Study On TCM Syndrome Distribution Of Adenomyosis And A Systematic Review And Meta-analysis Of The Efficacy Of Guizhi Fuling Formula In The Treatment Of Adenomyosis

Objective:1.Collected and analyzed the distribution of TCM syndromes of patients with adenomyosis;2.Guizhi Fuling formula,a representative prescription for promoting blood circulation and removing blood stasis in gynecology,was selected for systematic review and Meta-analysis to explore the efficacy and safety of Guizhi Fuling formula in the treatment of adenomyosis.Methods:1.The clinical research part was a cross-sectional study,which established the clinical observation form of adenomyosis,collected the diagnostic information of patients with adenomyosis,and used the data mining methods of factor analysis,systematic cluster analysis and association rule algorithm analysis.The distribution of TCM syndromes of patients with adenomyosis was analyzed systematically.2.Randomized controlled trials(RCTs)of Guizhi Fuling formula combined with western medicine in the treatment of adenomyosis were retrieved by searching Cochrane Library,PubMed,EMBASE,Sinomed,CNKI,VIP,and WanFang databases.Quantitative analyses and quality assessments were then conducted based on ed data.Stata 16 was used for Meta-analysis.Results:1.In the part of clinical observation,a total of 121 qualified clinical observation records were collected.The results of factor analysis showed that blood stasis was the basic syndrome factor for the widespread distribution of adenomyosis,kidney deficiency,qi stagnation,qi deficiency and yang deficiency were relatively common,and phlegm-dampness was relatively rare.the four common factor groups obtained by systematic cluster analysis based on factor analysis can be divided into four syndromes:blood stasis and qi deficiency syndrome,deficiency of spleen yang syndrome,kidney deficiency and liver stagnation syndrome,phlegm-dampness and blood stasis syndrome.The core four diagnosis information groups of adenomyosis are obtained by mining the association rules of the four diagnosis information using Apriori algorithm,which embodies the characteristics of five syndrome elements:yang deficiency,qi stagnation,blood stasis,kidney deficiency and qi deficiency.2.In the part of systematic review,21 studies and 2136 patients were included.The results of Meta-analysis showed that Guizhi Fuling formula combined with western medicine has a better effect in relieving dysmenorrhea,reducing menstrual volume,reducing uterine volume,reducing CA125 level and reducing endometrial thickness,and didn’t increase the incidence of adverse events such as headache,nausea and vomiting,menstrual disorder and so on.The quality of evidence was relatively low.Conclusion:1.The core pathogenesis of adenomyosis was constructed by blood stasis,yang deficiency,kidney deficiency,qi deficiency,qi stagnation,phlegm and dampness,while blood stasis,yang deficiency,kidney deficiency,qi deficiency and qi stagnation were in a more important key position,which should be regarded as the core of clinical treatment.Corresponding to the basic clinical treatment strategy of adenomyosis,activating blood circulation and removing blood stasis was the general treatment principle,warming yang,tonifying kidney and regulating qi(regulating qi stagnation and tonifying qi)were relatively important,which were summarized as activating blood circulation and warming yang,tonifying kidney and regulating qi.2.The evidence of systematic review showed that Guizhi Fuling formula combined with western medicine has a better therapeutic effect in the treatment of adenomyosis as a safe treatment,and demonstrated the feasibility of Guizhi Fuling formula in the effective treatment of adenomyosis.