| Objective:This study investigates the postoperative efficacy of Wenyang Yiqi Decoction combined with dydrogesterone on patients with phlegm-dampness-stasis polyps(EP).Estrogen receptor(PR)in endometrial tissue and Vascular endothelial growth factor(VEGF)before and after treatment with estrogen receptor(PR).VEGF expression,menstruation score,TCM syndrome score,endometrial thickness,hemoglobin and other indicators changes,objective evaluation of the clinical efficacy of this regimen,preliminary exploration of the possible mechanism of action of this regimen,to provide ideas and references for preventing recurrence of EP after surgery.Methods:A total of 92 patients who met the inclusion and exclusion criteria in the Department of Gynecology of Jiangsu Hospital of Traditional Chinese Medicine from June 2020 to June 2021 were selected as the study objects,and the patients were divided into treatment group and control group in a 1:1 ratio,with 46 cases in each group.The control group began to take dydrogesterone orally on the 11th day after hysteroscopy and the 11th day of two postoperative menstrual cycles,every 12 hours for 14 days,a total of 3 cycles;The treatment group was additionally given Wenyang Yiqi decoction for 14 days for 3 cycles on the basis of the above dydrogesterone treatment.Both groups had contraception during medication.The expression levels of PR and VEGF in the endometrial tissues of the two groups were compared during the operation and 6 months after the operation.Meanwhile,menstrual conditions,TCM symptom scores,endometrial thickness and recurrence of the two groups were recorded before and 6 months after the operation,and statistical analysis was made.Results:During the experiment,3 patients in the treatment group were lost to follow-up,and the success rate of follow-up was 93.48%,while 4 patients in the control group were lost to follow-up,and the success rate of follow-up was 91.30%,which was similar to the treatment group(P>0.05).The efficacy of the two groups after operation was compared:(1)menstruation:the complete remission rate of the treatment group was significantly higher than that of the control group(55.8%vs 40.4%),P<0.05,showing statistical difference.Both groups could effectively improve the menstrual period,menstrual texture and degree of dysmenorrhea,and the effect of the treatment group was better(P<0.05).There was significant difference in menstrual score between the two groups before and after treatment(P<0.05).There was no significant difference in preoperative and postoperative menstrual scores between groups(P>0.05).(2)TCM syndrome score:TCM syndrome score of the two groups decreased significantly after treatment,and the score of the treatment group was significantly lower than that of the control group,with statistical significance(P<0.05);At the same time,the two groups of treatment had a better effect on TCM syndrome improvement,from the effective rate,93.0%in the treatment group,only 83.3%in the control group,the treatment group significantly better effect(P<0.05);(3)Endometrial thickness:After treatment,endometrial thickness was reduced to varying degrees in both groups,especially in the treatment group,with significant difference(P<0.05).(4)Hemoglobin value:After medication,hemoglobin in both groups increased in different amplitude,and compared with the treatment group,the increase in the control group was more obvious,with statistical significance(P<0.05);There was no significant difference between the two groups(P>0.05).(5)Expression of PR and VEGF in endometrial tissue:after medication,the expression of VEGF in glands and interstitium was significantly decreased in the two groups(P<0.05),but the data between the two groups were similar(P>0.05).The expression of PR in glands and interstitium was increased compared with that before medication(P<0.05),and the expression of PR in treatment group was significantly higher than that in control group(P<0.05).(6)Recurrence rate:there were 3 patients in the treatment group and 8 patients in the control group,and the recurrence rate between the two groups(6.97%vs 16.60%)was significantly different(P<0.05).Conclusion:The treatment regimen of Warm Yang Yiqi combined with progesterone can significantly improve the TCM symptoms and abnormal menstruation,reduce the endometrial thickness,correct the expression of PR and VEGF in the endometrium,and reduce the postoperative recurrence rate.It is effective and worthy of clinical promotion. |
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