Clinical Study on Fuyuan Quyu Decoction Combined with Sequential Estrogen and Progestogen Therapy for Preventing Re-adhesion After Hysteroscopic Separation of Intrauterine Adhesions
Abstract:Objective:To observe the clinical effect of the therapy of Fuyuan Quyu Decoction combined with sequential estrogen and progestogen therapy on preventing re-adhesion after hysteroscopic separation of intrauterine adhesion. Methods:A total of 60 patients with syndrome of kidney deficiency and blood stasis based on syndrome differentiation after receiving hysteroscopic separation of intrauterine adhesions were included and randomly divided into the observation group and the control group , with 30 cases in each group. The two groups were given the sequential estrogen and progesterone therapy for treatment, based on which the observation group was additionally treated with Fuyuan Quyu Decoction. Both groups were treated for three menstrual cycles. Before treatment and after three menstrual cycles of treatment, the scores of intrauterine adhesion, traditional Chinese medicine (TCM) syndrome and Visual Analogue Scale (VAS) of abdominal pain were evaluated; the endometrial thickness, uterus cavity volume,resistance index (RI),pulsitility index (PI) and flow index (FI) were detected;the clinical effects and incidence of adverse reactions during treatment were compared between the two groups. After three menstrual cycles of treatment,the two groups were followed up for three months,and the incidence of re-adhesion in both groups were counted. Results:After treatment,the total clinical effective rate in the observation group was higher than that in the control group (P<0.05). The scores of intrauterine adhesion, TCM syndrome and VAS in both groups were decreased when compared with those before treatment (P< 0.05),and the above three scores in the observation group were lower than those in the control group (P< 0.05). The endometrial thickness, uterus cavity volume and FI values in the two groups were increased when compared with those before treatment (P<0.05),and the values of RI and PI were decreased when compared with those before treatment (P<0.05). The endometrial thickness,uterus cavity volume and FI value in the observation group were higher than those in the control group (P<0.05),and the values of RI and PI were lower than those in the control group (P < 0.05). The incidence of adverse reactions and re-adhesion were respectively lower than those in the control group (P<0.05). Conclusion:The application of Fuyuan Quyu Decoction combined with sequential estrogen and progesterone therapy as the intervention for patients after intrauterine adhesion surgery can effectively promote the endometrial repair,and recovery of uterine cavity shape and normal menstruation,reduce adhesion,improve the TCM syndrome,mitigate pain,decrease the vascular resistance of uterus,and recover the vascular blood perfusion of uterus,thus effectively preventing the re-adhesion after intrauterine adhesion surgery with good safety.