| Objective:This topic is through the retrospective study of traditional Chinese medic ine kidney and promoting blood circulation combined with laparoscopic surgery in the treatment of endometriosis infertility patients. After treatment, the patient’s pregnancy outcome, pregnancy time, relapse, symptom relief need to be observed. By observing the correlation between postoperative pregnancy and en dometriosis stage, fertility index, traditional Chinese medicine in the treat ment of disease, in order to explore the clinical effect of traditional Chinese medicine kidney nourishing and promoting blood circulation in patients with endometriosis infertility after laparoscopic surgery.Methods:1. Retrospective analysis of our hospital from October 2011 to March 2015in the diagnosis of endometriosis infertility patients with laparoscopic surgery. After menstruation is clean3-7days, they need to be treated with laparoscopic surgery. By Overall exploring the pelvic conditions in surgery, in order to make r-AFS staging(Iphase, Ⅱphase, Ⅲphase, Ⅳphase). The study was conducted in 416 patients who meet the inclusion criteria. According to the patients with endometriosis after laparoscopic surgery if use of traditional Chinese med icine kidney therapy,they are divided into laparoscopic operation combined with traditional Chinese medicine treatment group A (groupⅠa, groupⅡa, group Ⅲa, groupⅣa)and simple laparoscopic surgery groupB(groupⅠb, groupⅡb, group Ⅲb, groupⅣb).2.One week after discharge, the treatment group was treated with Chinese medicine and kidney and activating blood circulation method in our hospital gynecology clinic. Commonly used traditional Chinese medicine of Tonifying the kidney. On the basis of the kidney and promoting blood circulation as the main treatment, according to the menstrual cycle to adjust the addition and sub traction. Meanwhile, according to the dialectical and distinguish disease use traditional Chinese medicine treatment. If the patient were pregnant, they should accept tocolytic treatment. If not pregnant, they should continue the former law, at least three cycles. After the operation, Operation group did not need treatment.3. The two groups were followed up for 12 months after operation and records of two groups of pregnancy outcome and time.Results:1. In 416 cases,197 cases were pregnant, the pregnancy rate was 47.4%. The intrauterine pregnancy rate was 44.5%, ectopic pregnancy rate 1.2%, location of unknown pregnancy rate was 1.7%.2. The pregnancy rate of group A was 56.0%, intrauterine pregnancy rate 53. 1%, ectopic pregnancy rate 1.1%, position of unknown 2.3%pregnancy, intrau-terine abortion rate 3.1%. The pregnancy rate of group B was 33.0%, intraut-erine pregnancy rate29.3%,ectopic pregnancy rate 2.1%, position of unknown 1.9%pregnancy, intrauterine abortion rate 4.4%. Comparison of intrauterine pregnancy rate in group A and group B, the difference was statistically sign ificant (P<0.05).Comparison of Intrauterine pregnancy rate and ectopic pregnancy rate in group A and group B, the difference was not statistically significant (P>0.05).3. According to the intraoperative findings and AFS scoring system, endometriosis is divided into Iphase, Ⅱphase,Ⅲphase, IVphase. Comparison of pregnancy rate and intrauterine pregnancy rate in group la and group Ib, the difference was statistically significant (P<0.05).Comparison of intraut-erine abortion rate and ectopic pregnancy rate in group Ⅰa and group Ib, the difference was not statistically significant (P>0.05).Comparison of preg nancy rate and intrauterine pregnancy rate in group Ⅱa and group Ⅱb, the difference was statistically significant (P<0.05). Comparison of intrauteri-ne abortion rate in group Ⅱa and group Ⅱb,the difference was not statis-tically significant (P>0.05). Comparison of intrauterine pregnancy rate in group Ⅲa and group Ⅲb, the difference was statistically significant (P<0.05).Comparison of pregnancy rate in group Ⅲa and group Ⅲb, the difference was not statistically significant (P>0.05). Comparison of pregna -ncy rate, intrauterine pregnancy rate, intrauterine abortion rate in group IVa and group IVb, the difference was not statistically significant (P>0.05)4. Endometriosis phase Ⅰ-Ⅳ clinical pregnancy rate were 46.2%,52%,50%, 36.9%. Different stages of pregnancy:Comparison of pregnancy rate, intraute-rine abortion rate, intrauterine abortion rate in groupl and groupⅡ、Ⅲ、 IV, the difference was not statistically significant (P>0.05). Comparison of pregnancy rate, intrauterine pregnancy rateintrauterine abortion rate in group II and groupIII, the difference was not statistically significant (P>0.05) Comparison of intrauterine pregnancy rate, intrauterine abortion rate in group II and groupIV, the difference was not statistically significant (P>0.05) Comparison of pregnancy rate in groupⅡ and groupIV, the difference was stat istically significant (P<0.05).Comparison of pregnancy rate, intrauterine pregnancy rate, intrauterine abortion rate in groupIII and groupIV, thediffer-ence was not statistically significant (P>0.05)5. In 416 cases, they were197 cases pregnancy within 12 months. Distribution of pregnancy time:1-3 months:85cases (43.1%),4--6months:62cases (31.5%)-7-9 months:35cases(17.8%)、10～12 months:25cases(12.7%). After the operation 1-3 months,4-6months,10-12 months, Comparison of pregnancy rate, in group A and group B, the difference was statistically significant (P<0.05).After the operation 7-9 months, Comparison of pregnancy rate, in group A and groupB, the difference was not statistically significant (P>0.05)6. Within 6 months after the operation,416 cases recurred in 38 cases (9.1 %). Within 1-3 months, they were 5 cases of recurrence (1.2%).Within 4-6 months, they were 33 cases of recurrence(7.9%). Within 4-6 months, Comparison of recurrence rate in group A and group B, the difference was statistically significant (P<0.05).Within 4-6 months, comparison of recurrence rate in groupⅡa and group Ⅱb, the difference was statistically significant (P<0.05). Within 4-6 months, comparison of recurrence rate in groupⅢa and group Ⅲb, the difference was statistically significant (P<0.05). Within 4-6 months, comparison of recurrence rate in groupIVa and groupIVb, the difference was statistically significant (P<0.05)7. According to the fertility index score, score 8 to 10 points have 283cas-es and there are 158 cases of pregnancy (55.8%). Score 5 to 7 points have114 cases and there are 36 cases of pregnancy (31.6%).Score 0 to 4 points have 19 cases and there are 6 cases of pregnancy (15.8%). Within score 5 to 7 points, comparison of pregnancy rate in group A and group B, the difference was not statistically significant (P>0.05).Within score 8 to 10 and 0 to 4 points, comparison of pregnancy rate in group A and group B, the difference was statist-ically significant (P<0.05)8. After the operation, the pregnancy rate and fertility index score of endometriosis and treatment of traditional Chinese medicine for invigorating kidney and activating blood were positive correlation(P<0.05). Pregnancy rate and stage of endometriosis were no correlation(P>0.05).9. About these symptoms of dysmenorrhea, sexual intercourse pain, analabdom-inal pain, lower abdominal pain, lumbar pain, comparison of symptomatic impro-vement in group A and group B, the difference was statistically significant (P<0.05).Conclusions:1. Invigorating kidney and promoting blood circulation therapy can improve the pregnancy rate after operation, intrauterine pregnancy rate and shorten the duration of pregnancy.2. There was no correlation between laparoscopic r-AFS staging and pregnancy rate. There was a correlation between pregnancy rate and fertility index score, invigorating kidney and promoting blood circulation. Within fertility index score 5 to 7 points, treatment of traditional Chinese medicine for invigorating kidney and activating blood could significantly improve pregnancy rate. As the fertility index score decreased, the pregnancy rate decreased.3. The treatment of kidney invigorating and blood activating Chinese med-icine can significantly improve the clinical symptoms of patients, delay or prevent recurrence of endometriosis. |
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