Clinical Study On The Treatment Of Intestinal Inflammation In Patients With Infertility(Syndrome Of Liver Depression And Spleen Deficiency) With Liver-soothing Prescription

Objective:Using fecal as the observation index to explore the effect of liver-soothing prescription on intestinal inflammation improvement in patients with infertility(syndrome of liver depression and spleen deficiency).Method:1.Case source: infertile patients who visited the tutor’s clini c of the affiliated hospital of chengdu university of traditional Ch inese medicine from June to December 2019.2.Criteria for diagnosis and syndrome differentiation:the diagn ostic criteria for infertility in traditional Chinese and western me dicine were formulated by referring to obstetrics and gynecology(9t h edition,people’s medical publishing house)and gynecology of trad itional Chinese medicine(9th edition,traditional Chinese medicine p ublishing house).The standard of syndrome differentiation of syndrom e of liver depression and spleen deficiency and syndrome of liver de pression refers to the guiding principles of clinical research on ne w Chinese medicine(2002 China medical science and technology publis hing house)and gynecology of Chinese medicine.3.Inclusion criteria: observation group: patients aged 21-49 ye ars old,who met the diagnostic criteria of infertility with liver d epression and spleen deficiency syndrome,and were treated with live r-soothing prescription.Control group: patients aged 21-49 years wh o met the diagnostic criteria of liver depression syndrome infertili ty.4.Methods: collecting the general information of two groups of patient(age,body mass index(BMI)),infertility diagnosis,healt h questionnaire,infrared thermal imaging results of Shenque,abdomen and uterus location(ADT-YL-100 A digital medical infrared thermal i maging system)、fecal calprotectin(FC)(FC detection kit and port able immune analyzer)、assessment of syndrome score of liver depres sion and syndrome score of liver depression and spleen deficiency in the corresponding groups on the 7th day of the menstrual cycle(not in period)and the data of the two groups were compared and analyzed.On the 8th day of the menstrual cycle,the patients in the observati on group began to take the liver-soothing prescription(chaihu、bais hao、daoya、jianqv),3 times a day,150 ml each time,for 2 weeks.FC values,scores of syndrome of liver depression and spleen deficiency and clinical medical records of patients in the observation group o n the 19 th day of the menstrual cycle(1 day interval from last medi cation date)after treatment were collected,and the differences of various data before and after treatment were compared and analyzed,so as to evaluate the improvement effect of liver-soothing prescript ion on the intestinal state of patients.5.Statistical methods: SPSS26.0 data processing system is used to analyze the collected information and data.The measurement data r esults were expressed as mean ± standard deviation(`x±s),and the homogeneity test of variance and the independent sample t test were performed if the normal distribution was met.The counting data were tested by the rank sum test or chi-square test.Correlation is analy zed by correlation analysis.The difference was statistically signifi cant when P<0.05,and statistically significant when P<0.01.Results:1.A total of 31 patients in the observation group(liver depres sion and spleen deficiency infertility)were included in this study,including 18(58.06%)patients with liver depression tendency,8(25.81%)patients with spleen deficiency tendency,and 5(16.13%)pati ents without obvious tendency.27 patients in the control group(liv er depression infertility).2.Among the 58 infertility patients,6 of the patients(10.34%)w ith BMI<18.5(kg/m2);42 of the patients(72.41%)with 18.5≤BMI<24(kg/m2)(normal);9 of the patients(15.52%)with BMI≥28(kg/m2)(overweight);1 of the patients(1.72%)with BMI≥28(kg/m2)(obe sity).3.Among the 58 infertility patients,23(39.66%)were primary inf ertility patients and 35(60.34%)were secondary infertility patients.Among the causes of infertility in these patients,20(34.48%)were o viduct disease,6(10.34%)were endometrial polyps,3(5.17%)were end ometrial thinness,4(6.90%)were uterine fibroids,2(3.45%)were dec reased ovarian function,and 23(39.66%)were unknown reasons.4.In the experimental group,19(61.29%)had two or more partial constitutions,and the top three partial constitutions were yang def iciency quality,qi stagnation quality,and humid heat quality.In t he control group,18(66.67%)had two or more biased constitutions,a nd the top three biased constitutions were humid heat quality,phleg m-dampness quality,qi deficiency quality.5.The mean value of heat metabolism at the shenque of the obser vation group and the control group was(31.44±0.51)℃ and(31.26±0.25)℃,respectively,with no difference between the groups(P>0.05),all at normal levels.The mean value of heat metabolism at the abdom en of the observation group and the control group was(29.94±0.05)℃and(29.93±0.17)℃,respectively,with no difference between the groups(P>0.05).The mean value of heat metabolism at the uterine w as(29.33±0.22)℃ and(29.25±1.02)℃,respectively,in the observa tion group and the control group(P>0.05).The thermal metabolic va lue of the reproductive sites(lower abdomen and uterus)in the twogroups was lower than the normal level,with the characteristic of co ld uterus.6.The mean value of FC in the observation group was(223.67±326.95)ug/g,of which no patients with FC<15(ug/g)(no intestinal i nflammation);13 patients(41.94%)with 15≤FC<60(ug/g)(intestina l inflammation may exist at low level);18 patients(58.06%)with FC≥60(ug/g)(intestinal inflammation).The mean value of FC in the control group was(61.27±14)ug/g,of which 7 patients(25.93%)wit h FC<15(ug/g)(no intestinal inflammation);15 patients(55.56%)with 15≤FC<60(ug/g)(intestinal inflammation may exist at low le vel);5 patients(18.52%)with FC≥60(ug/g)(intestinal inflammat ion).The incidence and severity of intestinal inflammation were hig her in the observation group than in the control group(P<0.01).I n the observation group,there was no difference in FC level between the three groups(P>0.05).7.The age,BMI and heat metabolism value of shenque,lower abdo men and uterus location of 58 infertility patients were not correlat ed with their FC values(P>0.05).The score of syndrome of liver de pression and spleen deficiency in the experimental group was positiv ely correlated with its FC value(R=0.466,P<0.01).There was no co rrelation between the liver depression syndrome score and its FC val ue in the control group(P>0.05).8.After treatment,the mean value of FC in the observation grou p was(65.21±1.85)ug/g,of which 9 patients(29.03%)with FC<15(u g/g)(no intestinal inflammation);16 patients(51.61%)with 15≤FC<60(ug/g)(intestinal inflammation may exist at low level);6 patie nts(19.35%)with FC≥60(ug/g)(intestinal inflammation).After tre atment,the overall FC level in the observation group significantly decreased(P<0.01),and the people with intestinal inflammation sig nificantly decreased(P<0.01).9.After treatment,the mean syndrome score of the observation g roup decreased from(22.45±1)to(6.61±0),showing a significant d ifference(P<0.01).In most patients,the symptoms of chest distens ion and tightness,abdominal pain and loose stool were significantly improved,and the negative emotions of depression and impatience we re relieved,with the total effective rate of 96.77%.After 1 month of follow-up,2 patients(6.45%)were naturally pregnant.Conclusion:1.The heat metabolism condition of reproductive location of inf ertile patients with liver depression and liver depression and splee n deficiency syndrome is low and their uterus are cold,but the ther mal metabolic value of their reproductive location is independent of their intestinal condition.2.FC can objectively reflects the degree of intestinal inflammationin infertility patients,and is related to the TCM syndrome score of infertility patients with liver depression and spleen deficiency.3.Compared with the infertility patients with liver depression syndrome,the incidence and severity of intestinal inflammation are higher in the infertility patients with liver depression and spleen deficiency syndrome.4.liver-soothing prescription can effectively improve the intes tinal inflammation and systemic symptoms of infertile patients with syndrome of liver depression and spleen deficiency,and promote the natural pregnancy rate.