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| The influence of leuprolide acetate combined with Kuntai capsules on endometrial receptivity of patients with endometriosis after laparoscopic surgery |
| The People's Hospital of Lishui District, Nanjing, Jiangsu Province,211200 |
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Abstract Objective: To investigate the influence of leuprolide acetate combined with Kuntai capsules on endometrial receptivity of patients with endometriosis (EMs) after laparoscopic surgery. Methods: 120 patients with EMs who underwent laparoscopic surgery were randomly divided into observation group and control group (60 cases in each group). The patients in control group were treated by leuprolide acetate after surgery, and the patients in observation group were treated by leuprolide acetate combined with Kuntai capsule. The clinical efficacy, the recurrence rate within 1 year, and the pregnancy status of patients with infertility were compared between the two groups. The serum levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), tumor necrosis facto-α (TNF-α), matrix metalloproteinase-9 (MMP-9), soluble intercellular adhesion molecule -1 (sICAM-1), high mobility group box 1 (HMGB1) of patients before and after treatment were detected, the endometrial thickness and uterine artery pulsatility index (PI) and resistance index (RI) of patients were measured by color Doppler ultrasound. Results: There was no significant different in the total effective rate between the two groups (96.7% VS. 93.3%, P>0.05), but the recurrence rate within 1 year of patients in observation group was significant lower than that of patients in control group (5.9% VS.19.2%, P<0.05).After treatment, the levels of serum VEGF, IL-6, TNF-α, MMP-9, sICAM-1 and HMGB1 of patients in observation group were significant lower than those of patients in control group (P<0.05). After treatment,
the endometrial thickness of patients in observation group was significant higher than that of patients in control group, and the uterine artery PI and RI of patients in observation group were significant lower than those of patients in control group (P<0.05). The incidences of hot flashes, night sweats, fatigue, mood swing, sleep disturbance and vaginal dryness of patients in observation group were significant lower than those of patients in control group(P<0.05), but there was no significant different in the incidence of bone pain between the two groups (P>0.05). As for the patients with infertile, the cumulative pregnancy rates of patients at 6 and 12 months after surgery in observation group was 45.5% and 68.2%, which were significant higher than those of patients in control group (16.0% and 36.0%, respectively, P<0.05). Conclusion: The application of leuprolide acetate combined with Kuntai capsules used for patients with EMs after laparoscopic surgery can improve the endometrial capacity, can improve the pregnancy rate of infertility patients, and can reduce the recurrence rate. The mechanism may be related to its antiinflammatory effect and downregulation of VEGF expression.
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