 60 patients who failed in in vitro fertilization and embryo transfer(IVF-ET)in the reproductive and genetic center of Shandong University of traditional Chinese Medicine affiliated Hospital from November2020 to August 2021 and met the diagnostic criteria of CE were collected and randomly divided into observation group(n = 29)and control group(n = 28).The control group was given oral antibiotics(levofloxacin 0.5g QD + ornidazole0.5gbid)for 14 days,on the basis of the control group,the observation group was given one dose of qd of Bushen Huoxue decoction for 2 months.To explore the specific manifestations and positive coincidence rate of diagnosis underhysteroscopy in patients with CE,and The levels of serum interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were compared before and after treatment,and to compare the difference of CD56+expression of endometrial u NK cell markers before and after treatment.Hysteroscopic examination and endometrial CD138 immunohistochemistry were performed again after treatment.The effective rates of endometrial morphology,pathological tissue and comprehensive curative effect were compared between the two groups after CE treatment.The TCM syndrome of kidney deficiency and blood stasis before and after treatment were compared,and the pregnancy outcomes of the two groups after frozen embryo transfer(FET)were followed up.SPSS25.0 software was used for statistical analysis.Results:1.Taking the pathological examination of endometrium as the gold standard,the positive coincidence rate of hysteroscopy in the diagnosis of CE was 75.44%.The incidence of endometrial congestion was the highest(39.53%17/ 43).2.After treatment,the levels of serum IL-6 and TNF-α in both groups were lower than those before treatment,and the levels in observation group were lower than those in control group after treatment,with statistical significance(P < 0.05).After treatment,the level of IL-10 was higher than that before treatment,and the level of IL-10 in the observation group was slightly higher than that in the control group,but the difference was not statistically significant(P > 0.05).There was no significant difference in the expression of CD56+ between the two groups before treatment.After treatment,the expression of CD56+ in the endometrium of the two groups decreased,and the level of the observation group was lower than that of the control group,and the difference wasn’t statistically significant.3.Comparing the curative effect of endometrial morphology under hysteroscopy between the two groups,the effective rate of treatment in observation group was higher than that in control group(80.95%vs72.73%),and there was no significant difference(P > 0.05).In the comparison of thecurative effect of endometrial pathology between the two groups,the effective rate of the observation group was significantly higher than that of the control group(89.66% vs 75.00% P < 0.05).After treatment,the comprehensive effective rate of the observation group was significantly higher than that of the control group(65.52% vs 32.14% P < 0.05).After treatment,the scores of kidney deficiency and blood stasis syndrome in both groups decreased,and the decrease in the observation group was significantly higher than that in the control group(P < 0.05).4.The clinical pregnancy rate of observation group was significantly higher than that of control group,with statistical significance(P < 0.05).The ectopic pregnancy rate of observation group is higher than that of control group,while the biochemical pregnancy rate and early abortion rate are lower than that of control group,with no significant difference(P > 0.05).Conclusion: 1.Under the condition of endometrial histopathological examination as the gold standard,hysteroscopy has a high positive coincidence rate for the diagnosis of CE,but the diagnosis still needs to be combined with the results of histopathological examination.2.Bushen Huoxue decoction combined with antibiotics can reduce the score of TCM syndrome type of CE patients with kidney deficiency and blood stasis,and improve the effective rate of treatment.3.Bushen Huoxue decoction combined with antibiotics can regulate the levels of serum IL6,IL-10,TNF-α and the expression of CD56+in endometrium,regulate the inflammatory immune state of endometrium,and improve the outcome of pregnancy. |
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