Retrospective Study On The Postoperative Recurrence And Pregnancy Rate Of Stage ?-? Endometriosis Patients Treated By GnRH-a Combined With Luoshi Endometriosis Formula

ObjectiveThrough a retrospective study on the postoperative recurrence rate and pregnancy rate within 2 years in patients with endometriosis(EMT)which confirmed by laparoscopy and postoperative pathology,it was analyzed whether the combination of Luoshi Endometriosis Formula(LEF)and GnRH-a to alleviate postoperative clinical symptoms and improve fertility was better than LEF or GnRH-a alone,so as to guide clinical medication.MethodsPatients with ASRM stage ?-? endometriosis confirmed by laparoscopy and postoperative pathology in our hospital from June 2015 to March 2017 were divided into four groups:LEF group,GnRH-a group,LEF with GnRH-a group,control group.The course of treatment was three months of patient who was treated by GnRH-a.Every patient took modified Si Wu Tang decoction after operation.Then by phone call follow-up visit,we count the recurrence rate of the four groups above,and the pregnancy rate of patients who had a history of infertility in 2 years.Results1.There was no difference among LEF group,the GnRH-a group,the GnRH-a combined with LEF group and the control group in terms of age,the proportion of chocolate cyst,the operation history of EMT,and the preoperative clinical symptom scores.There was no difference in infertility type and infertility duration among the patients who had a history of infertility,and they were comparable(P>0.05).2.There was no significant correlation between ASRM scores and clinical symptom scores(P>0.05,r=0.146).3.There was no difference in the clinical efficacy among LEF group,the GnRH-a group,the GnRH-a combined with LEF group and the control group(P>0.05).4.There was no difference in the improvement of postoperative clinical symptom scores among LEF group,the GnRH-a group,the GnRH-a combined with LEF group and the control group(P>0.05).5.GnRH-a combined with LEF group had better effect than control group on decreasing the rate of recurrence(P<0.0038).There was no difference between the remaining comparisons in each two groups(P>0.0038).6.GnRH-a combined with LEF group had better effect than control group on the rate of pregnancy(P<0.0038).There was no difference between the remaining comparisons in each two groups(P>0.0038).7.The LF scores:the pregnancy rate of 7-8 scores group was higher than that of 0-3 scores group within two years after surgery(P<0.017).There was no difference between the remaining comparisons in each two groups(P>0.017).8.The EFI scores:the pregnancy rate of 9-10 scores group was higher than that of 0-4 scores group and 5-6 scores group within two year(P<0.0038).There was no difference between the remaining comparisons in each two groups(P>0.0038).9.The ASRM scores of the patients in the non-pregnant group were higher than those in the pregnant group(P<0.05),while the LF and EFI scores were lower in the non-pregnant group(P<0.001).10.The ASRM scores had a negative linear relationship with the LF and EFI scores,and the LF scores had a positive linear relationship with the EFI scores.11.There was no difference in adverse reactions among LEF group,GnRH-a group,GnRH-a combined with LEF group and control group(P>0.05).Conclusions1.The severity of clinical symptoms in patients with EMT is not proportional to the ASRM scores.In other words,clinical symptoms caused by EMT were not directly bound up to with the extent of EMT.2.LEF group,GnRH-a group,GnRH-a combined with LEF group have equivalent efficacy in improving the postoperative clinical symptoms.While LEF group may have more advantage in decreasing adverse reactions.3.GnRH-a combined with LEF was an effective method for decreasing reccurence rate and may had better efficacy than GnRH-a or LEF alone.4.GnRH-a combined with LEF was an effective method for increasing pregnancy rate and may had better efficacy than GnRH-a or LEF alone.5.About ASRM?LF and EFI scores,we found that there were higher LF?EFI scores and pregnancy rate while lower ASRM scores,and wice versa.6.ASRM scores can not fully meet the assessment of fertility in endometriosis patients with infertility.LF and EFI scores may have more clinical value.The higher LF and EFI scores were,the better the pregnancy outcomes were.