Effectiveness And Postoperative Recurrence Of Moderate-severe Intrauterine Adhesions By Treating Of Uterus Thicking Decoction Which Be Based On Endometrial Receptivity

Objective:To explore therapeutic effect of moderate-severe intrauterine adhesions by uterus thicking decoction.This experiment is aim to objectivly evaluate effectiveness of uterus thicking decoction.The long-term goal is to prevent recurrence of adhesion,help infertile patients improve endometrial conditions in order to help conceive,seek more effective treatment of prevent adhesion recurrence and guiding the clinical medication.Methods:Collected the 45 cases of patients in our hospital who were diagnosed with moderate-severe intrauterine adhesions.Randomly divided into three groups,the western medicine group(15 cases),Chinese medicine group(15 cases),combined group(15 cases).Patients were all treated with hysteroscopic surgery and placed a balloon catheter after surgery.The western medicine group accepted estradiol valerate and dydrogesterone after surgery,the Chinese medicine group accepted purgation-tonifying eight extra channels decoction after surgery,and the combined group accepted Chinese medicine combined with western medicine.Compared the TCM syndrome change,hysteroscopic adhesion score and receptivity related factor αvβ3 and PR between the two groups.Results:1)The total effective rate:the total effective rate in the western medicine group was 76.92%,in the Chinese group was 83.33%,the combined group was 93.33%,there was no significant difference among the three groups(P>0.05);but the western medicine group with the combination group had significant difference(P<0.05);2)TCM syndrome:syndrome scores of three groups after treatment were lower than those before treatment,the differences were statistically significant(P<0.05).Among the three groups,the score decreased level of Chinese medicine group and combination group were more than that in the western medicine group,the difference was statistically significant(P<0.05);3)Adhesion score:intrauterine adhesions scores in three groups reduce were reduced after treatment,the differences were statistically significant(P<0.05);Chinese medicine group,western medicine group had statistical significance with combined group(P<0.05),4)Number of hysteroscopy:the rate of hysteroscopy number less than or equal to second times in western medicine group was 38.46%,Chinese medicine group was 58.33%,and the combined group was 73.33%,the three groups had no statistical significance(P>0.05);5)Expression of αvβ3:αvβ3expression in surface epithelium and glandular epithelial cells of three groups were increased,and the difference was statistically significant(P<0.05);and after study changes of αvβ3 expression in the surface epithelium and glandular epithelium of the combined group were obvious respectively,with Chinese medicine group and Western medicine group,the difference was statistically significant(P<0.05).In three kinds of cells,aαvβ3 expression in surface epithelial cells and glandular epithelial cells had statistically significance with stromal cells(P<0.05);6)Expression of PR:PR expression after study in three groups of three kinds of cells had statistical significance with those before study(P<0.05),and after the study,PR expression in three kinds of cells in combined group had statistical significance with the PR expression in same cells in western medicine group and Chinese group,the difference was statistically significant(P<0.05).Among the three kinds of cells,The stromal cells showed significant difference with the epithelium and the glandular epithelium(P<0.05).Conclusion:Uterus thicking decoction combined with western medicine can reduce the uterine adhesions condition in patients,prevent the adhesion recurrence,improve menstrual syndrome and the endometrial receptivity.