Effect Of Jiajian Yulin Decoction On Endometrial Receptivity In Patients With Kidney Deficiency And Blood Stasis After Moderate To Severe TCRA Surger

Objective:To observe the effect of modified Yulin Decoction on endometrial receptivity of patients with kidney deficiency and blood stasis syndrome after surgery for moderate to severe intrauterine adhesions in order to provide new ideas and methods for clinical treatment of this disease.Methods:Sixty patients of childbearing age who were admitted to the inpatient department of gynecology of the Second Affiliated Hospital of Hunan University of Chinese Medicine from January 2021 to December 2021 and conformed to the syndrome of intrauterine adhesion,kidney deficiency and blood stasis were selected and randomly divided into the Chinese and western medicine group(treatment group)and the western medicine group(control group).Thirty cases in each group were subjected to intrauterine adhesion separation in our hospital 3–7 days after their menstruation was clean,and intrauterine adhesion was scored during the operation.The control group was routinely subjected to infection prevention and estrogen and progesterone sequential treatment after the operation.On the basis of the control group,patients in the treatment group were additionally treated with modified Yulin Decoction after the postoperative vaginal bleeding was eliminated.The treatment was continued for 14 days and lasted for three menstrual cycles.The overall efficacy and safety were evaluated by recording the changes of menstrual conditions,the scores of traditional Chinese medicine symptoms,the changes of AFS of intrauterine adhesion,endometrial thickness,RI and PI of uterine artery blood flow,and the levels of TNF-αand VEGF.Results:After treatment,the two groups had remarkable curative effects.The overall effective rates of the treatment group and the control group were 96.67% and 83.33%,respectively.The effective rates of TCM in the treatment group and the control group were 96.67% and 83.33%,respectively,and there was significant difference in improving the efficacy of TCM(P < 0.05).After treatment,the scores of menstruation,TCM syndrome,intrauterine adhesion,RI,PI,TNF-α and VEGF of uterine artery were all significantly lower than those before treatment(P<0.05).The endometrium was significantly thickened than that before treatment(P<0.05).Inter-group comparison showed that the treatment group’s menstrual condition score,TCM syndrome score,intrauterine adhesion score,and RI,PI,TNF-α and VEGF levels of uterine artery blood flow were significantly lower than those of the control group(P <0.05).The endometrial thickening in the treatment group was significantly better than that in the western medicine group(P<0.05).No serious side effects or adverse reactions to the treatment were observed in all patients during the trial.Conclusion:Modified Yulin Decoction has definite curative effect on patients with kidney deficiency and blood stasis syndrome after operation for moderate to severe intrauterine adhesions.It can significantly improve menstrual flow and TCM clinical symptoms,and has the effects of increasing endometrium,reducing intrauterine adhesions score,endometrial blood flow RI and PI as well as serum TNF-α and VEGF levels and other endometrial receptivity.The mechanism may be related to the regulation of immune imbalance of the body,inhibition of endometrial fibrosis,regulation of inflammation and improvement of uterine blood perfusion.