Efficacy Of Integrated Traditional Chinese And Western Medicine In Preventing Postoperative Re-adhesion In Patients With Intrauterine Adhesions:A Meta-analysis

Objective:Meta analysis method was employed to analyze and summarize the efficacy of integrated traditional Chinese and Western medicine in preventing postoperative re-adhesion of patients with intrauterine adhesions,and its advantages compared with simple Western medicine treatment,so as to provide a better treatment plan for the treatment of such diseases,and Its scientific clinical medication basis and evidence-based guidance.Methods:Pub Med,CNKI(China Knowledge Network),Wanfang medical network,VIP(VIP Electronic Journal Full-text Database)and other literature databases were searched.The literature related to the randomized controlled trial of using integrated traditional Chinese and Western medicine to prevent postoperative re-adhesion in patients with intrauterine adhesion was collected.The search terms were "prevention after intrauterine adhesions","re-adhesion after intrauterine adhesions","postoperative recurrence of intrauterine adhesions","integration of traditional Chinese and Western medicine","random" and other keywords,and the retrieval time is from the establishment time of the database to October 31,2021.The articles that meet the research are screened in strict accordance with the inclusion and exclusion criteria,and the quality of the included research is evaluated with the Cochrane risk deviation assessment tool,and then the required data are extracted and Revman5.3 software provided by the Cochrane library is used to analyze collected data.Result:Through screening,a total of 15 trials that met the requirements were included in this study,there were 650 cases in the experimental group and 649 cases in the control group,a total of 1299 cases,excluding the data of 11 cases that were dropped out due to various reasons.After meta-analysis,the data showed that the prevention of recurrence by integrated traditional Chinese and Western medicine was more effective than the artificial cycle of Western medicine(OR=4.05,95%CI=[2.40,6.82],Z=5.25,P<0.05).It can improve the recovery rate of menstruation(OR=3.37,95%CI=[2.18,5.22],Z=5.45,P<0.05),promote the curative effect of intrauterine adhesion(OR=3.02,95%CI=[1.58,5.76],Z=3.35),P<0.05),reduce postoperative uterine recurrence(OR=0.27,95%CI=[0.12,0.60],Z=3.22,P<0.05),increase pregnancy rate(OR=1.97,95%CI= [1.16,3.34],Z=2.50,P<0.05).And it can reduce the distribution of endometrial perforator blood flow in grade I,increase the distribution of grade II and III,grade I(OR=0.24,95%CI=[0.15,0.37],Z=6.53,P<0.05),grade II(OR=1.78,95%CI=[1.18,2.69],Z=2.73,P<0.05),grade III(OR=2.50,95%CI=[ 1.62,3.85],Z=4.13,P<0.05).Meanwhile,it can promote the repair and growth of the endometrium of the uterine basal layer(MD=1.28,95%CI=[1.11,1.44],Z=15.07,P<0.05),reduce Uterine artery PI,RI,PI(MD=-0.11,95%CI=[-0.15,-0.06],Z=4.59,P<0.05),RI(MD=-0.04,95%CI=[-0.06,-0.02],Z=4.06,P<0.05),reduce intrauterine adhesion score(SMD=-1.01,95%CI=[-1.83,-0.38],Z=2.97,P<0.05).Conclusions :1.The treatment plan of integrated traditional Chinese and Western medicine can significantly improve the comprehensive clinical efficacy of preventing postoperative re-adhesion of intrauterine adhesions,which is conducive to the recovery of menstruation,and accelerates the repair and regeneration of endometrial basement layer.Which is conducive to improve the acceptance of endometrium to embryos and increase the probability of pregnancy.It can also effectively reduce the uterine artery blood flow resistance,improve uterine blood perfusion and blood supply,thereby,reducing the early recurrence rate of intrauterine adhesions,and the efficacy is better than that of the Western medicine group.2.Compared with simple artificial cycle treatment,the traditional Chinese medicine for tonifying kidney and activating blood combined with artificial cycle method can promote the growth of the endometrium,and promote the recovery of endometrium,and the effect is more obvious.However,the quantitative relationship between endometrial growth and the amount of estrogen and the optimal amount of estrogen after uterine adhesion can not be determined in this meta-analysis,it still needs to be confirmed by theoretical analysis through a large number of multi center drug clinical treatment practices.3.There are still some shortcomings in this research method,that is,the included randomized controlled research objects are all studies with small sample size,and most of the papers on traditional Chinese medicine are Chinese literature,lack of high-quality English literature,resulting in low stability of the research results and lack of convincing.Therefore,the conclusion still needs to be confirmed by a large number of effective clinical random studies.