Controlling the Recurrence of Pelvic Endometriosis after A Conservative Operation: Comparison between Chinese Herbal Medicine and Western Medicine
ABSTRACT 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 amulti-center, randomized, parallel controlled and prospective clinical trial.
Patients were randomly divided into twogroups: CM group (106 cases) and WM group (102 cases). Drugs were given to patients during 1–5 days of thefi rst menstruation after a conservative operation in both groups. Patients with stages Ⅰ and Ⅱ (revised AmericanFertility Society) were treated for 3 months, while the patients with stages Ⅲ and Ⅳ were treated for 6 months.The patients in the CM group were treated using three types of Chinese herbal medicine based on syndromedifferentiation. 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 4months of treatment. Any cases of dysmenorrheal chronic pelvic pain, menstruation and any adverse reactions ofpatients were recorded once a month during the preoperative and postoperative periods and once every 3 monthsduring the follow-up period.
During the preoperative, postoperative and the follow-up periods, patients underwenttype B ultrasonography of the pelvis and measurements of serum CA125 levels, gynecologic examination, routineevaluations of blood, urine, hepatic function (glutamate pyruvate transaminase), renal function (blood urea nitrogen)and electrocardiograms. During the follow-up period they underwent type B pelvic ultrasonography, measurementof serum CA125 levels and further gynecologic examinations.
The two treatments were compared for clinicalrecurrence rates, pregnancy rates and the incidence of adverse reactions. Results: The incidence and timing ofrecurrence of endometriosis were not signifi cantly different between the two groups. The fi rst pregnancy achievedby the patient in the CM group was signifi cantly earlier than that in the WM group (P<0.05). Moreover, the incidenceof adverse reactions in the WM group was signifi cantlyhigher than in the CM group (P<0.01).
Conclusions: Treatment with Chinese herbal medicines preventedthe recurrence of endometriosis after a conservativeoperation, improved the conception rate and showedfewer and lighter adverse reactions than did treatmentwith WM therapy. Treatment with Chinese herbalmedicine meets the need of patients wishing to havea child following endometriosis and is an appropriateform of clinical treatment.KEYWORDS endometriosis, infertility, fertilizationin vitro, embryo transfer, recurrence rate, pregnancyrate