| Objective: To observe the effects of Bushen Huoxue Prescription on endometrial tissue repair and Wnt/β-catenin signaling pathway in patients with severe intrauterine adhesions.To investigate the possible mechanism of Bushen Huoxue Prescription to promote endometrial repair of intrauterine adhesions.Methods: A total of 60 patients,diagnosed with severe intrauterine adhesions by hysteroscopy and identified as kidney deficiency and blood stasis,who visited the gynecology department of the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine between January 2022 and December 2022 were selected and randomly divided into control and treatment groups,with 30 cases in each group.Both groups underwent hysteroscopic separation of intrauterine adhesions in our department at the 3rd to 7th day after menstruation,with no time limit for secondary amenorrhea.After surgery,the control group was given sequential estrogen and progestin therapy(estradiol valerate tablets combined with didrogestrel tablets),while the treatment group was given a combination of Bushen Huoxue Prescription on top of that.The duration of treatment in both groups was 3 menstrual cycles.To record and compare the intrauterine adhesions score,before and after treatment in the two groups.Endometrial thickness and uterine artery pulsatility index(PI)were measured on the day of ovulation.the number of glands in the endometrium was examined by HE staining.Masson staining was used to evaluate the degree of endometrial fibrosis.Immunohistochemical staining was used to detect the expression of β-catenin,TCF-1,and CD117 in the endometrial tissues of each group.Overall efficacy was assessed and safety evaluations were performed.Results: After 3 menstrual cycles,in terms of endometrial thickness,PI and intrauterine adhesions scores,the treatment group had 7.73±0.45 mm,1.94±0.40,and 3.40±1.16 points,respectively,and the control group had 7.28±0.52 mm,2.19±0.40,4.17±1.20 points.Compared with the control group,the improvement was more significant in the treatment group(P<0.05).The treatment group was superior to the control group in promoting endometrial glandular growth and reducing the area of endometrial fibrosis compared to the control group(P<0.001).The expression levels of β-catenin,TCF-1,and CD117 were higher in the treatment group than in the control group(P<0.05).There were no side effects or adverse reactions caused by the therapeutic use of drugs during the study.Conclusion: In patients with severe uterine adhesions with evidence of kidney deficiency and blood stasis,the efficacy of postoperative treatment with combined application of Bushen Huoxue Prescription is certain,which can effectively increase endometrial thickness and gland count,improve endometrial fibrosis to a certain extent.It can improve the uterine blood microcirculation anf facilitate the endometrial repair,and effectively prevented recurrence of adhesions after surgery for severe cavity adhesions.Bushen Huoxue Prescription can increase the expression level of β-catenin and TCF-1,increase the expression of CD117 protein,thus promoting the regeneration and repair of endometrium.This process may be related to the activation of the Wnt/β-catenin signaling pathway. |
