Effects Of Luoshineiyifang Combined Laparoscopic In The Treatment Of Endometriosis Associated Infertillity On Th1/Th2 Of Blood Serum

ObjectiveTo observe the clinical value of laparoscopy combined with Luoshineiyifang treating unbalance of Th1/Th2,discomfort and infertility caused by endometriosis at stageⅠ-Ⅱ.To investingate the mechanism of action on which luoshineiyifang treat Endometriosis from immunologist,and explore a reasonable treatment for such patients.And at the same time examine the Interferon-γ(INF-γ)and interleukin-4(IL-4) secreted by T helper celI(Th cell) in the peritoneal fluid of endometriosis patients and with leiomyoma or benign ovarian tumor.We also calculate the ratio of INF-γ/IL-4,and explore their role in the endometriosis.MethodsAll the cases which were dated from January,2008 to October 2008 came from gynecology ward in the First Affliciated Hospital of Guangzhou University of Traditional Chinese.They were randomly divided into Chinese herbal medicine combined laparoscopic group(n=20),simple laparoscopic (n=19),no extra medicine after Laparoscopic.Observe the ovulation of the follicle by B-US and give a good guide for sex time for both group patients.ELISA is applied to test the level of IL-2 and IL-10 and to calculate the ratio of both factors before and three months after Laparoscopic.Calculate the IL-2/IL-10 value,and statistical treatment of the two groups after three months later,follow-up after 6 months of pregnancy and pregnancy rate.In addition,22 cases were randomly selected from the 39 cases.At the same time,21 women with leiomyoma or ovarian tumor were selected.Examine the concentrations of interferon—γ(IN F—γ) and interleukin—4(IL—4) secreted by T helper celI(Th cell) in the peritoneal fluid.We also calculate the ratio of IFN-γ/IL-4, andexplore their role in the endometriosis.Results(1) Before treatment,there was no significant difference on the level of IL-2,IL-10,IL-2/IL-10 value between them.(P＞0.05).(2)After treatment,dysmenorrhea,menorrhagia,painful sexual intercourse, anal discomfort,lower abdominal pain symptoms all had improve in Chinese herbal medicine combined laparoscopic group and simple laparoscopic group(P＜0.05).But there were significances between the two groups,and Chinese herbal medicine combined laparoscopic group improved more (P＜0.05)(3) After treatment,pregnancy rate of Chinese herbal medicine combined laparoscopic group was higher than that of simple laparoscopic group(P＜0.05).But abortion rate had no significant difference in two groups (P＞0.05).(4)After treatment,the levels of serum IL-2,IL-2/IL-10 in Chinese herbal medicine combined laparoscopic group and simple laparoscopic group were both obviously higher than those of pretherepy(P＜0.05),and those of Chinese herbal medicine combined laparoscopic group were more higher than those of simple laparoscopic group after treatment(P＜0.05).The levels of serum IL-10 in Chinese herbal medicine combined laparoscopic group and simple laparoscopic group were both obviously lower than those of pretherepy (P＜0.05),and those of Chinese herbal medicine combined laparoscopic group were more lower than those of simple laparoscopic group after treatment(P＜0.05).(5)The levels of INF-γ,IFN—γ/IL-4 in the peritoneal fluid of Chinese herbal medicine combined laparoscopic group was significantly lower than that of simple laparoscopic(P＜0.05).The level of IL-4 in the peritoneal fluid of Chinese herbal medicine combined laparoscopic group was significantly higher than that of simple laparoscopic(P＜0.05).Conclusion (1) By comparing patients with endometriosis and non-endometriosis,the levels of peritoneal fluid IFN-γ,IL-4 and IFN-γ/IL-4,suggest that the ratio of imbalance between Th1 cells and Th2 cells,and the ratio of the Th2 shift,may lead to endometrial cell escape immune surveillance,and implant,develop.(2) Chinese herbal medicine combined laparoscopic can improve clinical uncomfort more efficiently than simple laparoscopic.Mechanism may be: Luoshineiyifang can increase the value of serum Th1,reduce the value of serum Th2,so as to enhance the value of serum Th1/Th2,and improve the imbalance of Th1/Th2 in mild endometriosis,effectively improve symptoms, improve the postoperative pregnancy rate.It hints laparoscopic surgery combined Luoshineiyifang is a more effective treatment for mild endometriosis.