Observation of the clinical effect of different schemes for preventing recurrence of endometrial polyps in patients with qi stagnation and blood stasis syndrome after hysteroscopic resection
Objective To observe the clinical effect of different schemes for preventing recurrence of endometrial polyps(EPs)in patients with qi stagnation and blood stasis syndrome after hysteroscopic resection.Methods A total of 280 EPs patients with qi stagnation and blood stasis syndrome who underwent hysteroscopic resection were divided into the dydrogesterone group(postoperative oral dydrogesterone,60 cases),the dydrogesterone+Chinese medicine group(postoperative oral dydrogesterone+Chinese medicine,75 cases),the Mirena group[postoperative intrauterine implantation of the levonorgestrel intrauterine system(trade name:Mirena),68 cases],and the Mirena+Chinese medicine group(postoperative intrauterine implantation of Mirena+postoperative oral Chinese medicine,77 cases)according to different postoperative recurrence prevention protocols.The endometrial thickness,menstrual volume and recurrence rate were compared among the four groups at different time points after surgery.Results At 12 months after surgery,the endometrial thickness and pictorial blood loss assessment chart(PBAC)score were(7.48±0.77)mm and(54.70±6.64)points in dydrogesterone group,(6.31±1.16)mm and(49.08±6.21)points in dydrogesterone+Chinese medicine group,(6.85±0.71)mm and(45.46±6.17)points in Mirena group,and(5.94±0.64)mm and(39.73±6.17)points in Mirena+Chinese medicine group.At 24 months after surgery,the endometrial thickness and PBAC score were(9.59±1.11)mm and(58.14±7.40)points in dydrogesterone group,(7.94±1.42)mm and(45.78±7.65)points in dydrogesterone+Chinese medicine group,(8.86±1.44)mm and(40.66±5.96)points in Mirena group,and(7.23±1.74)mm and(38.36±6.48)points in Mirena+Chinese medicine group.At 12 and 24 months after surgery,the endometrial thickness and PBAC score of dydrogesterone+Chinese medicine group were lower than those of dydrogesterone group,and Mirena+Chinese medicine group was lower than Mirena group(P<0.05).The endometrial thickness and PBAC score of Mirena group were lower than those of dydrogesterone group,and Mirena+Chinese medicine group was lower than dydrogesterone+Chinese medicine group(P<0.05).After 24 months of follow-up,the recurrence rate of dydrogesterone+Chinese medicine group was 8.00%,which was lower than 33.33%of dydrogesterone group;the recurrence rate of Mirena+Chinese medicine group was 1.30%,which was lower than 13.24%of Mirena group(P<0.05).The recurrence rate of Mirena group was lower than that of dydrogesterone group(P<0.05).Conclusion For EPs patients with qi stagnation and blood stasis syndrome,intrauterine implantation of Mirena+oral Chinese medicine after hysteroscopic resection can reduce menstrual volume,endometrial thickness and recurrence rate,and the effect is obvious.
Qi stagnation and blood stasisEndometrial polypsLevonorgestrel intrauterine systemDydrogesteroneChinese medicineHysteroscope
万方数据
维普
