| Objective: 1)To investigate the expression and clinical significance of EMX2 and its upstream regulatory gene HOXA10 in endometrial polyps and normal endometrium of normal women.2)Use evidence-based medicine approach to evaluate the efficacy of traditional Chinese medicine(TCM)treatment on endometrial receptivity in infertility patients.3)Analysis of endometrial polyps type of syndrome and syndrome factor distribution,discusses the relationship between endometrial polyps and body mass index(BMI),traditional Chinese medicine for provide theoretical basis for prevention and treatment of endometrial polyps.4)Observe after hysteroscopic endometrial polyps resection of SHAO FU ZHU YU TANG to prevent recurrence of endometrial polyps effect.Methods: 1)In October 2013 to December 2014,selected from Xin Jiang Medical University Affiliated Hospital of Traditional Chinese Medicine and Xin Jiang Jia Yin Hospital patients with endometrial polyp,9 cases of endometrial polyps,49 cases of endometrial polyps with infertility patients,12 cases of normal women.Real-time fluorescent quantitative PCR technique to detect each group were used respectively to endometrial tissues EMX2 and HOXA10 mRNA expression leve.And choose 3 cases in each group,a total of 9 cases,using Western blot detection each groups in the endometrial tissue,gain relative expression of EMX2 and HOXA10 protein.2)Search and analyze the clinical research literature which has focused on the treatment of infertility patients from January 1999 to August 2012.These studies used TCM and adopted the Cochrane system to review outcomes.Cases meeting these criteria were collected and were analyzed using the meta-statistical method.3)In accordance with the requirements of the 123 cases of endometrial polyps according to TCM syndromes distribution,TCM syndrome type and body mass index for investigation and research,and the patient's body mass index statistical analysis.4)In October 2013-December 2014 transcervical electrocision of polyps and pathology confirmed 74 cases of endometrial polyps,make informed choices by patients postoperative treatment.49 cases of hysteroscopic surgery for SHAO FU ZHU YU TANG(observation group)and 25 cases of polyps hysteroscopy surgery resection only(control group).At 3 and 6 months follow-up,compare the recurrence rate of two groups,menstruation and hemoglobin.Results: 1)According to the real-time fluorescent quantitative PCR technique,the relative expression of EMX2 and mRNA HOXA10 were statistically significant between the 3 groups(F=7.358,P<0.001;F=8.076,P=0.001),endometrial polyps with infertility group and the control group between the EMX2 mRNA content was statistically significant,endometrial polyps with infertility group EMX2 mRNA levels are significantly higher than control group(P<0.001).Endometrial polyps merger between infertility group and the control group the HOXA10 mRNA content was statistically significant,endometrial polyps with infertility group HOXA10 mRNA levels significantly lower than the control group(P<0.001).Western blot test showed that the relative expression of EMX2 and HOXA10 protein between the 3 groups was statistically significant(F=63.653,P<0.001;F=2702.703,P<0.001),endometrial polyps group and the control group between Emx2 and HOXA10 protein relative expression have significant difference(P=0.02,P<0.001);uterine endometrial polyps complicated with infertility group and control group in the Emx2 and HOXA10 expression in group had significant difference(P < 0.001);Emx2 and HOXA10 protein relative expression quantity between the endometrial polyps with infertility group and endometrial polyps group with significant difference(P < 0.001).The protein expression increased.2)Thirteen papers were selected,including a total of 1,256 cases.The meta-analysis showed that TCM can effectively treat infertility patients and can significantly improve endometrial receptivity and improve pregnancy rates.Funnel plots showed symmetry,suggesting there was no publication bias.3)In the TCM syndrome type,phlegm dampness and blood stasis type(34.95%);And Qi stagnation and blood stasis(26.02%);Qi deficiency and blood stasis type(21.14%);Damp heat and blood stasis type accounted for 17.89%.Body mass index(bmi)were 28.79±4.68;24.67±6.51;25.97±8.94;24.85±6.71.Body mass index and endometrial polyps of TCM syndrome types have statistical significance(P<0.05).4)All completed 6 months follow-up after surgery.The recurrence rate of contraception group 2.08%,the control group 19.05%.3 months after the operation,the amount of menstrual reduction was 53.06%in the observation group and 44%in the control group(2? =0.544,P=0.461),6 months after the operation,the amount of menstrual reduction was 28.57%in the observation group and 60.00%in the control group(2? =6.861,P=0.009).After 3 months and 6 months after the operation,hemoglobin was significantly improved,and there was statistical difference(t=2.317,P=0.025,t=3.587,P<0.001).Conclusions: 1)EMX2 genes are expressed in endometrial polyps group is high,and the HOXA10 in endometrial polyps group is low.2)TCM may be an effective way to improve endometrial receptivity.The caveat is that these randomized controlled trials are not of high quality.3)In patients with endometrial polyp is fat more,especially in phlegm dampness and blood stasis type.The clinical response to obese women with early intervention,is expected to reduce the incidence of endometrial polyps.4)After clinical application of SHAO FU ZHU YU TANG to validate the prevention of recurrence of endometrial polyps is effective.It can reduce the amount of menstruation to reduce the situation,and at the same time after the operation of hemoglobin has not been affected.But the mechanism remains to be further in-depth study and application of traditional Chinese medicine in the prevention of endometrial polyps as a try. |
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