| Objective:by observing the improvement of the menstrual curative effect and the overall curative effect in intrauterine adhesion of the patients after the surgery and the effects of matrix metalloproteinase-9(mmp-9),vascular endothelial growth factor(VEGF),transformation growth factor-?1(TGF-?1)expression in endometrial tissues,by using the Traditional Chinese medicine which can invigorating spleen and kidney and blood circulation,to discuss the clinical effect of the Traditional Chinese medicine in the treatment of uterine adhesion after the surgery,and the influence of cytokines expression associated with the formation of intrauterine adhesion,to explore the mechanism of treatment of intrauterine adhesion as the preliminary study.Methods:Collecting 40 patients who went to see a doctor at the department of gynecology,central hospital of hubei province,because of the intrauterine adhesion,from October,2016 to December,2017,and all patients were diagnosed with moderate uterine adhesion.And collecting 40 cases of normal endometrial tissue.The 40 patients diagnosed with moderate uterine adhesion were randomly divided into the control group and the treatment group.Control group(western medicine group):the second day after the hysteroscopic surgery and the fifth day of menstruation,taken the Climen by oral administration,each time 1 tablet,once a day,for 21 days in a row,three menstrual cycles were taken;Treatment group(Chinese medicine group):the second day after the hysteroscopic surgery and the fifth day of menstruation,taken the above-mentioned western medicine and the Traditional Chinese medicine which can invigorating spleen and kidney and blood circulation,daily 1 dose,water decoction,2 times in the morning and evening,continuously taking the next period of menstruation,taking 3 menstrual cycles.A proper amount of endometrium tissue closed to the uterine cavity adhesion was obtained by laparoscopic adhesion separation.Both groups were implanted with balloon catheter in uterine cavity after the surgery,take it out after 5 days,and anti-infective treatment for 3 days,3 months after surgery and 3 days after menstruation is clean,go back the hospital,review the test of hysteroscope and take appropriate amount of endometrial tissue.By observing the improvement of the menstrual curative effect and the overall curative effect,at the same time detecting The expression of TGF-?1,mmp-9 and VEGF in normal endometrial tissues,and the Changes and differences in expression of TGF-?1,mmp-9 and VEGF in endometrial tissues in both groups were treated before and after treatment by immunohistochemistry.Results: 1.The expression of TGF-?1 and VEGF in the endometrial tissues of patients with intrauterine adhesion was higher than that in the normal endometrium group,and the difference was statistically significant(P < 0.05).2.The expression of mmp-9 in the endometrial tissues of patients with intrauterine adhesion was lower than that in the normal endometrium group,and the difference was statistically significant(P < 0.05).3.Comparison of the total effect of the two groups after treatment,control group:1 case of recovery,4 cases of obvious effect,7 cases is effective,8 cases of null and void,the overall curative effect was 60%;treatment group:3 cases of recovery,11 cases of obvious effect,4 cases is effective,2 cases of null and void,the overall curative effect was 90%,superior to control group,and the difference was statistically significant(P < 0.05).4.Comparison of menstrual effect of the two groups after treatment,control group:1 case of recovery,4 cases of obvious effect,9 cases is effective,6 cases of null and void,the overall curative effect was 70%;treatment group:4 cases of recovery,10 cases of obvious effect,5 cases is effective,1 case of null and void,the overall curative effect was 95%,superior to control group,and the difference was statistically significant(P < 0.05).5.The expression of TGF-?1 in the endometrium was decreased after two groups of drugs,and the down-regulation of TGF-?1 expression was higher in the treatment group than in the control group,and the difference was statistically significant(P < 0.05).6.The expression of VEGF in the endometrium decreased after two groups of drugs,and there was no significant difference in the level of VEGF expression in the two groups(P>0.05).7.The expression of mmp-9 in the endometrium was increased after two groups of drugs,and the up-regulation of mmp-9 expression in the treatment group was higher than that in the control group,and the difference was statistically significant(P < 0.05).Conclusion:Combining the Traditional Chinese medicine which can invigorating spleen and kidney and blood circulation with western medicine can effectively improve the menstrual curative effect and the overall curative effect in intrauterine adhesion of the patients after the surgery.The mechanism might be through increasing the expression of mmp-9 in endometrium,reducing the expression of TGF-?1 and VEGF in the endometrium,enhancing immune function,which can promote the growth and repair of endometrium.The last we can cure intrauterine adhesion effectively. |
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