Controlling the Recurrence of Pelvic Endometriosis after A Conservative Operation： Comparison between Chinese Herbal Medicine and Western Medicine

• Published in: Chinese journal of integrative medicine Vol. 19; no. 11; pp. 820 - 825
• Main Author: 赵瑞华 郝增平 张毅 连凤梅 孙伟伟 刘永 王蕊 龙隶 程玲 丁永芬 宋殿荣 孟庆伟 王蔼明
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2013
• Subjects: Adult; Demography; Drugs, Chinese Herbal - adverse effects; Drugs, Chinese Herbal - therapeutic use; Endometriosis - drug therapy; Endometriosis - surgery; Female; Humans; Medicine; Medicine & Public Health; Original Article; Pelvis - surgery; Pregnancy; Recurrence; 中国医药; 中药材; 保守性; 复发率; 子宫内膜异位症; 手术; 控制; 盆腔; endometriosis; recurrence rate; fertilization; infertility; embryo transfer; pregnancy rate
• ISSN: 1672-0415; 1993-0402; 1993-0402
• DOI: 10.1007/s11655-012-1247-z

Objective： To compare the clinical effect of Chinese medicine （CM） and Western medicine （WM） for controlling the recurrence of pelvic endometriosis after a conservative operation. Methods： The study was a multi-center, randomized, parallel controlled and prospective clinical trial. Patients were randomly divided into two groups： CM group （106 cases） and WM group （102 cases）. Drugs were given to patients during 1--5 days of the first menstruation after a conservative operation in both groups. Patients with stages I and I1 （revised American Fertility Society） were treated for 3 months, while the patients with stages Ill and IV were treated for 6 months. The patients in the CM group were treated using three types of Chinese herbal medicine based on syndrome differentiation. Patients in the WM group were treated using gonadotropin releasing hormone agonist （GnRH-a） or gestrinone. Patients treated with GnRH-a received add-back therapy of Tibolone Tablets once a day after 4 months of treatment. Any cases of dysmenorrheal chronic pelvic pain, menstruation and any adverse reactions of patients were recorded once a month during the preoperative and postoperative periods and once every 3 months during the follow-up period. During the preoperative, postoperative and the follow-up periods, patients underwent type B ultrasonography of the pelvis and measurements of serum CA125 levels, gynecologic examination, routine evaluations of blood, urine, hepatic function （glutamate pyruvate transaminase）, renal function （blood urea nitrogen） and electrocardiograms. Dudng the follow-up period they underwent type B pelvic ultrasonography, measurement of serum CA125 levels and further gynecologic examinations. The two treatments were compared for clinical recurrence rates, pregnancy rates and the incidence of adverse reactions. Results： The incidence and timing of recurrence of endometriosis were not significantly different between the two groups. The first pregnancy achieved by the patient in the CM .qroup was si.clnificantly earlier than that in the WM group （P〈0.05）. Moreover, the incidence of adverse reactions in the WM group was significantly higher than in the CM group （P〈O.01）. Conclusions： Treatment with Chinese herbal medicines prevented the recurrence of endometriosis after a conservative operation, improved the conception rate and showed fewer and lighter adverse reactions than did treatment with WM therapy. Treatment with Chinese herbal medicine meets the need of patients wishing to have a child following endometriosis and is an appropriate form of clinical treatment.