| ObjectiveIntrauterine adhesion is mostly manifested as hypomenorrhea,secondary amenorrhea,periodic abdominalgia.,infertility and abortion,etc.The occurrence of intrauterine adhesion is mostly related to the intrauterine(operation and the history of intrauterine infection.In recent 3years,the incidence of the disease is on the rise with the increase of induced abortion,annulus removal and other intrauterine operations.In recent years,the incidence of the disease is on the rise with the increase of induced abortiol,annulus removal and other intrauterine operations.After opening the two-child policy,because of infertility and repeated failure of assisted reproductive technology,many asymptomatic intrauterine adhesion patients were found by hysteroscopy.At present,the pathogenesis of intrauterine adhesion is still unclear,hysteroscopic intrauterine adhesion decomposition surgery,targeted treatment of intrauterine adhesion,is conducive to improving menstruation and improving pregnancy rate.However,intrauterine adhesion often Adhesion again after hvsteroscopy surgery,and high recurrence rate is more common iin patients with moderate or severe adhesion.Therefore,combine traditional Chinese and western medicine to explore factors of intrauterine adhesions has great significance for the occurrence,development and prevention of this disease,and it is in line with the theory of "treating before illness " in Chinese medicine.MethodsThrough the literature research to understand the intrauterine adhesion pathogenesis,diagnosis and treatment progress,syndrome related factors,etc.On this basis,by collecting related clinical data of patients with intrauterine adhesion and Hysteroscopy examination Intrauterine adhesions cases,using clinical epidemiological methods,to analyze the risk factors of intrauterine adhesion and the distribution of symptoms for Hainan region people.It provides new ideas and methods for the diagnosis and treatment of intrauterine adhesion diseases in Hainan region,and embodies the thoughts of "treating the disease for its origin" and "treating the disease for its future" in Chinese medicine.1.Using the method of questionnaire,choose 100 cases as experimental group,which from doing hysteroscopy examination revealed intrauterine adhesions during November 2016 to November 2017 in Haikou city Chinese medicine hospital gynaecology inpatient department and outpatient department,according to the ratio of 1:1 to investigate 100 cases of non intrauterine adhesions women as the control group(hysteroscopy revealed normal uterine women),to doing questionnaire investigation and gathering information.2.The relationship between age,nationality,height,weight,place of residence,marital status,education,occupation,previous medical history,living status,mental status,menstrual history,pregnancy history,uterine cavity operation history and the incidence was summarized through the collection of general demographic and sociological characteristics of the patients.3.Concluded Chinese medicine syndromes by collecting data of four diagnostic methods.To analyze the characteristics of Chinese medicine syndrome distribution.4.Data,processing:Epidata was used for data entry and database establishment,SPSS21.0 software was used for data analysis,using the frequency distribution analysis,?2 test,t test,rank sum test and inspection of the above statistical analysis of clinical data,using binary Logistic regression analysis of risk factors associated with intrauterine adhesions.Resu ts1.The study included 100 patients with intrauterine adhesions.Among the included cases,the highest incidence age was 31-40 years old,accounted for 60%,the high incidence of intrauterine adhesions was 32 years old.2.Among the 100 patients in the experimental group,Han nationality accounted for 95%,Li nationality accounted for 3%,Zhuang nationality accounted for 1%,and other nationalities accounted for 1%.3.There was no significant difference between the control group and the experimental group in body weight,height and BMI P>0.05.4.82%of 100 cases of intrauterine adhesions live in urban and economically developed areas,and 18%live in economically backward areas.72%of the control group lived in cities and economically developed areas,and 28%lived in economically backward areas.5.A survey of 100 patients with intrauterine adhesions was conducted.The results showed that 5%of them had primary school education,29%junior high school education,9%senior high school education,6%junior high school education,20%junior college education,29%undergraduate education,2%master's degree or higher education.The number of unemployed persons was the highest,accounting for 38%,followed by 25%of the employees,9%of the self-employed persons,8%of the teachers,6%of the medical staff,and less than 5%of the rest.6.Two groups of marital status chi square test,P=006<0.05,there are significant differences.In the control group,1 case was unmarried,97 cases were married,1 case was divorced and remarried,1 case was remarried after divorce.In 100 cases of intrauterine adhesions,10 cases were unmarried,85 cases were married,3 cases were divorced and 2 cases remarried after divorce.The number of unmarried couples in the experimental group was significantly higher than that in the control group,and the number of married people was significantly less than that in the control group.7.Among 100 patients with intrauterine adhesions,84(84%)had no other diseases in the past;13(13%)had one other disease,including 6 liver diseases,1 aortitis,1 thyroid fibroma,1 cystitis,1 gastric ulcer,1 hemorrhoids and 2 appendicitis;3(3%)had two other diseases.There were 1 case of liver disease+diabetes mellitus,1 case of liver disease+severe trauma,and 1 case of thyroid dysfunction(hypothyroidism after hyperthyroidism).8.100 patients complicated with other gynecological diseases,including pelvic inflammation,cervicitis,vaginitis,endometritis,uterine fibroids,Mycoplasma infection,endometriosis,ovarian tumors,etc.Among them,64%were complicated with 1 to 7 kinds of gynecological diseases,28(28%)with 1 kind of gynecological diseases,23(23%)with 2 kinds of diseases,13(13%)with more than 3 kinds of diseases.There were 61 cases of gynecological inflammation(including pelvic inflammation,cervicitis,vaginitis,Chlamydia infection,endometritis,endometrial polyps),and the experimental group and the control group had several gynecological diseases Z=-2.752,P=0.006<0.05,there were significant differences between the two groups.The results of binary logistic regression analysis showed that P=0.04<0.05,OR=1.482,gynecological diseases were the risk factors of intrauterine adhesions.Chi-square test showed that ?2=7.227 and P=0.007<0.05 were significantly different between the two groups.The number of gynecological inflammation cases in the group of intrauterine adhesions was significantly higher than that in the control group,and the binary logistic regression analysis showed that P-0.008<0.05,OR=0.463.Simple gynecological inflammation was not an independent risk factor for intrauterine adhesions.9.Chi-square test with several contraceptive methods,?2=27.530,P=0.000<0.05,there is a significant difference between the two groups,statistically significant.The number of contraceptives in the experimental group was significantly higher than that in the control group.The binary logistic regression analysis showed that contraception was a risk factor for intrauterine adhesion.Chi-square test for the use of condoms,contraceptives,intrauterine devices,the results showed that whether the use of condoms,intrauterine devices in the two groups P<0.05,there are significant differences,statistically significant,the number of contraceptive use in the experimental group was significantly more than the control group.10.There was no significant difference between the experimental group and the control group in drinking,staying up late,nervousness,physical condition and other aspects P>0.05.There were significant differences in smoking,temperament and mental stress(P<0.05).The results showed that smoking and mental stress were risk factors.11.Compared with plain abdominal pain,the experimental group and the control group were tested by rank sum test Z=-2.248,P=0.025.There were significant differences between the two groups.24 cases(24%)in the control group had plain abdominal pain,40 cases(40%)in the experimental group had plain abdominal pain,and the number of plain abdominal pain in the experimental group was significantly higher than that in the control group.12.The allergic history of the control group and the experimental group was compared with the chi-square test,?2=12.054,P=0.001<0.05,and there was significant difference;OR=4.429 was analyzed by binary Logistc regression,and allergic history was the risk factor of intrauterine adhesion.13.Chi-square test was used to compare familial hereditary diseases between intrauterine adhesions group and non-adhesions group.?2=7.254,P=0.014<0.05.There were significant differences between the two groups.There were 7 cases of familial hereditary disease in the intrauterine adhesion group(7%),and no family genetic disease in the control group.14.The age of menarche,menstrual regularity,menstrual range,cycle range,blood clots,dysmenorrhea were compared between the two groups.The results showed that there was no significant difference between the two groups(P>0.05).Compared with P<0.05,there were significant differences in menstrual volume.The patients with less menstrual volume in the group of intrauterine adhesion were significantly more than those in the control group.The reduction of menstrual volume was a risk factor.15.The total number of pregnancies,abortions,induced abortions,missed abortions,uterine curettage,ectopic pregnancies,and intrauterine operations were P<0.05.There were significant differences between the experimental group and the control group.The number of births,drug abortion,spontaneous abortion and cesarean section were all P>0.05.There was no difference between the two groups.Chi-square test showed significant difference between intrauterine operation and intrauterine operation during pregnancy(Pregnancy,abortion,induced abortion,missed abortion,Palace clearance,intrauterine operation,and intrauterine operation during pregnancy are all risk factors for intrauterine adhesions.Extra-uterine pregnancy is not a risk factor for intrauterine adhesions.16.Distribution of symptoms:72 cases(72%)had only one type,27 cases(27%)had two types,and 1 case(1%)had three types.Among them,the liver depression syndrome is the most,second is kidney deficiency syndrome,and the third is kidney deficiency and blood stasis syndrome.ConclusionAfter literature study and clinical research,the risk factors of intrauterine adhesions in Hainan are:previous gynecological diseases,contraception,smoking,mental stress,allergic history,reduced menstrual output,uterine cavity operation especially in pregnancy,such as pregnancy,induced abortion,missed abortion,clearance of the uterus.The most common type of syndrome is liver depression,the second is kidney deficiency,and the third is kidney deficiency and blood stasis syndrome.In view of the above risk factors and symptoms of distribution characteristics should be targeted in clinical work to guide patients,standardized operation,to help patients reduce the incidence of intrauterine adhesion. |
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