Clinical Study On The Effect Of Bushen Zhuyun Recipe On Endometrial Receptivity In Patients With Recurrent Miscarriage Due To Kidney Deficiency

Objectives:This study observed the effects of Bushenzhuyun decoction combined with aspirin on menstrual status,TCM syndromes and endometrial receptivity indexes of patients with recurrent spontaneous abortion with kidney deficiency,to evaluate the degree of improvement of endometrial receptivity and to investigate its efficacy and safety in the treatment of recurrent spontaneous abortion.Methods:By randomized controlled method,this trial included 60 patients with recurrent spontaneous abortion with kidney deficiency who visited Guang 'anmen Hospital of China Academy of Chinese Medical Sciences from January 2019 to January 2020.They were randomly divided into the treatment group(30 cases)and the control group(30 cases).The treatment group was treated with Bushenzhuyun decoction combined with aspirin,and the control group was treated with aspirin alone for 3 consecutive menstrual cycles.we compared the menstrual status scores,TCM syndrome efficacy and endometrial receptivity indexes such as endometrial thickness,endometrial type,endometrial and subendometrial blood flow type,uterine artery RI and PI of the two groups before and after treatment.Meanwhile,safety check such as blood routine,urine routine,liver and renal function were monitoredResults1.Basic information:There was no statistically significant difference between the two groups in age,BMI,educational background,history of weight loss,number of spontaneous abortion,history of live birth and history of uterine cavity operation(P>0.05)2.Menstrual status scores:Both of the two groups could reduce the menstrual status scores(P<0.05),and the reduction amplitude of the treatment group was significantly higher than that of the control group(P<0.05).3.TCM syndrome efficacy:Both of the two groups could reduce the TCM syndrome score(P<0.05),and the reduction amplitude of the treatment group was significantly higher than that of the control group(P<0.05).The effective rate of improving TCM syndromes in the treatment group was 96.7%,while that in the control group was 6.7%,and the difference between the two groups was statistically significant(P<0.05).4.Endometrial thickness:Both of the two groups could thicken the endometrial thickness(P<0.05),and the improvement degree of the treatment group was significantly better than that of the control group(P<0.05).5.Endometrial type:There was no statistically significant difference in endometrial type between the two groups before treatment(P>0.05).After treatment,the proportion of type A and type B endometrium in the treatment group was higher than that in the control group,and the proportion of type C endometrium was lower than that in the control group,with statistically significant differences(P<0.05).After treatment,endometrium type in the two groups was significantly improved compared with that before,and the difference was statistically significant(P<0.05).6.Endometrial and subendometrial blood flow type:There was no statistically significant difference in endometrial and subendometrial blood flow type between the two groups before treatment(P>0.05).After treatment,the proportion of type III endometrial and subendometrial blood flow in the treatment group was higher than that in the control group,and the proportion of type I and type II endometrial and subendometrial blood flow was lower than that in the control group,with statistically significant differences(P<0.05).After treatment,the endometrial and subendometrial blood flow type in the two groups was significantly improved compared with that before,and the difference was statistically significant(P<0.05).7.Uterine artery RI and PI:Both of the two groups could reduce the uterine artery RI(P<0.05),and the reduction amplitude of the treatment group was significantly higher than that of the control group(P<0.05).Both of the two groups could reduce the uterine artery PI(P<0.05),and the reduction amplitude of the treatment group was significantly higher than that of the control group(P<0.05)8.Safety check:The liver and renal function,blood routine and urine routine of the two groups before and after treatment showed no obvious abnormalitiesConclusion:Bushenzhuyun decoction combined with small dose of aspirin in the treatment of recurrent spontaneous abortion with kidney deficiency can better improve menstrual status,clinical syndrome of kidney deficiency and endometrial receptivity indexes than aspirin alone.The mechanism of treating recurrent spontaneous abortion may be related to improving endometrial receptivity,adjusting uterine microenvironment,and facilitating embryo implantation and development.