Evaluating The Efficacy Of Treatment And Changes Of Serum Levels Of TNF-α And EGF In Vaginal Bleeding After Drug Induced Abortion

Objective To evaluate the effect of Mifepristone and Qianzhi JiaoNang on patients with vaginal bleeding after drug induced abortion.To investigate changes of the levels of tumor necrosis factor-α(TNF-α)and epidermal growth factor (EGF)before and after drug induced abortion and their correlations with persistent vaginal bleeding after drug induced abortion.Methods One hundred and fifty patients with vaginal bleeding volume less than menstrual blood volume whose embryonic sac discharged smoothly within 6 hours after drug induced abortion were randomized into two groups.Patients were treated with Cefditoren Pivoxil Tablets 100mg bid×5days routinely in the control group,while patients in experiment group were randomized into Mifepristone 50mg group(Mifepristone 50mg after embryonic sac discharged),Mifepristone 30mg group(Mifepristone 10mg qd×3 days after embryonic sac discharged) and Qianzhi JiaoNang group(Qianzhi JiaoNang 5 pills tid×6 days after embryonic sac discharged).Styptic effect within 14 days after drug induced abortion and levels of sera TNF-αand EGF were evaluated before drug induced abortion,right after embryonic sac discharged and 14^thday after drug induced abortion.Results The effective styptic ratio of Mifepristone 50mg group,Mifepristone 30mg group and Qianzhi JiaoNang group were higher than control group (P＜0.01).No significant difference of effective styptic ratio were found among experimental groups(P＞0.05).Furthermore,the incidence of vaginal bleeding in experiment groups was significantly less than control group(P＜0.05)and no significant difference were found among experimental groups(P＞0.05). Significantly elevated serum TNF-α(P＜0.05)and lower EGF(P＜0.01)were found right after embryonic sac discharged compared with that before drug induced abortion.In patients with styptic vaginal bleeding,decreased serum levels of TNF-α(P＜0.01)and no significant serum levels of EGF(P＞0.05) were found on the 14th day after drug induced abortion than that after embryonic sac discharged.No difference of levels of TNF-α(P＞0.05)and EGF(P＞0.05) was found in patients still with vaginal bleeding on the 14th day after drug induced abortion compared with that right after embryonic sac discharged.Conclusion The effect on decreasing and stopping vaginal bleeding after drug induced abortion were found in both Mifepristone and Qianzhi JiaoNang. Mifepristone combined with Misoprostol may lead to abortion due to embryonic development disorder through increasing serum TNF-αand decreasing serum EGF directly or indirectly.Elevated serum levels of TNF-αmight associated with long duration of vaginal bleeding.