title: 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 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 II (revised American Fertility 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 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. During 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 group was significantly 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 <0.01).
  
  
  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.
authors.affiliation: Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China, rhzh801@sohu.com.
authors.forename: Rui-hua
authors.initials: RH
authors.lastname: Zhao
authors.forename: Zeng-ping
authors.initials: ZP
authors.lastname: Hao
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Feng-mei
authors.initials: FM
authors.lastname: Lian
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Sun
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Long
authors.forename: Ling
authors.initials: L
authors.lastname: Cheng
authors.forename: Yong-fen
authors.initials: YF
authors.lastname: Ding
authors.forename: Dian-rong
authors.initials: DR
authors.lastname: Song
authors.forename: Qing-wei
authors.initials: QW
authors.lastname: Meng
authors.forename: Ai-ming
authors.initials: AM
authors.lastname: Wang
mesh_terms: D000328:Adult; D003710:Demography; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D010388:Pelvis / Q000601:surgery*; D011247:Pregnancy; D012008:Recurrence
chemical_list: D004365:Drugs, Chinese Herbal