Prospective Research About TCM Syndromes And Recurrence Of Endometriosis Patients Before And After Surgery

Objective:To undertake prospective research based on clinical epidemiological research methods;to collect TOM syndromesof EMS patients before and after surgery,as well as possible to collect the factors that will influence the syndromes;and to discuss on the distribution and combination rules of the TCM syndromes before and after surgery and possible relativity for recurrence,and eventually provide symptomatic and epidemic evidence to prevent and treat against EMS,so that women and patients after surgery in various physical state can get effective preventive guide.Methods:Firstly,Semi-open questionnaires are used to collect data of 208 post-operative EMS patients whose age range from 18 to 54,with average age of 36.56±7.94.Secondly,the TCM syndromes of EMS patients and possible influencing factors are collected.Thirdly,to conduct 1-year follow up visit and monitor patients' recurrence,and finally complete the preoperative and follow up questionnaires.Results:This research has surveyed with 208 patients.1.Of the symptoms in survey,consecutive dysmenorrhea,worsening dysmenorrhea,infertility, hypermenorrhea,prolonged menstrual period,abnormal menstruation,darkred menstrual blood and bloodclots are the most seen ones.Light dark tongue, darkred tongue,tongue with petechia and ecchymosis,venation of tongue with winding,venous strings are the most seen symptoms.2.In the distribution of pre-surgery syndromes,firstly all with blood stasis,secondly Qi stagnation and kidney deficiency are major ones.In the distribution of one week post-surgery syndromes,firstly Qi deficiency,secondly blood stasis and kidney deficiency.During the period before surgery and 1 week after surgery, blood stasis,Qi stagnation and kidney deficiency evidently fall down,but Qi deficiency and blood deficiency obviously increase.During the period after surgery for 1 week to 1 year,kidney deficiency obviously increase,but Qi deficiency decrease to some extent,still remains as the first major syndromes. 3.blood stasis based Qi stagnation,blood stasis based kidney deficiency are major syndromes in the distribution of pre-surgery type.Weakness of the spleen and stomach,weakness of both the spleen and kidney are major syndromes for the type after surgery for one week and the type after surgery for one year as well.One week after surgery,weakness of the spleen and stomach,weakness of both Qi and blood,weakness of both the spleen and kidney obviously increase compared to that before surgery.All blood stasis syndromes decrease compared to that before surgery.As for the types after surgery for one week to one year, weakness of both the spleen and kidney,blood stasis base kidney deficiency increase to some extent while weakness of the spleen and stomach,weakness of both Qi and blood decrease.Nevertheless,weakness of both the spleen and kidney remains as the second major syndromes.4.In the relativity research for recurrence,through Logistic regression analysis it point that even one of the following risky factors——age under 24 or within the range from 30 to 34,worsening dysmenorrhea,dysmenorrhea after surgery,blood stasis,blood stasis based Qi stagnation,blood stasis based Qi deficiency,blood stasis based renal deficiency,wet sputum and stasis after surgery for 1 year are risky factors——will possibly cause recurrence,while we found out that laparotomy,bradymenorrhea after surgery are possibly protective factors against recurrence.Conclusions:1.Blood stasis blocks chongren and baogong is the basic pathogenesis of EMS,blood stasis based Qi stagnation is the most common syndromes.2.Major pre-surgery syndromes is blood stasis based Qi stagnation, with practical syndromes as the most.Blood stasis and Qi stagnation decrease after surgery,while Qi deficiency and blood deficiency increase.The principal type of syndromes converts into the type of blood stasis based.Qi deficiency.3.Age under 24 or within the range from 30 to 34,worsening dysmenorrhea,dysmenorrhea after surgery,blood stasis,blood stasis based Qi stagnation,blood stasis based Qi deficiency,blood stasis based renal deficiency,wet sputum and stasis after surgery for 1 year are risky factors that will cause possible recurrence.Laparotomy,combining bradymenorrhea after surgery are possibly protective factors against recurrence.