I. What is uterine adhesion?
Uterine adhesions are partial or complete adhesions of the uterine cavity to each other due to endometrial damage caused by uterine surgery, infection or radiation. In recent years, the number of abortions or recurrent abortions has increased, and the number of uterine adhesions as one of their long-term complications is also increasing year by year, seriously endangering the physical and mental health of women. It has been reported that about 1,7% of secondary amenorrhea and 40% of infertility patients have varying degrees of uterine adhesions.
What are the causes?
(1) Uterine operations.
(1) Uterine operations during pregnancy: excessive scraping during abortion or postpartum or post-abortion bleeding scraping, cesarean section.
(2) non-pregnancy uterine operations: diagnostic scraping, myomectomy, irradiation of radioactive substances, cervical biopsy or polypectomy, etc.
(2) Reproductive system infection: post-abortion infection, puerperal infection, endometrial tuberculosis infection and infection due to various uterine surgeries.
(3) Congenital malformation of the uterus: such as longitudinal uterus.
(4) Other: physical, immune, genetic and other factors.
The pathogenesis of the disease is not yet clear internationally.
(2) Clinical manifestations of uterine adhesions
(1) Menstrual abnormalities: damage to the basal layer of the endometrium mainly causes hypomenorrhea, and when the cervical canal is completely adhered, it may even cause or amenorrhea.
(2) Reproductive dysfunction: When adhesions in the uterine cavity are not conducive to fertilization and growth, they can cause infertility, recurrent and habitual miscarriage, preterm labor, placenta praevia, placental implantation and other reproductive dysfunction problems.
(3) Periodic lower abdominal pain: mainly lower abdominal cramping pain before and after menstruation.
III. Diagnostic methods
1.Gold standard: hysteroscopy.
2. Other examination methods: transvaginal ultrasound, three-dimensional hysteroscopic ultrasound, hysterosalpingography, tubal iodine-oil imaging and other methods.
IV. Treatment and protection
1. Standard Western medical procedure: hysteroscopic dissection of uterine adhesions.
2. Due to the high recurrence rate of postoperative adhesions, the following methods are mainly used in Western medicine to prevent re-adhesion after surgery: prophylactic antibiotics, sequential estrogen therapy, intrauterine device, balloon catheter, intrauterine injection of anti-adhesion agent, amniotic membrane transplantation, endometrial stem cell transplantation, etc. However, there is still a lack of absolutely effective methods to prevent re-adhesion.
3.There is no record of “uterine adhesions” in ancient Chinese medical texts, combined with the clinical manifestations of menorrhagia and amenorrhea, Chinese medicine believes that “menstrual water comes out of the kidneys” and “if it does not pass, it is painful”, which can be summarized as follows Therefore, tonifying the kidney, activating blood circulation and removing blood stasis is the main treatment for this disease. Treatment should be combined with the method of “tonifying the kidneys and regulating the circumference” in Chinese medicine, and the dialectical and phased treatment. The treatment must seek the root of the disease, Chinese medicine based on the specific circumstances of the patient and the dialectical treatment, depending on the person, time and place, has a long-term curative effect, can significantly alleviate the disease.
4, Chinese medicine believes that “the upper work of treatment before the disease”, protection is more important than treatment. First, scientific choice of contraceptive methods to reduce the abortion rate. Second, actively treat inflammatory diseases of the reproductive system before the operation; strictly aseptic operation must be carried out during the operation to avoid surgical infection, no excessive scratching of the uterine cavity, and actively prevent re-adhesion after the operation. Third, life conditioning, Chinese medicine, “the righteousness of the internal, the evil can not dry”, patients should be moderate exercise, improve physical quality; with a nutritious diet, less spicy and stimulating food; adjust work and rest, avoid staying up late; keep a relaxed mood, so that the liver qi regulation, the disease can be restored.