Clinical Study On The Curative Effect Of Bushenhuayu ReciPe With TCRA Treating IUA, And Study On The Risk Factors Of It

ObjectiveThis research preliminarily discusses the possible risk factors related to the cause of intrauterine adhesion (IUA). The author applies the experienced Bushen Huayu Prescription, combined with Transcervical Resection of Adhesion (TCRA) to treat IUA and observe the clinical effect and safety of the prescription.Methods1. The cases include the 148 patients accord with IUA diagnostic criteria in our hospital from June 2014 to January 2016, and 84 cases of healthy women who had physical examination in the same period are selected as healthy controls. Through the self-designed IUA risk factor questionnaire, the author records and statistically analyzes the basis information, living habit, dietary habit, psychological and emotional state, maternal history, gynecological disease history, uterine size, etc. of the two groups of people.2. According to western medicine and traditional Chinese medicine (kidney deficiency and blood stasis) diagnostic criteria,42 patients in our hospital from June 1,2014 to January 1,2016 who are treated by intrauterine adhesiolysis with hysteroscope are chose and divided into 2 groups:â‘ control group has 22 cases:artificial cycle treatment after surgery;â‘¡treatment group has 20 cases:add the Bushen Huayu Prescription on the basis of control group. The two groups of people are treated for three menstrual cycles. In this period, the effectiveness and safety of drug are evaluated by comparing the curative effect, TCM symptom complex score, IUA score, endometrial thickness monitored by type-B ultrasonic and clinical observation of adverse effect. Results1. Research result of IUA risk factors:Univariate analysis shows that the incidence of IUA is related to age, anxiety, impatience, predilection for spicy, eating cold food during menstruation, staying up late, intercourse during menstruation, taking exercise, menstrual warmth, gravidity, parity, abortion, curettage, gynecological inflammatory diseases, age of first sex and uterine size. Multiple logistic regression analysis shows that eating cold food during menstruation, anxiety, staying up late, intercourse during menstruation, gravidity, abortion times, curettage times, uterine size, inflammatory diseases are positively associated with IUA and are risk factors.2. The clinical effects of Bushen Huayu Prescription to prevent the IUA postoperative re-adhesion:(1) Compared by TCM syndrome efficacy, the total effective rate of treatment group is 95% and control group is 86.4%. Through analysis, the overall efficacy of TCM syndrome of treatment group is better than the control group. On TCM syndrome score, applied paired-sample T test, the intra-group comparison between before and after treating shows the total score after treatment is lower than that before treatment and symptoms are also improved compared with before treatment. Comparison between the two groups applies independent-samples T test. In first cycle, the two groups have no significant difference in TCM score. In the second and third cycles, the scores of two groups are different significantly that the score of treatment group is lower than that of control group and the symptoms improvement of treatment group is better than control group.(2) In TCM cardinal symptoms, menstrual quantity and color quality, the total effective rates of treatment group are 95% and 94.74% respectively and for control group are 83.33% and 75% respectively. After analysis, the difference has statistical significance and difference of the menstrual cycles and period time between two groups has no statistical significance.(3) Compare two groups IUA scores between after and before treatment and the difference has statistical significance, showing that IUA is improved after treatment. Compare between the two groups after treatment and the difference has statistical significance. After treatment, the IUA score of treatment group is lower than that of control group.(4) After treatment, monitored by type-B ultrasonic, the endometrial thickness of two groups of patients has significant difference compared with that before treatment and comparison between two groups has no significant difference.ConclusionAfter the form of self-designed questionnaire, the author has begun to understand the factors associated with the incidence of IUA, including eating cold food during menstruation, anxiety, staying up late, intercourse during menstruation, gravidity, abortion times, curettage times, uterine size, gynecological inflammatory diseases, in which the emotional anxiety, curettage times and gynecological inflammatory diseases are high risk factors.Bushen Huayu Prescription can effectively prevent the IUA lysis postoperative re-adhesion. For the improvement of TCM cardinal symptoms, menstrual quantity and color quality. After three menstrual cycles treatment, hysteroscopy shows the IUA score of treatment group is lower than that of control group, illustrating that Bushen Huayu Prescription has more curative effect and no obvious adverse reactions. It is safe and worth popularizing.