| Objective:Based on evidence-based medicine,This study investigated the effect of prophylactic bilateral salpingectomy(PBS)on ovarian reserve function during total hysterectomy(TLH).Secondly,this study explored the effect of Invigorating the kidney and Regulating menstruation cycles therapy on ovarian function after operation.This study provides a basis for further clinical research and treatment.Method:This study chose 75 patients who needed total laparoscopic hysterectomy.They were diagnosed as benign uterine lesions before operation.They were operated in the department of gynaecology in Jiangsu Province Traditional Chinese Medicine Hospital from December 2015 to December 2017.These patients were randomly divided into total hysterectomy group,total hysterectomy plus preventive bilateral salpingectomy group,and Chinese medicine group after total hysterectomy plus preventive bilateral salpingectomy.Patients of Chinese medicine group were treated with Invigorating the kidney and Regulating menstruation cycles therapy.All three groups were observed AMH and sex hormone levels and improved kupperman perimenopausal symptoms rating scale score before surgery,1 month after surgery and 3 months after surgery.At the same time,this study also observed whether the patients had side effects during the treatment.Results:1.The clinical effect:PBS does not have a greater side effect on ovarian function;25 cases of Chinese medicine treatment group,0 cases were cured,accounted for 0%,8 cases were markedly improved,accounted for 32%,effectiveness in 13 cases,accounted for 52%,4 cases were invalid,accounted for 16%.The total effectiveness was 21 cases,accounted for 84%;which is better than TLH+PBS group.Chinese medicine has a good effect on decrease of ovarian reserve function after operation.2.The index analysis:The baseline analysis showed that there were no significant differences in the general data,preoperative hormone levels and improved Kupperman scores in the three groups(P>0.05).The three sets of data are comparable.LH group compared with TLH+PBS group,1 months after surgery,3 months after the surgery,the AMH of patients in two groups were decreased,FSH,FSH/LH increased(P<0.05);Although there was no significant difference in postoperative E2 and LH changes(P>0.05),E2 showed a decreasing trend and LH showed an upward trend.It is suggested that the two methods of operation all can cause the decline of ovarian reserve function.There was no significant difference in hormone levels between the two groups after operation(P>0.05),suggesting that PBS does not have a greater side effect on ovarian function.Compared with the TLH+PBS group,Chinese medicine group at a high level of AMH after operation(P<0.05);FSH,FSH/LH at a low level(P<0.05).E2 and LH differences were not statistically significant(P>0.05).The changes of hormone suggest that Chinese medicine has a good effect on decrease of ovarian reserve function after operation.There was no obvious change in the improved Kupperman score in the three groups,suggesting that the patients did not have obvious perimenopausal symptoms after hysterectomy.Conclusion:1.The two methods of operation of TLH and TLH+PBS all caused the decline of ovarian reserve function.PBS does not aggravate the decline of ovarian reserve function.2.Although the patient has no obvious symptoms after the operation,the hormone levels in the body have changed.All the hormones were improved after the treatment of Invigorating the kidney and Regulating menstruation cycles therapy,which could prevent and delay the decline of ovarian function.3.No side effects were found during the treatment of all the patients,and there was no obvious abnormality in the safety test.It is proved that this method is effective and safe to delay the decline of ovarian reserve function after operation. |
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