Variety IUD Clinical Efficacy And Adverse Reactions Related Research

ObjectiveTo explore clinical effects and adverse reactions of y-Cu365, I-220, T-220,ML375and Gyne Fix IN IUD, and how Cu-IUDs played a contraceptive effectthrough releasing copper ions. To analy size the diagnosis, treatment andprevention of bleeding and ectopic IUDs, providing more clinical experienceand experimental materials for IUD clinical applications.Methods1.The healthy women who chose voluntarily to be placed/checked the IUD(y-Cu365, I-220, T-220, ML375and Gyne Fix IN) in Tai’an Maternal and ChildHealth Hospital and Tai’an Chinese Traditional Medicine Hospital from January2009to August2012were divided into five IUD groups, operated byexperienced doctors, follow-up work conducted by trained members. Theverified experimental data were analyzed with SPSS17.0software.2.We studied each of the20cases of the same gestational age womenaborted who were pregnant with IUD or normally pregnant and5cases ofdysfunctional uterine bleeding women who were conducted endometrial curetta-ge between April2012and December2012. The concentration of copper ions ofthe samples after collected and processed were measured with the USA PE Aanalyst800KS-21for the analysis how IUDs release copper ions.3.With the help of X-ray, B ultrasound, CT, laparoscopy or hysteros copy，33of ectopic IUD cases after checked and treated were analy sized from January2008to September2012.4. The outpatients or inpatients suffering uterine bleeding from February2011to February2012were grouped as treatment and control groups for therapy. Bupleurum hemostatic soup (including Bupleurum, radix curcumae, whitepeony root, Codonopsis, Scutellaria baicalensis, Cacumen biotae, Rubia cordi-folia, safflower, pseudo-ginseng) for the former, tranexamic acid and indome-thacin enteric table for the latter, the clinical efficacy of both were observed.Result1.The24month adverse reaction incidence of y-Cu365, I-220, T-220,ML375and GyneFix IN were19.14%,18.29%,24.12%,20.00%,16.43%correspondingly, prolonged menstrual period and increased vaginal discharge took ahigh proportion among three groups of y-Cu365, I-220and ML375, so bleedingand lower abdominal pain to the T-220group, bleeding and prolonged menstrualperiod to the Gyne Fix IN group. There were not significant difference (P>0.05)among the overall incidence of adverse reactions of any two groups of IUDs.Clinical effects among the above group had a different preference, removal formedical reasons and shedding occupied a slightly higher proportion (1.74%,1.52%;7.65%,4.12%correspondingly)of y-Cu365and T-220groups, soremoval for the disease and pregnancy with IUDs to I-220and ML375groups（3.60%，1.86%；4.62%，2.31%correspondingly）, removal for the disease toGyne Fix IN. There were significant difference (P<0.05) between the y-Cu365and T-220groups, between Gyne Fix IN and T-220groups in continuation rates,there was not significant difference (P>0.05) between the other two groups.2.The copper ion concentrations of the pregnancy group with IUD, normalpregnancy group and dysfunctional uterine bleeding group were1.33±0.19mg/kg,0.87±0.15mg/kg,0.60±0.11mg/L respectively, there were significant difference(P<0.05) between any two groups, Cu-IUDs played the contraception rolethrough significantly changing intrauterine local concentration of copper ions,And the IUD cases who had higher concentrations of copper ion complained ofmost symptoms of dysmenorrheal and pelvic inflammatory disease.3.Among33cases of ectopic IUDs for diagnosis and treatment,21ofpartial ones to the cervix or muscle layer with mild symptoms were removedwith the help of X-ray or B ultrasound;6completely cases to the cervix andmuscular with obvious pain or uterine perforation were cut out by hysteros copyor laparotomy,7cases outside the uterus, such as rectouterine depression,bladder uterus depression, the broad ligament and abdominal, were removed bylaparoscopic or open surgery. 4. Between treatment experiments of IUD bleeding, the total effective ratein the treatment group was93.3%, significantly better than the control group(66.6%). There was a significant difference (P<0.05) between the two.Conclusion1.According to experiments, five IUDs had different tendencies andrespective characteristics in terms of adverse reactions and clinical effects,overall, y-Cu365, I-220and Gyne Fix IN were better in both above aspects thanthe other two T-220and ML375. With the continuous progress of science andtechnology, as well as IUD-related research and development, to choose theright type of IUD types, to be placed by skilled physicians, and to be follow-upcan reduce the adverse reactions and improve the clinical effect as well aspromote a set of women’s health.2. Cu-IUD played a role in contraception through the release of copper ionsin the uterine cavity partially, while a higher concentration of copper ionsincreased the occurrence probability of dysmenorrhea, menorrhagia, irregularbleeding and pelvic inflammatory disease.3.X-ray and/or B-ultrasound, CT, hysteroscopic and laparoscopic methodswere needed for safe and effective treatment of checkups of the ectopic IUDcases, satisfactory clinical results were obtained. Strengthening IUD placingtechnology, as well as follow-up after1,3,6,12months and annually thereafter,can reduce the incidence of complications.4. Bupleurum hemostatic soup showed better efficacy to uterine bleedingthan the control group, without significant adverse reactions. Which hadimportant significance to advance women IUD acceptance and protect thephysical and mental health of women, and had great clinical promotional value.