| Objective:This study intends to use the self-control method before and after treatment,based on the basic pathogenesis characteristics of thin endometrial oligomenorrhea of ??kidney deficiency and blood stasis type,taking the typical symptoms of thin endometrial-oligomenorrhea as the entry point,combined with the syndrome of kidney deficiency and blood stasis To observe the clinical curative effect of Bushen Huoxue method in the treatment of kidney deficiency and blood stasis type thin endometrium.Methods:（1）A total of 60 patients with thin endometrium of kidney deficiency and blood stasis type who met the inclusion criteria were selected and treated with traditional Chinese medicine for tonifying kidney and activating blood.The prescription is the teacher’s experience prescription.The composition of the prescription is: 15 g of Shudi,15 g of red peony,10 g of Angelica,6g of Chuanxiong,6g of peach kernel,6g of safflower,20 g of Eclipta,10 g of Ligustrum lucidum,15 g of Cornus officinalis,20 g of Morinda officinalis,Epimedium15 g,Ziheche 15 g,Achyranthes 15 g,Turtle bug 10 g.Medication method: Decoct in water in a decoction machine,and vacuum pack each dose into 2 bags,each bag is 100 ml,1 bag at a time,2 times a day,start taking it on the 8th day of menstruation,and continue to take it for 21 days,stop taking it during menstruation,and take it in total3 menstrual cycles are 1 course of treatment.For those who become pregnant during the treatment,the follow-up medication should be stopped,otherwise,the next course of treatment will be continued.Observation before and after treatment（1）Menstrual score: Menstrual volume score mainly includes menstrual volume,color,quality and menstrual period,menstrual volume score:normal menstrual volume（>20ml）,score 0;menstrual volume decreased by 1/3 or <10ml,Score 1 point;Menstrual volume reduced by 2/3,score 2 points,and drip is 3 points;Menstrual color score:0 point for bright red,1 point for dark red,2 points for dark brown;0 points for blood clots,1 point for small blood clots,and2 points for larger blood clots;menstrual period score: 0 points for menstrual periods of 3 to 7 days,1 point for menstrual periods of 2 to 3 days,and 2 points for menstrual periods less than 2days.（2）TCM symptom score: The symptom score of kidney deficiency and blood stasis is mainly based on symptoms such as weak waist and knees,dizziness and tinnitus,tingling in the lower abdomen,and loss of libido.0 is asymptomatic,1 is occasional,2 is frequent,and 3 is For continued unrelieved.（3）Endometrial thickness measurement: Before treatment and after 3 menstrual cycles,the endometrial thickness was measured by transvaginal ultrasound in the preluteal phase.The examination location was the B-ultrasound room of the Huayuanshan District,Hubei Provincial Hospital of Traditional Chinese Medicine.（4）Uterine artery hemodynamic status: B-ultrasound follicle monitoring was performed from the 8th to 11 th day of menstruation.When the follicle diameter reached 18 mm or more,the blood flow signal of the uterine artery in the uterine isthmus on both sides was the most obvious,and the most obvious blood flow signal was selected.The uterine artery pulsatility index（PI）and resistance index（RI）were obtained from the best section,measured 3 times,and the average of the 3 results was obtained.（5）Measurement of serum estradiol level: Before treatment and after treatment for three menstrual cycles,fasting blood was drawn at 8-10 am on the2 nd to 4th day of menstruation to measure estradiol level.（6）Clinical efficacy,the specific evaluation criteria are as follows:Invalid: endometrial thickness in the preluteal phase is less than7 mm,no improvement in menstrual flow compared to before treatment,and no change in clinical symptoms.Effective: Endometrial thickness in the pre-luteal phase of the corpus luteum ≥ 7 mm,compared with the menstrual flow before treatment,the clinical symptoms are relieved.Significantly effective: the thickness of the endometrium in the preluteal phase is ≥8mm,the menstrual flow is significantly increased compared with that before the treatment,and the clinical symptoms are significantly improved.Recovery:endometrial thickness in the preluteal phase ≥9mm,menstrual flow returned to normal,and clinical symptoms disappeared.Result:（1）A total of 60 patients completed clinical treatment in this study,60 patients were between 20 and 45 years old,the youngest was 22 years old,the oldest was 44 years old,and the average age was（34.33±5.62）years old,of which 20 to 25 years old5 Among them,11 people were 26-30 years old,16 people were 31-35 years old,19 people were 36-40 years old,and 9 people were 41-45 years old.The disease duration of the 60 patients was from 2 to20 months,with an average disease duration of 10.7±4.76 months,of which 9 were from 2 to May,23 from June to October,15 from November to 15,and 13 from 16 to 20.（2）The menstrual volume,color,quality,menstrual period and total menstrual score of 60 patients after treatment with traditional Chinese medicine for tonifying kidney and activating blood were significantly improved compared with those before treatment,and the difference was statistically significant（P<0.05）.（3）After treatment,the symptoms of patients with soreness and weakness of waist and knees,dizziness and tinnitus,tingling in lower abdomen,dark menstrual color with blood clots,loss of libido and other symptoms were significantly improved compared with those before treatment,and the difference was statistically significant（P<0.05）.（4）Before treatment,the endometrial thickness of 60 patients in the preluteal phase（when the largest follicle diameter was ≥18 mm）was 5.54±0.58 mm,and the endometrial thickness after treatment was 8.49±0.68 mm,and the difference was statistically significant（P<0.05）.（5）The uterine artery pulsatility index and uterine artery resistance index were significantly reduced in 60 patients after treatment with traditional Chinese medicine for tonifying kidney and activating blood,and the improvement of uterine artery pulsatility index was more obvious,and the difference was statistically significant（P<0.05）..（6）After the treatment with traditional Chinese medicine for tonifying the kidney and activating blood,the basal serum estradiol level of the patients was significantly increased,and the difference was statistically significant（P<0.05）.（7）Among the 60 patients,13 were cured,24 were markedly effective,10 were effective,and 3 were ineffective,with a total effective rate of 95%.Conclusion:（1）Bushen Huoxue method can effectively improve menstrual volume,color,quality and menstrual period in patients with kidney deficiency and blood stasis type thin endometrial;Clinical symptoms such as dizziness,tinnitus,tingling pain in the lower abdomen,dark menstruation with blood clots,loss of libido and other clinical symptoms;（3）Bushen activating blood method can significantly increase endometrial thickness in patients with thin endometrial with kidney deficiency and blood stasis;（4）Bushen activating blood method can significantly Improve uterine artery blood flow in patients with kidney deficiency and blood stasis type thin endometrial,reduce uterine artery pulsatility index and uterine artery resistance index;（5）Bushen activating blood method can significantly improve the basic serum estradiol in patients with kidney deficiency and blood stasis type thin endometrial（6）Bushen Huoxue method has a good clinical effect in the treatment of kidney deficiency and blood stasis type thin endometrium;（7）Although the results of this study show that the kidney deficiency and blood stasis type thin endometrium can effectively improve The clinical symptoms of patients with endometrium,increased menstrual flow,increased endometrial thickness,improved endometrial blood flow,and increased basal serum estradiol levels.Differences,so there may be some bias in the research results;at the same time,due to the limitation of research time,there is a lack of long-term clinical efficacy observation.Therefore,in the future clinical research,we can optimize the research design,strengthen the long-term clinical efficacy observation,and more scientifically evaluate the clinical efficacy of Bushen Huoxue method in the treatment of thin endometrium combined with kidney deficiency and blood stasis type oligomenorrhea. |
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