祛瘀消膜汤联合温针灸对药物流产不全刮宫术后 宫腔粘连, 内膜纤维化及血清 sFIt-1, BNIP3 的影响.

OBJECTIVE: To observe the effects of Quyu Xiaomo decoction combined with warm-needling moxibustion on intrauterine adhesion, endometrial fibrosis and serum Bcl2 interaction protein 3 (BNIP3) and soluble vascular endothelial growth factor receptor-1 (sFlt-1) after medical abortion with incomplete curettage. METHODS: Totally 96 patients with medical abortion with incomplete curettage admitted into the hospital from Jan. 2020 to May 2023 were extracted to be divided into the control group and the combined group via the random number table method. All patients were given routine treatment after curettage. Forty-eight patients in the control group were given warmneedling moxibustion after curettage, and 48 patients in the combined group received Quyu Xiaomo decoction on the basis of the control group. Clinical efficacy and traditional Chinese medicine syndrome score before and after treatment were compared between two groups. The duration of abdominal pain, vaginal bleeding time and menstrual relapse time of two groups were recorded. The incidence of intrauterine adhesion was observed by hysteroscopy after treatment. Serum levels of sFIt-1, BNIP3, luteinizing hormone (LH), estrogen (E2) and tumor necrosis fact-α (TNF-α) were measured before and after treatment, mRNA expression levels of matrix metalloproteinase 9 (MMP9) and transforming growth factor β3 ( TGF-β3) in endometrial tissues were detected by reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: The total effective rate of the combined group was 97. 92% (47/48), higher than 83. 33% (40 / 48) of the control group, the difference was statistically significant (P< 0. 05). The score of lochia dripping astringency, lower abdominal pain, less dripping volume, dark purple with clumps, astringent or heavy pulse, dark purple tongue or purple spot on the edge of the postpartum in combined group was lower than that in the control group, with statistically significant differences (P<0. 05). The duration of abdominal pain, vaginal bleeding and menstrual rehydration in the combined group were shorter than those in the control group, the incidence of intrauterine adhesions in the combined group was lower than that in the control group, with statistically significant differences (P<0. 05). After treatment, the level of E2 in combined group was higher than that in control group, the levels of LH and TNF-α were lower than those in control group, BNIP3 and sFlt-1 were higher than those in control group, and MMP9 and TGF-β3 mRNA were lower than those in control group, with statistically significant differences ( P < 0. 05 ). CONCLUSIONS: Quyu Xiaomo decoction combined with warm-needling moxibustion in the treatment of patients with medical abortion with incomplete curettage can regulate sex hormone levels, improve inflammatory state, increase levels of BNIP3 and sFlt-1, improve endometrial fibrosis, enhance uterine cavity anti-adhesion, alleviate patients' disease condition and improve clinical efficacy. [ABSTRACT FROM AUTHOR]