| Objective:Medical abortion is the preferred treatment of termination of early pregnancy. However, Abnormal uterine bleeding after medical abortion hasn’t been well solved. This reaction may increase infection, einfertility and other complications after abortion or miscarriage. Finding a good treatment of abnormal uterine bleeding after medication abortion is the requirement of many patients. Preliminary research confirmed Yimu Suogong particles can be a good treatment of abnormal uterine bleeding after medical abortion and can incrase the rate of full abortion, and is widely used in clinical treatment. This issue on treatment of vaginal bleeding is based on many years of clinical experience, extensive literature review, a random trial, through observation of changes of estrogen, progesterone and human chorionic gonadotropin of medical abortion patients to whom Yimu Suogong particle are used to study the therapeutic mechanism of changes of hormone levels. Through above work, a purpose is expected, which includes a better understanding of Yimu Suogong particles, a safer and more effective way of clinical usage for women at childbearing age. Methods:120 cases from January 2013 to July 2014 of outpatient of pregnant women were randomly divided into two groups,60 patients in treatment group,60 patients in control group. Both groups of patients underwent medical abortion,. After the two groups uterine discharge embryo, routinely given 10U Oxytocin intramuscular.Two hours later, patients take Tinidazole tablets, one time a day,lg per time.5-6 days make a course of treatment. Patients of treatment group started to take Yimu Suogong particles after five hours after medical abortion three times a day,l bag per time.7-14 days make a course of treatment. Abnormal uterine bleeding, abortion results, curettage abortion rate and recovery of menstruation period were observed, and serum estrogen, human chorionic gonadotropin and progesterone values on one day before abortion, during seven and fourteen days after abortion were recorded, SPSS 18.0 software was used for statistical treatment. Results:After medical abortion, the level of 7th day HCG and P of treatment group and control group was statistically significant (P<0.01); while the level of 14th day HCG and P before and after medical abortion showed no significant difference between the two groups (P>0.05). After medical abortion, the level of 14th day HCG and E2 of treatment group and control group was statistically significant (P<0.01); while the level of 14th day HCG and E2 before and after medical abortion shows no significant difference between the two groups (P>0.05). Uterine bleeding time of treatment group and control group was statistically significantly different (P=0.023< 0.05); the difference of menstrual recover time of these two groups was statistically significant(P<0.01). The curettage rate of treatment group was 8.62%, The curettage rate of the control group was 23.21%;the difference of curettage rate of these two groups was statistically significant (χ2=5.224,P= 0.022<0.05). Meanwhile, the number of complete abortion of treatment group were 45 cases, accounting for 79.31%; the number of control group was 31 cases, accounting for 57.14%; Certain difference of the proportion of complete abortion of these two groups existed (χ2=7.073, P=0.029< 0.05). the number of the proportion of few uterine bleeding cases showed quite a difference compared to control group (χ2=6.727,P=0.035< 0.05). Conclusion:Yimu Suogong particles can reduce early progesterone level after medical abortion, thus contributing to the discharge of intrauterine residue, and further improve the complete abortion rate and reduce the rate of curettage. HCG value synchronizes with the change of Progesterone,which makes it more possible to use progesterone level as a standard way to evaluate the outcome of medical abortion. Meanwhile increasing levels of estrogen after late medical abortion, on the one hand to promote the repair of the endometrium to treat abnormal uterine bleeding after medical abortion, on the other hand to increase sensitivity of uterine smooth muscle reaction to prostaglandins, thereby promoting uterine involution. Ovarian is the main organ for secreting estrogen for women of childbearing age, So,we can infer Yimu Suogong particles increase estrogen levels probably by restoring the function of Ovarian to achieve. Ovarian secretes estrogen to regulate the menstrual cyclical. If the ovarian function recovery, the menstrual cycle will recovers quickly. In short, Yimu Suogong particles can treat abnormal uterine bleeding after medical abortion by reducing early progesterone level and improving late estrogen levels. This research laid a solid theoretical foundation for wider clinical application of Yimu Suogong particles. |
