| Objective: To analyze the clinical observation of modified Xuefu Zhuyu Decoction in the treatment of endometrial polyp recurrence after operation with qi stagnation and blood stasis syndrome,and to provide the basis for the prevention and treatment of endometrial polyp recurrence after operation with traditional Chinese medicine.Methods: A total of 64 patients who received hysteroscopic surgery from the First Gynecology Department of the Second Affiliated Hospital of Hunan University of Chinese Medicine from December 2018 to November 2020 were collected and randomly divided into the treatment group and the control group,with 32 cases respectively.The control group began to take dydrogesterone10mg/ time,twice/day,orally for 10 consecutive days on the 16 th day of the monthly menstrual cycle after surgery.The duration of 1 course was 1 menstrual cycle,and 3 courses of treatment were taken continuously.The treatment group was additionally treated with modified Xuefu Zhuyu Decoction on the basis of treatment in the control group,and began to take it on the second day after the vaginal bleeding was cleaned after surgery,one dose per day,a total of 300 ml,150ml at each temperature twice in the morning and evening for 10 days.The drug was stopped during menstruation,and the next course of treatment was started on the 9th day of menstrual cycle after menstruation.In the course of this study,2 patients did not follow the requirements during the period of taking medicine and were excluded,and another patient was deemed to have fallen off due to incomplete data.The final number of effective cases was 61,31 cases in the control group and 30 cases in the treatment group.Records in the two groups before operation,treatment after 3 period of treatment,drug withdrawal after 3cycles of endometrial thickness and TCM syndrome score and serum VEGF levels,two groups of patients after 3 course of treatment and drug withdrawal syndromes was after 3 cycles of curative effect,finally observed two groups of patients relapse after withdrawal 3 cycle,at the same time record the medicine two groups of patients during the period of adverse reactions.Results:(1)Comparison of endometrial thickness:(1)After 3 courses of treatment and 3 cycles of withdrawal,the endometrial thickness in 2 groups was significantly reduced compared with that before operation(P<0.05).(2)After 3courses of treatment,the endometrial thickness in 2 groups was analyzed by t test,t=1.413,P=0.002<0.05,the endometrial thickness in the treatment group was significantly thinner than that in the control group.(3)After 3 cycles of drug withdrawal,endometrial thickness in the control group tended to be more obvious.(2)Comparison of TCM syndrome scores: after 3 courses of treatment,TCM syndrome scores in the two groups were significantly lower than those before surgery.Comparison between groups: after 3 courses of treatment,TCM syndrome scores in the treatment group were lower than those in the control group(P<0.05).Comparison within groups: The scores of TCM syndromes in 2groups had no significant change after 3 cycles of withdrawal and 3 cycles of treatment(P>0.05);However,the score of the treatment group was still lower than that of the control group,indicating that the modified Xuefu Zhuyu Decoction could improve the clinical symptoms more effectively,and the duration was longer,and the efficacy was better than that of droprogesterone alone(P<0.05).(3)Influence on serum VEGF level: Modified Xuefu Zhuyu Decoction can effectively reduce the serum VEGF level of patients,and the duration is long;(4)Comparison of recurrence rate: the recurrence rate in the treatment group was lower than that in the control group,which were 3.33% and 48.39%,respectively.It was confirmed that the modified Xuefu Zhuyu Decoction could effectively reduce the postoperative recurrence of EP patients,and the efficacy was better than that of dydrogesterone(P<0.05).(5)Comparison of TCM syndromes efficacy: After treatment,both groups of patients had certain curative effects,but the treatment group was significantly better than the control group(P<0.05),which proved that the modified Xuefu Zhuyu Decoction can effectively improve the TCM syndromes of patients,and the effect is more obvious and lasts longer than the treatment of didrogesterone.(6)Comparison of adverse reactions: Patients in the two groups had no obvious discomfort during and after surgery.Conclusion:(1)Modified Xuefu Zhuyu Decoction can effectively improve the clinical symptoms of endometrial polyp patients with qi stagnation and blood stasis syndrome,with significant curative effect,which is beneficial to the patients’ physical and mental health;(2)Modified Xuefu Zhuyu Decoction can effectively inhibit abnormal thickening of endometrium,and the effect is significant;(3)Modified Xuefu Zhuyu Decoction can significantly reduce the level of serum VEGF in patients,and the presence of hyperechoic masses and uneven echo in uterine cavity was observed by ultrasound,further confirming that Modified Xuefu Zhuyu Decoction can effectively reduce postoperative recurrence of EP.(4)In the process of treating postoperative recurrence of endometrial polyps with qi stagnation and blood stasis syndrome by modified Xuefu Zhuyu Decoction,there is no obvious adverse reaction,and clinical use is safe.Compared with the simple use of western medicine after surgery,the treatment has more obvious advantages,and is worthy of further promotion and application. |
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