Effect Of Yishen Huoxue Decoction Combined With Estrogen And Progesterone On Endometrial Receptivity Of Postoperative Intrauterine Adhesions

Objective:In this study,Yishen Huoxue decoction combined with estradiol and progesterone was used to treat postoperative patients with intrauterine adhesions.By observing the change of menstrual volume before and after treatment,the difference of endometrial thickness and EDV,endometrial volume,intimal vascular index(?),blood flow index(FI)and blood vessel index(VFI)were evaluated by transvaginal three dimensional power Doppler ultrasound.The degree of adhesion was observed under hysteroscopy.To observe whether Yishen Huoxue decoction can improve endometrial receptivity to improve the pregnancy rate of postoperative patients,so as to provide a safe and effective treatment method for clinical less menstrual volume after IUA and uterine cavity adhesion infertility.Methods:Thirty patients with intrauterine adhesion diagnosed by transvaginal three-dimensional ultrasound in Jiangsu Provincial Hospital of traditional Chinese Medicine from August to August 2016.08-2017.08 were all treated with hysteroscopy combined with hysteroscopy.They were randomly divided into treatment group(Yishen Huoxue Decoction +estrogen and progesterone)and control group(estrogen and progesterone)with 15 cases in each group.In order to evaluate the degree of adhesion and endometrial receptivity,three dimensional ultrasonography was performed in the first menstrual cycle before treatment to evaluate the degree of adhesion and endometrial receptivity.After three menstrual cycles,hysteroscopy and loop removal were performed to evaluate the degree of adhesion and to observe the menstrual status of the patients after operation.The thickness,volume,quantitative blood flow parameters of endometrial spiral artery(?,FI,VFI)were measured by ultrasound after the removal of the ring.Finally,the comprehensive evaluation of endometrial receptivity was obtained.Statistics two groups of patients after six months of pregnancy.Results:(1)Through the comparison before and after treatment,we found that the menstruation,TCM symptom score,adhesion score and endometrial receptivity of the two groups were improved compared with those before treatment(P<0.05),the curative effect was statistically different.(2)Through the comparison between groups,it was found that the curative effect of the treatment group was better than that of the control group.1)Comparison of menstrual volume,TCM symptom score and adhesion score in the treatment group was superior to that in the control group(P<0.05).2)In terms of endometrial receptivity,the treatment group was superior to the control group(P<0.05)in endometrial thickness and volume(P<0.05).There was no significant difference between the two groups in terms of quantitative blood flow parameters(VI,fi,VFI)of endometrial spiral artery(P>0.05).3)Within half a year,1 case of pregnancy was successful in the treatment group and 0 cases in the control group.(3)Overall curative effect:the treatment group recovered 6 cases(40%),effective 8 cases(53.3%),invalid 1 cases(6.7%),the total effective rate was 93.3%.In the control group,3 cases(20%)were cured,9 cases(60%)were effective,3 cases were invalid(20%),and the total effective rate was 80%.(4)Safety analysis:there was no difference in blood routine,liver and kidney function and breast ultrasound between the two groups before and after taking medicine,which indicated that the clinical safety of this study was good.Conclusion:Yishen Huoxue prescription combined with estradiol and progesterone sequential method can increase menstrual volume,improve clinical symptoms after IUA,improve endometrial receptivity in terms of endometrial thickness and volume to improve long-term pregnancy rate,and the curative effect is better than that of single hormone therapy.