| Objective:To understand the related factors of endometrial lesions in perimenopausal patients with abnormal uterine bleeding and the characteristics of TCM syndrome types of endometrial pathological types in perimenopausal patients with abnormal uterine bleeding.Methods:Questionnaire survey was used to collect relevant data.Patients admitted to the Department of Gynecology,Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from December 2021 to February 2023 were selected to collect general data,clinical symptoms,laboratory indicators,gynecological color doppler ultrasound reports,hysteroscopic scrape pathology reports,TCM syndrome and other data of the study population.During the study,a total of458 patients were included according to the inclusion criteria,and 337 patients with perimenopausal abnormal uterine bleeding were finally collected combined with the exclusion criteria.office 2019 was used for database establishment,data screening,descriptive analysis and cartographic tabulation of the above data,and SPSS26.0 was used for statistical analysis.Results:1.337 patients underwent hysteroscopic curettage after admission,and the postoperative pathological distribution was as follows:44 patients(13.06%)had endometrial changes in proliferative stage,46 patients(13.65%)had endometritis in secretory stage,and 13 patients(3.86%)had endometritis.Endometrial polyp in 65 cases(19.29%);There were 153 cases(45.40%)of simple endometrial hyperplasia and 7 cases(2.08%)of submucosal fibroids.Endometrial complex hyperplasia,atypical hyperplasia in 5 cases(1.48%);Endometrial cancer was found in 4 cases(1.19%).2.Univariate analysis showed statistically significant differences in BMI,bleeding time,intrauterine device,hypertension,family history of malignant tumor,endometrial uniformity,and endometrial thickness(P<0.05).Patients with higher BMI,longer bleeding time,IUD placement,history of hypertension,family history of malignant tumors,uneven endometrial,and thicker endometrial thickness had a higher proportion of endometrial lesions.3.logistic regression analysis showed that BMI,intrauterine device and endometrial thickness were possible influencing factors(P<0.05).The incidence of lesions in patients with BMI≥24mm was 1.672 times that of other BMI patients(BMI<24Kg/m~2),the incidence of lesions with IUD was 2.087 times that without IUD,and the incidence of lesions in patients with large endometrial thickness was higher than that in patients with small endometrial thickness.The incidence rate of lesions in patients with large endometrial thickness≥15mm was 3.928 times higher than that in patients with other endometrial thickness.4.In the distribution of TCM syndrome types in perimenopausal AUB patients,there were 209 cases of spleen deficiency,77 cases of kidney deficiency(12 cases of kidney Yang deficiency,65 cases of kidney Yin deficiency),5 cases of blood heat(3 cases of deficiency heat,2 cases of solid heat)and 46 cases of blood stasis.Among them,spleen deficiency syndrome accounted for 62%.Among the patients with endometrial lesions,there were 156 cases of spleen deficiency,60 cases of kidney deficiency(9 cases of kidney Yang deficiency,51 cases of kidney Yin deficiency),2 cases of blood heat(2 cases of deficiency heat,0 cases of solid heat),and 29 cases of blood stasis.There were 289 cases of perimenopausal AUB caused by deficiency,accounting for85.8%of the total number of income,and 75.4%of the patients had endometrial lesions.Conclusions:BMI,IUD and endometrial thickness were independent risk factors for the occurrence of endometrial lesions in perimenopausal patients with abnormal uterine bleeding.The patients with abnormal uterine bleeding and endometrial lesions in perimenopausal period are mostly caused by deficiency.In addition to correcting the deficiency,it is more important to seek the cause to treat the disease.Clinical treatment should be based on the integrated mode of"five diagnoses combined with ginseng and ten lines of syndrome differentiation". |
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