| Objective:By observing the clinical efficacy of combining western medicine treatment(Femoston+Foley Catheters)with Bushen Huoxue Decoction and western medicine treatment alone on endometrial repair in patients with IUA with kidney deficiency and blood stasis after TCRA,to study the feasibility and effectiveness of this combined protocol of Chinese and Western medicine treatment and to explore the possible mechanisms of its action.Methods: Sixty-seven patients with IUA who met the inclusion criteria and were seen at Jiangxi Provincial Hospital of Traditional Chinese Medicine were selected(a total of 64 patients eventually participated in the study),including 32 patients in the observation group and 32 patients in the control group.In both groups,TCRA was performed within2-3 days of menstrual cleansing,In the observation group,Western medical treatment(Femoston+Foley Catheters)was combined with Bushen Huoxue Decoction was given on the second day after surgery,and in the control group,Western medical treatment(Femoston+Foley Catheters)was given for3 courses of treatment.The indices such as endometrial thickness,uterine artery resistance,IUA score and TCM evidence score before and after treatment were recorded for the two groups of patients,respectively,and finally the collected data were statistically processed and used to observe differences in the efficacy of treatment regimens between the two groups.Results:1.Total clinical efficacy:The total effective rate of the observation group was 93.75%,including 11 patients(34.38%)recovered,19 patients(59.37%)effective and 2 patients(6.25%)ineffective;the total effective rate of the control group was 71.88%,including 4 patients(12.5%)recovered,19 patients(59.38%)effective and 9 patients(28.12%)ineffective,with a statistically significant difference(P<0.01).2.TCM efficacy: The total effective rate of the observation group was 93.75%,including 2 patients(6.25%)recovered,15 patients(46.88%)significantly effective,13 patients(40.62%)effective,and 2 patients(6.25%)invalid,while the total effective rate of the control group was68.75%,including 0 patients(0%)recovered,7 patients(21.87%)significantly effective,15 patients(46.88%)effective,and 10 patients(31.25%),and the difference was statistically significant(P<0.01).3.Endometrial thickness: endometrial thickness before and after treatment in the observation group was 4.92±0.55 mm and 7.55±0.84 mm,respectively;endometrial thickness before and after treatment in the control group was 5.11±0.66 mm and 6.96±0.88 mm,respectively.The endometrial thickness increased in both groups after treatment compared with that before treatment(P<0.05),and the endometrial thickening was more obvious in the observation group after treatment(P<0.05).4.TCM evidence score: TCM evidence score in the before treatment observation group was 28(20,32)and after treatment was 6(4,12);TCM evidence score in the pre-treatment control group was 28(22,34)and after treatment was 15(8,20).Compared with the pre-treatment period,the TCM evidence scores decreased in both groups(P<0.05),and the decrease was more obvious in the observation group after treatment than in the control group after treatment(P<0.01).5.uterine artery resistance(RI): The median before and after treatment RI in the observation group was 0.87(0.82,0.9)and 0.73(0.70,0.75),respectively;the median before and after treatment RI in the control group was 0.88(0.84,0.92)and 0.80(0.77,0.86).Compared with the pre-treatment period,the RI values were lower in both groups(P<0.05),and the reduction was more pronounced in the observation group after treatment than in the control group after treatment(P<0.01).6.IUA score: The IUA scores in the pre-treatment observation group were: 7(5,8)and after treatment were: 2(2,3);the IUA scores in the pre-treatment control group were: 7(5,8)and after treatment were: 4(3,5).The IUA scores in both groups were significantly lower than before treatment(P<0.05),and the IUA scores in the observation group were lower after treatment compared with the control group(P<0.01).7.Safety score: Before and after treatment,no significant abnormalities were found in the three major routine and liver and kidney function tests in both groups,and no serious adverse reactions occurred during drug use,so the safety of this study was considered fair.Conclusion: After TCRA,patients with deficiency of kidney and blood stasis type IUA were treated with Bushen Huoxue Decoction combined with Western medicine,which had better clinical efficacy than Western medicine alone,and was relatively safe to use.It could better increase the thickness of the endometrium,reduce the resistance of uterine artery blood flow,reduce the IUA score.promote the regeneration and repair of the endometrium,help patients recover menstrual volume and relieve clinical symptoms of traditional Chinese medicine.The mechanism of action may be related to the estrogen-like effect of Bushen Huoxue Decoction to promote endometrial proliferation,improve endometrial blood supply to provide a material basis for endometrial repair,and regulate inflammatory factors to provide a favorable microenvironment for endometrial repair. |
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