The Study Of The Wuzi Siwu Decoction On Endometriosis Infertility Patients Which Had Been Done Laparoscopic Operation

ObjectivesTo observe the influence of five-seed four-substance decoction (Wu Zi S i Wu Tang) on the conception rate, recurrence rate and the ovarian function after laparoscopic surgery of endometriosis infertility patients with kidney deficiency and blood stasis syndrome. To evaluate the clinical efficacy of the decoction, so as to provide a practical evidence for the improvement and promotion of Chinese medicine in pregnancy rate of endometriosis infertility women after laparoscopic surgery. To preliminarily summarize a set of Chinese medicine treatment protocol to cure endometrial infertility after laparoscopic surgery, and popularize and apply the treatment protocol clinically.MethodsFrom January 2014 to March 2015,59 patients (1 case off) with endometriosis combining with infertility after laparoscopic surgery were included into the study at the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, with 34 patients phase I.. phase Ⅱ, who were randomly divided into treatment group and control group,17 people in each, and 25 patients phase Ⅲ、phase Ⅳ who were randomly divided into treatment group of 13 people and control group of 12 people. For treatment group, patients began to take five-seed four-substance decoction after 7days of laparoscopic surgery, with one dose per day. Thereafter, they would take the decoction from the first day to the 20th day after every menstruation, and consecutively for 5 menstrual cycles. For the control group, patients did not take therapeutic measures. Observation indicators:blood test of FSH, LH, E2 and CA125 before surgery, and in the first and sixth menstruation after surgery, colorized B ultrasonography through vagina before surgery and in the sixth menstruation after surgery, scores according to dysmenorrhea score sheet filled by patients, and scores according to Chinese medicine syndrome score sheet. The pregnancy rate and recurrence rate were calculated after six months.Results1. There was no significant difference in FSH, LH and E2 for the two groups before surgery, and in the first and sixth month after surgery for the non-pregnant patients (P> 0.05).2. For treatment group, the preoperative CA125 of patients phase Ⅰ、phase Ⅱ were significantly lower than those phase Ⅲ、phase IV (P<0.01); The postoperative first month CA125 of patients phase Ⅰ、phase Ⅱ were significantly lower than those above phase Ⅲ(P<0.05); The postoperative sixth month CA125 of non-pregnant patients phase Ⅰ、phase Ⅱ were significantly lower than phase Ⅲ (P>0.05). For control group, the preoperative CA125 of patients phase Ⅰ、phase Ⅱ were significantly lower than those phase Ⅲ、phase Ⅳ(P<0.01); The postoperative first month CA125 of patients phase Ⅰ、phase Ⅱ were lower than those phase Ⅲ、phase Ⅳ, but the difference was not statistically significant (P>0.05); The postoperative sixth month CA125 of non-pregnant patients phase Ⅰ、phase Ⅱ were lower than phase Ⅲ(P>0.05), but the difference was not statistically significant (P> 0.05).3. There were significant differences between the two groups with non-pregnant patients in the dysmenorrhea score and syndrome score before the surgery and in the sixth month after surgery (P<0.05).4. There were no statistically significant difference between the two groups in pregnancy rate of patients phase Ⅰ、phase II (P> 0.05). While there was statistically significant difference between the two groups in pregnancy rate of patients phase Ⅲ、phase IV (P<0.05).There were no statistically significant difference between the two groups in recurrence rates of patients phase Ⅰ、phase Ⅱ(P> 0.05).Conelusions1. The five-seed four-substance decoction has an effect in improving the conception rate on endometriosis infertility patients with kidney deficiency and blood stasis syndrome after laparoscopic surgery. The study showed that the pregnancy rate of patients in phase Ⅲ was higher than that in control group.2. In treatment group, the CA125 level in the postoperative sixth month of patients phase Ⅲ、phase Ⅳ was significant decreased than that before treatment. There was no significant difference in FSH, LH and E2 for the two groups in the first and sixth month after surgery.3. The five-seed four-substance decoction has a great effect in improving the clinical symptoms of patients.4. Recommendation: ①Endometriosis infertility patients above phase III should be treated by combining with Chinese medicine instead of GnRH-a drug after laparoscopic surgery. ②In the 2nd-4th days of the first menstruation after surgery, routine testing on FSH, LH and E2 should be performed to know the function condition of ovarian and adjust proposals timely so as to assist pregnancy.5. The preliminary assumption for treating endometriosis infertility patients by combining with Chinese medicine after laparoscopic surgery are as follows:①For patients in or phase Ⅰ、phase Ⅱ, the recommended treatment are combining with Chinese medicine.②For patients in phase Ⅲ, when EFI≥8, treatment by combining with Chinese medicine is advocated. When EFI≤7, treatment by combining with Chinese medicine or/and western medicine are recommend. If the patient doesn’t conceive within six months, IVF-ET should be taken.③For patients in phase , the treatment proposal should be made according to patients will as well. Treatment by combining with Chinese medicine is suggested. If patients have not yet conceive after six months, IVF-ET should be taken.