| Objective: To observe the effect of Chinese herbal medicine and Intracavitaryphysiotherapy on the expression of endometrial heparin-binding EGF-like growthfactor(HB-EGF) and endometrial receptivity of kidney deficiency patients infrozen-thawed embryo transfer treatment cycle，and explore the mechanism of Chineseherbal medicine and Intracavitary physiotherapy in improving endometrial receptivityand the clinical pregnancy rate.Methods:1.the retrospective study: Retrospective analysis was made on207FETcycles in207kidney deficiency patients from February2001to December2010.Thepatients were divided into2groups:one was Intracavitary physiotherapy treatmentgroup,treated with Intracavitary physiotherapy while given Chinese herbal medicine(105cases),and another was not Intracavitary physiotherapy treatment group, treatedwith Chinese herbal medicine (102cases).The relationship between pregnancy rate ofFET and following factors were analyzed:age,the endometrial thickness, the number oftransferred embryos, the embryo morphology score and pregnancy rate.2.clinical research:70kidney deficiency patients in frozen-thawed embryo transfer treatment cycle whochoose natural cycle for endometrial preparation were randomized into Intracavitaryphysiotherapy treatment group,treated with Intracavitary physiotherapy(35cases),and notIntracavitary physiotherapy treatment group,treated with only Chinese herbal medicinefor endometrial preparation(35cases),to observe basic conditions before thetreatment,the syndrome points of Kidney-deficiency, endometrial thickness, Pulsatilityindex(PI),Resistive index(RI),the expression level of endometrial heparin-binding EGF-like growth factor(HB-EGF), pregnancy rate in both groups before and after thetreatment.Results:1. the retrospective study:（1） There was no statistical significance inthe difference of basic conditions of two groups before treatment （P＞0.05）,and theywere comparable.（2）There was no statistical significance in the difference of the numberof transferred embryos of two groups (P＞0.05）,and they were comparable.（3）There wasno statistical significance in the difference of the embryo morphology score of two groups(P＞0.05）,and they were comparable.（4）There was statistical significance in thedifferences of endometrial thickness of two groups in ovulatory period(P＜0.05）,andIntracavitary physiotherapy treatment group was thicker than not Intracavitaryphysiotherapy treatment group.（5）There was statistical significance in the difference ofpregnancy rate of two groups (P＜0.05）,and Intracavitary physiotherapy treatment groupwas higher than not Intracavitary physiotherapy treatment group.2.clinical research:（1）There was no statistical significance in the difference of basic conditions of two groupsbefore treatment （P＞0.05）,and they were comparable.（2）There was no statisticalsignificance in the difference of the syndrome points of Kidney-deficiency of two groupsbefore treatment （P＞0.05）,and they were comparable.（3）There was no statisticalsignificance in the difference of the number of transferred embryos of two groups (P＞0.05）,and they were comparable.（4）There was no statistical significance in the differenceof the embryo morphology score of two groups (P＞0.05）,and they were comparable.（5）There was statistical significance in the difference of the syndrome points ofKidney-deficiency of two groups after the treatment (P＜0.05）,and Intracavitaryphysiotherapy treatment group was lower than not Intracavitary physiotherapy treatmentgroup.（6） There were statistical significance in the differences of E2results inblood of two groups（P＜0.05）, and Intracavitary physiotherapy treatment group washigher than not Intracavitary physiotherapy treatment group.（7）There were no statisticalsignificance in the differences of P results in blood of two groups（P＜0.05）.（8）There was statistical significance in the differences of PI and RI results ofendometrial blood stream of two groups after the treatment(P＜0.05）,and Intracavitaryphysiotherapy treatment group was lower than not Intracavitary physiotherapy treatment group.（9）There was statistical significance in the differences of endometrial thicknessof two groups after the treatment (P＜0.05）,and Intracavitary physiotherapy treatmentgroup was thicker than not Intracavitary physiotherapy treatment group.（10）Therewas statistical significance in the difference of the expression level of endometrialheparin-binding EGF-like growth factor(HB-EGF) mRNA of two groups (P＜0.05）,andIntracavitary physiotherapy treatment group was higher than not Intracavitaryphysiotherapy treatment group.（11）There was statistical significance in the difference ofpregnancy rate of two groups (P＜0.05）,and Intracavitary physiotherapy treatment groupwas higher than not Intracavitary physiotherapy treatment group.Conclusion: Chinese herbal medicine and Intracavitary physiotherapy can improvethe kidney deficiency clinical symptoms,improve the uterus local environment,reducedthe endometrial blood flow resistance,improve endometrial blood supply, increasedendometrial thickness,and may improve the expression level of endometrialheparin-binding EGF-like growth factor(HB-EGF) mRNA，then improve endometrialreceptivity and clinical pregnancy rate.It’s better than only Chinese herbal medicinetreatment. |
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