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endometrium

A layer that forms the inner wall of mammalian uterus

Endometrium（ endometrium , computere endome trium) refers to the composition Mammals The inner wall of the uterus is part of the female reproductive organs. yes estrogen and Progesterone Are reactive, so it can be Sexual cycle （ Estrus cycle 、 menstruation Period).

Endometrium is divided into functional layer and Basement layer 2 layers. 2/3 of the inner membrane surface is Compact layer And the spongy layer are collectively referred to as the functional layer sex hormone Impact occurrence Periodic change And fall off. The base layer is close to Myometrium 1/3 of the endometrium is not affected by ovarian sex hormones and does not undergo periodic changes.

Chinese name: Endometrium
Foreign name: endometrium，uterine endome- trium

Tiering: Functional layer and base layer 2 layers
Definition: Refers to the layer that forms the inner wall of mammalian uterus

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four matters needing attention

function

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endometrium (2 sheets)

Estrogen can cause Uterine hypertrophy The progesterone can promote the endometrium to have special changes in the early pregnancy, or change the nature of the endometrium, so that it has the ability to produce decidua. The endometrium is covered with mucosa, which consists of Inherent layer Consists of. Mucosal epithelium is Columnar epithelium 、 Cuboidal epithelium or Stratified columnar epithelium When estrogen is secreted epithelial cells It will grow and split to increase the number. The part below the mucosal epithelium in the lamina propria is called the functional layer, and epithelial cells enter it to form Uterine gland And react to estrogen. The lower layer of the functional layer is called the basal layer, which is rich in blood vessels.

Pathological mechanism

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Programmatic cell death （programmedcell death， PCD ）, also known as Apoptosis （ apoptosis ）。 PCD occurs in many tissues and organs, including the reproductive tract. animal experimental observation To, uterus, ovary, fallopian tube, testicle and prostate PCD occurs in all organs. Early light and electron microscopic studies show that human endometrium also has Apoptotic body Exists. adopt agarose gel electrophoresis and DNA Chromosome technique DNA fragmentation with PCD characteristics was found in human endometrium at the early stage of hyperplasia (6-10 days), secretory phase (25-28 days), and menstrual phase (1-5 days); However, DNA fragmentation did not occur in late hyperplasia (11-14 days), early secretion (15-20 days) and middle secretion (21-24 days). But mainly see macromolecule DNA。 The periodic occurrence of PCD suggests that it plays an important role in regulating women's menstrual cycle.

The mechanism of PCD production in endometrium is still unclear, but it is related to the Periodic change of The estrogen and progesterone receptor of endometrium, as a transcription factor, regulates the gene expression related to estrogen and progesterone, thus causing endometrial hyperplasia and secretion changes. At the same time, some polypeptide growth factors and their receptors synthesized by the uterus, such as EGF, PDGF, IGF-1, IGF-2, may be the mediators of estrogen effect, promoting cell proliferation and differentiation. It was found by immunocytochemistry that human uterus produced cell death inhibitory factors, such as BCL-2, as early as embryonic stage. The expression of BCL-2 in adult endometrium is mainly in Interstitial cell Medium, and with periodic changes, it reaches the peak in the late stage of hyperplasia, decreases in the early stage of secretion, and disappears in the late stage of secretion and menstruation. Therefore, it is speculated that the disappearance of BCL-2 in late secretory phase and menstrual period is closely related to the death of endometrial cells and the occurrence of menstruation.

endometrium cell factor

1. Epidermal growth factor and its receptor: epidermal growth factor （ EGF ）Mainly distributed in Uterine cavity Epithelium and Glandular epithelium as well as Interstitial cell Medium and presented Periodic change 。 Its physiological functions lie in: ① stimulating the proliferation of endometrial glandular epithelium and stroma, and Synergy To differentiate the stroma; ② act on cell surface It can rapidly stimulate the phosphorylation of arginine and promote the endometrium PGE2 Release of.

2. Platelets growth factor Platelet growth factor mainly comes from endometrial stromal cells. It can stimulate the proliferation of interstitial cells or adjacent epithelial cells, so it has autocrine and Paracrine Role of. At the same time, PDGF EGF enhanced Cell proliferation effect.

⒊ Insulin like growth factor : via In situ hybridization Found that, insulin IGF-1, IGF-2 mRNA Widely distributed in endometrial epithelium, stroma and Muscularis Its synthesis is regulated by estrogen rather than progesterone.

4. Blood vessel Active substances and Angiogenic factor : (see table)

A variety of growth factor and growth inhibition factor

growth factor	molecular weight （×1000）	Target cell	growth factor	molecular weight （×1000）	Target cell
EGF	six	Epithelium, Interstitial	TGF— β	twenty-five	Epithelium, Interstitial
TGF— α	five point six	Epithelium, Interstitial	TNF— α	fourteen	Stroma
PDGF	thirty-two	Epithelium, Smooth Muscle	Growth inhibitor	-
IGF—1/IGF—2	seven	Epithelium, Interstitium, Smooth Muscle	IL—2	fifteen	T lymphocytes
FGF	fifteen	Endothelium, Interstitial	MIF	one hundred and forty	Mullerian duct cell
IL—2	fifteen	T and B lymphocytes	TNF— α	fourteen	Epithelium, Lymphocyte
ET—1	three	Stroma	CSF—1	nine	Hematopoietic Cells, Interstitial

Main lesion

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inflammation

endometritis About 10-15% of adult women are affected. The symptoms of this disease usually appear in the twenties and continue until the menopause 。 Most patients will be tested whether they have this disease between the ages of 25 and 35. Sometimes, when Lunar tide Endometritis is formed when it begins to stabilize. Infection that endangers endometritis sterility The proportion of infertile women accounted for 9.4%. The causes of infertility caused by this disease include:

After the sperm enters the uterine cavity, Bacterial toxin 、 white blood cell Inflammatory factors such as phagocytosis cause sperm death or decrease in motility, making sperm enter Fallopian tube The number of children is reduced, thus affecting fertility.

be fertilized Zygote It is not easy to implant in inflammatory endometrium, or the implantation barrier caused by anti endometrium causes infertility.

The implantation of fertilized eggs is unstable, which is extremely easy to miscarry, leading to infertility.

clinical manifestation

1、 Leukorrhea : Due to increased secretion of endometrial glands. It is generally thin water sample, light yellow, sometimes Bloody leucorrhea 。

2. Pelvic pain: about 40% of patients Chief complaint Falling abdomen during menstruation Distention pain 、 Lumbosacral region Pain.

3、 dysmenorrhea : Most occur in Nulliparous However, there are few patients with severe dysmenorrhea, which may be caused by excessive thickening of endometrium, obstruction of normal degeneration and necrosis of tissues, and stimulation of excessive spastic contraction of uterus.

4、 Menorrhagia : The menstrual period is still regular, but the volume of menstruation is doubled, and the bleeding period is also significantly prolonged. Only a few patients suffer from massive bleeding anemia , which may be caused by intimal thickening and inflammatory hyperemia.

5. Old age Chronic endometritis Symptoms: often combined Atrophic vaginitis The occurrence of purulent leucorrhea, which often contains a small amount of blood, is often mistaken for malignant uterine disease. When pyometra occurs, the secretion has a purulent odor, and the patient will not feel the abdomen Dull pain External, systemic inflammatory reaction Symptoms, but with or without symptoms.

Diagnosis and diagnosis

with Uterine cavity When the probe probes into the uterine cavity, if any Purulent fluid The diagnosis can be established after outflow, but the uterine cavity tissue should be taken gently at the same time to understand whether there is Malignant tumor Exists. Sometimes due to Cervical canal There are many scars and the cervical tube is bent, so the probe is not easy to insert, so patient operation is required. Once the diagnosis is established, the cervix will be dilated, and pus can flow out smoothly. If the drainage is not satisfactory, a rubber tube can be placed in the cervical tube for drainage to prevent the cervical tube from blocking again in a short time and affecting the discharge of pus.

Influence of gestation

1. Endometritis can cause endometrial congestion, edema, and a large number of inflammatory exudates, which is not conducive to the ascending of sperm and the implantation and development of pregnant eggs;

2. Inflammatory factors, such as bacterial toxins and leukocyte phagocytosis, can cause sperm death or reduce motility, thus greatly affecting fertility;

3. The fertilized egg is not easy to be implanted in the inflammatory endometrium, or Anti endometrial antibody It may cause implantation obstacle or unstable implantation of the fertilized egg, which is very easy to miscarry.

Thickening

reason

I Endogenous estrogen

⑴ Anovulation : Adolescent girls, perimenopausal women Hypothalamus pituitary ovary axis A link of Polycystic ovary syndrome And so on, can have anovulation, so that the endometrium Sustainability suffer estrogen Action, no progesterone resistance, lack of periodicity Secretory phase It is in a state of proliferation for a long time. Endometrium under 40 years old Atypical hyperplasia In patients, more than 80% of the endometrium had no secretory phase except for focal atypical hyperplasia; 70% of the basic body temperature was monophasic. So most patients Anovulation 。

⑵ Obesity: in obese women, adrenal gland Secretory Androstenedione , via adipose tissue within Aromatase And transformed into Estrone ； The more adipose tissue, Transformation capacity The stronger it is, the higher the level of estrone in the plasma, thus causing the influence of persistent estrogen.

⑶ Endocrine Functional tumor : Endocrine function tumour It is a rare tumor, but in the research statistics, 7.5% of them are endocrine functional tumors. Pituitary gland The gonadotropic function of, Granulosa cell tumor of ovary It is also a tumor that continuously secretes estrogen.

II Exogenous Estrogen induced

⑴ Estrogen replacement therapy (ERT): Perimenopause Or postmenopausal, due to estrogen deficiency Climacteric syndrome , and there may be osteoporosis 、 Abnormal lipid metabolism 、 cardiovascular Change, even Brain cell Change of activities, etc. Therefore, ERT is gradually widely used and has achieved good results. However, estrogen alone in ERT will stimulate Endometrial hyperplasia 。 One year's use of estrogen alone can lead to 20% of women's endometrial hyperplasia (Woodruff 1994). The use of ERT often lasts for years, even all their lives. If progesterone is not used at the same time, there will be serious endometrial hyperplasia, or even Endometrial carcinoma Occurrence of.

⑵ Tamoxifen Application of tamoxifen: tamoxifen TAM Antiestrogen It is used in the late postmenopausal period mammary cancer patient. Under the condition of low estrogen, TAM has a weak estrogen like effect, so taking TAM for a long time can also cause endometrial hyperplasia.

treatment

endometrium Atypical hyperplasia The first step is to make a clear diagnosis and find out the cause of atypical hyperplasia, whether there is polycystic ovary, ovarian functional tumor or other endocrine Dysfunction Etc. Any of the above Should be Targeted treatment. At the same time, atypical hyperplasia of endometrium can start Symptomatic treatment , using medication or surgical treatment 。 The choice of these two treatment schemes should be based on age, the type of endometrial hyperplasia, and the requirements for fertility.

Endometrial thickening Abnormality can lead to infertility, The endometrium is the receptor Endogenous hormone If the excessive thickening is caused by the change of hormone level, it may not only affect menstruation, but also affect normal ovulation, and is not conducive to the implantation of fertilized eggs, leading to habituation Miscarriage or infertility. It is recommended to have a vagina three days after menstruation B-mode ultrasonography To investigate the detailed thickness of endometrium. If the endometrium is too thick, it is very painful when menstruation comes, not to mention that the fertilized egg is not easy to implant.

Endometriosis

Main symptoms

Generally speaking, women's endometrium covers the uterus Coelom If the endometrium grows in other parts of the body due to certain factors, it is called Endometriosis 。 This ectopic endometrium Histology There are not only endometrial glands, but also endometrial stroma around the upper part; The function of endometriosis varies significantly with the estrogen level, that is menstruation It changes periodically, but only partially affected by pregnancy hormone, which can produce a small amount of "menstruation" and cause various clinical phenomena.

If the patient becomes pregnant, the ectopic endometrium may have decidual changes. Although the ectopic endometrium grows in other tissues or organs, it is different from Malignant tumor Infiltration. Endometriosis Morbid fastigium At 30-40 years old. The reality of endometriosis incidence rate It is far more than clinical findings. If the patient is suffering from other gynecological diseases Exploratory laparotomy Time and to resected Adnexa uteri Detailed sample making Pathological examination It can be found that about 20-25% of patients have ectopic endometrium.

clinical examination

1. Method of B-ultrasound: B-ultrasound is a common item Gynecological examination , through B-ultrasound endomembrane like cyst It can be seen from the acoustic image that Granular The small echo is as thick as cystic fluid. Experts pointed out that, B-ultrasonic inspection There are certain limitations, and this method is usually not recommended.

2、 laparoscope Laparoscopy is an effective method to diagnose endometriosis, and has certain therapeutic effect on endometriosis. Laparoscopic examination showed that the freshest implant was yellow vesicles;

3、 X-ray Examination: X-ray examination is a commonly used examination method Pelvic inflatable radiography Lateral film shows more obvious adhesion mass of fallopian tube and ovary, which can be more clearly shown on inflation radiography or inflation radiography.

harm

1. Cause sterility : The infertility caused by endometriosis has accounted for about 50% of female infertility, which is an important reason for female infertility, mainly because endometriosis will lead to Pelvic adhesion 、 Obstruction of fallopian tube And affect hormone function and immunity To cause infertility.

2、 ectopic pregnancy : Endometriosis is easy to cause Pelvic adhesion , causing obstacles to the operation of the fallopian tube, resulting in the failure of the fertilized egg to be successfully sent into the uterine cavity for local planting Ectopic pregnancy 。

3、 Irregular menstruation : Endometriosis will give the ovary Substantive organization Cause certain damage, which will seriously affect the metabolism of hormones Menstrual disorder 、 Menstruation Many patients also have dysmenorrhea symptoms.

4、 ovarian tumor : The main place of endometriosis is the ovary, so every time a woman comes to menstruation, menstrual blood will accumulate in the ovary, leading to the formation of tumors. Not only that, if not treated in time, the blood in the tumor will accumulate more and more, and will deteriorate, red blood cell Damaged Chocolate cyst 。

therapeutic method

1、 Modern medical medication

①、 Pseudopregnancy therapy : Use large doses of estrogen and progesterone Steroidal drug cause Pseudopregnancy Treatment. The ectopic endometrium will be transformed into decidua, and then the decidua will be necrotic, absorbed and subsided. Kistner introduces the daily use of Norethisterone 5mg、 Ethinylestradiol 0.075mg treatment, good effect, Adverse reactions Light. continued Administration From June to December, the symptoms were significantly relieved, and the focus was narrowed or disappeared. Some patients may relapse after drug withdrawal. After treatment, the ovulation function can be restored in a short time. Post treatment Pregnancy rate It is 30% - 43%, applicable to young patients with mild illness who require fertility, and patients with recurrent symptoms after surgery.

②、 Pseudomenopause therapy : Synthetic 17- α- acetylene Testosterone derivative Danazol 。 The drug is weak androgen Action Gonadotropin The release of Steroid hormone It can reduce the estrogen in the body and inhibit the growth of endometrium amenorrhoea , but its FSH and LH It belongs to low value rather than high value, so it is also called pseudomenopause therapy. For Domoski report This medicine The pregnancy rate after treatment was 72%. During the treatment, the symptoms were alleviated by 100%, and the physical signs were improved by 85%. 15% to 30% recurred after drug withdrawal. The commonly used dose is 400-800mg per day, which is taken orally for 2-4 times, starting from the 5th day of menstruation, and the treatment lasts for 3-6 months. Ovulation can resume within a few weeks after drug withdrawal. The adverse reactions are Hot flushes , sweating acne , edema, weight gain, etc. Others have elevated SGPT, which is related to the Chemical structure Cause bile It is caused by depression and can recover after stopping the medicine. Danazol treatment Endometriosis The curative effect is good, and the adverse reaction is mild, if combined fibroid However, it is expensive and difficult to be widely used.

③ Drug induced ovariectomy: long-term effect Gonadotropin releasing hormone analogue Treatment (long-term effect GnRH - α）。 Drug action It can significantly inhibit the level of FSH and reduce the secretion of ovarian estrogen. Meldrum reported on the 5th day of menstruation with GnRH- α one hundred μ g， subcutaneous injection , once a day x 28 days, blood test after one month of treatment Estradiol It was significantly reduced, similar to that of ovariectomized patients. The symptoms of the patients improved during treatment, and they resumed menstruation after stopping treatment for a week. Long term treatment is similar to ovariectomy, which is a definite method for the treatment of endometriosis.

2、 Modern medical surgery

① Conservative surgery: it is applicable to young patients who require fertility. The scope of surgery includes separation of pelvic adhesion Electrocautery Or removal of pelvic lesions, uterine suspension, ovary Endometriotic cyst Stripping, etc. If the operation fails to completely remove the focus, medication should be used for 3-4 months after the operation. The pregnancy rate after conservative surgery was 40% - 60%.

② Semi conservative surgery: for those who do not have fertility requirements, or younger people whose condition requires hysterectomy, semi conservative surgery with ovarian preservation should be performed as far as possible, and normal ovarian tissue on one or both sides should be preserved to avoid postoperative occurrence Menopausal syndrome 。

③、 radical operation : The patient is in a serious condition, and the older one is feasible Hysterectomy and adnexectomy To achieve the goal of radical cure. If the adhesion is serious and it is difficult to remove the uterus, it is feasible Subtotal hysterectomy Or only bilateral ovaries were removed.

3、 TCM treatment based on syndrome differentiation

⒈ Qi stagnation and blood stasis

Principal evidence : Premenstrual or menstruation abdominal distension and pain, refusal to press, blocked menstruation, clot Pain relief after discharge, or infertility, premenstrual breast pain, bilateral flank pain, depression or irritability, Purple tongue Dark or with petechiae ， Pulse string Or string slip.

Treatment: Soothing the liver and regulating qi ， activate blood circulation and remove blood stasis 。

Prescription: infradiaphragmatic stasis-expelling decoction 。 Chinses angelica : 20g, red peony: 15g, rhizome of chuanxiong ：10g， Peach kernel : 15g, safflower: 15g, trifoliate orange: 15g, Yuanhu : 15g, Lingzhi: 15g, Cortex moutan : 10g, ebony: 15g, Rhizoma Cyperi ：15g， Fried liquorice ：10g。 if Qi stagnation Mainly, the distention is greater than the pain Chinaberry ：15g； stasis of blood Mainly, pain is more than swelling, add typha: 15g, reuse Wulingzhi 20g; Severe pain Scorpion : 3, Trigonopsis : 15g, zedoary: 15g; Having a diseased body Dragon's Blood ：15g， Pangolin ：15g， Gleditsia sinensis : 20g, sparganium: 15g, zedoary turmeric: 15g; The amount of menstruation plus typha: 15g, madder: 159, panax notoginseng: 10g（ Chong Fu ）。

2. Cold coagulation and blood stasis

Main Syndrome: Premenstrual or Menstrual Abdomen Chilly pain , get Febrile pain The amount of menstruation is small, dark and lumpy, and the pain under the lumps is reduced, Form cold Afraid of cold, Pale If the pain is severe, the patient will vomit, or become infertile. The tongue is dark, the fur is white, and the pulse is tight.

Treatment: Warming meridians to dissipate cold, promoting blood circulation and removing blood stasis.

Prescription: Shaofu Zhuyu Decoction 。 Small fennel ：15g， Dried ginger : 15g, Yuanhu: 15g, Lingzhi: 15g, myrrh : 15g, Chuanxiong: 10g, Angelica: 20g, Typhae: 15g, Guan Gui : 15g, red peony: 15g. if abdominal pain Extremely severe, with cold limbs and sweating Sichuan pepper ：15g， Preparation of Sichuan Aconitum ：10g， Preparation of Aconitum kusnezoffii ：10g； Yang deficiency In case of internal cold, add ginseng: 15g, cooked aconite: 15g, Fairy Spleen ：20g； The dampness pathogen is heavy, with chest tightness and abdominal distension, and the tongue coating is white and greasy. Add Atractylodes lanceolata: 15g, orange peel: 10g, Zelan: 15g, Poria cocos: 20g.

3. Qi deficiency and blood stasis

Main syndrome: abdominal pain during or after menstruation, Hi press Hewen, Anal distention , stool is not solid, spirit is tired, complexion is not bright, menstruation is more or less, color talks dark matter is thin, lumpy, tongue is fat, Lingual substance Light purple or petechiae, thin white fur, weak pulse.

Treatment: invigorate qi and yang, promote blood circulation and remove blood stasis.

Prescription: Buyang Huanwu Decoction 。 Astragalus: 3O: g, Angelica: 2Og, Paeonia lactiflora: 15g, Dilong: 20g, Chuanxiong: 10g, Peach kernel: 15g, Safflower: 15g. Sweat and fear of cold add cinnamon twigs: 15g, white peony: 15g; For those with severe abdominal pain, add argyi leaf: 15g, cumin: 15g, frankincense: 15g, myrrh: 15g; Nausea and vomiting plus Evodia rutaecarpa: 15g, dried ginger: 10g, Pinellia ternata ：10g； Loose stool Plus nutmeg : 15g, fenugreek: 15g, Psoralea corylifolia ：20g。

⒋ Heat depression stasis of blood

Principal evidence; Premenstrual or menstrual period fever ， Abdominal pain refusal , even menstrual period High fever , until the net body temperature gradually returns to normal, the menstrual color is dark red, thick, lumpy, and the cycle is advanced or Prolonged menstruation , large amount, bitter mouth, dry throat, irritability, dry stool, Pain during sexual intercourse ， Lingual redness , or there are petechiae on the edge and tip, ecchymosis , moss yellow, pulse string number.

Treatment: clear away heat and nourishment, promote blood circulation and remove blood stasis.

Prescription: Modified Xuefu Zhuyu Decoction 。 Peach kernel: 15g, safflower: 15g, angelica sinensis: 20g, birthplace: 30g, red peony: 20g, chuanxiong: 10g, bupleurum chinense: 10g, fructus aurantii: 10g, achyranthes bidentata: 10g, liquorice: 10g, Chinese bellflower : 10g, salvia miltiorrhiza: 20g, cortex moutan: 15g. Menorrhagic fever If added with Scutellaria baicalensis Georgi: 15g, Artemisia annua: 15g; Dry stool and rhubarb: 15g, fructus aurantii: 10g; For patients with abdominal pain, add Houttuynia cordata: 20g, Eupolyphaga sinensis Insect: 15g, wulingzhi: 15g; If your mouth is bitter and your throat is dry, add 15 g gardenia and 15 g scutellaria for those who are irritable and irritable.

⒌ Kidney asthenia stasis of blood

Main syndromes: abdominal pain during or after menstruation, distention of the waist, more or less menstruation or blood clots, infertility, dizziness, and loose stools, Frequency of urination , the tongue is dark or has petechiae and ecchymosis, the tongue coating is thin and white, Pulse sedimentation Fine and astringent.

Treatment: tonifying kidney, regulating menstruation, promoting blood circulation and removing blood stasis.

Prescription: Guishen Pill close Taohong Siwu Soup 。 Cooked land: 20g, Chinese yam: 20g, Cornus officinalis : 15g, Poria cocos: 20g, Angelica sinensis: 20g, fruit of Chinese wolfberry ：20g， Eucommia ulmoides ：15g， Dodder : 25g, peach kernel: 15g, safflower: 15g, Chuanxiong: 10g, white peony: 20g. For those with severe back pain, add fairy spleen: 20g, parasitic: 15g, dog ridge: 15g; Poor stool and psoralen: 20g, Hematite ：20g。

3、 Other inspection methods

1. Heterotopic powder: earthworm Soil worm , insects, centipedes Leech Prepare equal parts, grind powder, bottle or capsule for standby, 2-3 times a day, 2-3 times a time. It is suitable for endometriosis, combined with oral medicine treatment.

2. Blood activating Huayu Recipe : Sparganium fortunei 15g, Curcuma zedoary 15g, Raw cattail 12g, Wulingzhi 12g, peach kernel 9g, Water frying Take one dose per day, suitable for dysmenorrhea and infertility caused by endometriosis.

3. Huayu Tongfu Pill: Vinegar Rhubarb , baked with vinegar Turtle shell , amber, powder and make pills in the proportion of 2:2:1, 2.5g each time, twice a day, and take them with boiled water before meals, menstruation One course of treatment is continuous taking for 3 months. It is applicable to those with endometriosis.

4、 Acupuncture and massage therapy

⒈ body acupuncture ： Acupoint selection Guan Yuan 、 Midpole 、 Hegu 、 Sanyinjiao , once a day, 7 times in a row, 20 minutes for each time, before or during menstruation.

2. Ear point seed pressing: take the acupoints of uterus, endocrine and liver, apply the acupoints with magnetic granules or Wangbuliuxing, and press and stimulate several times a day to treat dysmenorrhea.

3. Along Ren Vessel Massage up and down, starting from Shenque , massage one by one Air sea , Guan Yuan Tianshu 、 Four fulls , Return, Uterus Air impact Massage 1 minute at each acupoint from 7 days before menstruation to 3 days after menstruation, applicable to those with dysmenorrhea.

five , Drinking diet tyerapy method

⒈ Chinese rose Soup: 15g rose flower, proper amount of brown sugar, fried soup for dinner. It is suitable for infertility with qi stagnation and blood stasis.

⒉ Hawthorn charcoal 30g, brown sugar 30g, Sunflower seed 15g， Decoct soup 2 small bowls, twice a day Separate service 。 It is suitable for dysmenorrhea of blood stasis type.

six 、 Enema therapy

Salvia miltiorrhiza: 30g, Rhizoma sparganii: 20g, Rhizoma curcumae: 20g, Angelica sinensis: 20g, Red rattan ：30g， Patrinia villosa : 20g, peach kernel: 20g, safflower: 20g, Chuanxiong: 15g, Yuanhu: 15g, rhubarb: 15g, 100ml thick decoction, every night retention enema , once a day, menstrual period is disabled. It is applicable to dysmenorrhea caused by endometriosis, ovarian endometriosis cyst and rectal endometriosis.

VII Vaginal medication method

Stalactite , frankincense, myrrh, dragon's blood, sparganium, zedoary, etc, Pressing surface Sifting, disinfection and standby, take 5~10g of drug powder each time, put it into the posterior vault of the vagina, and then fill it with cotton balls with tails, 24 hours Then take it out and put it into the flower bud Plant essence Nursing medicine. Once every three days, starting from the clean menstruation, one menstrual cycle is a course of treatment, and it can be used for 2-4 consecutive courses. It is applicable to endometriosis, posterior fornix nodule or sunken mass of uterus and rectum.

Too thin

The thickness of endometrium will change at different times of the female menstrual cycle, mainly due to the influence of hormone Caused by the influence of secretion. If it is caused by abortion and other factors Thin endometrium It will have a great impact on women's pregnancy.

Causes

⒈ Endocrine disorder

Women's emotions have a great impact on the endometrium. Long term tension and worry often lead to Endocrine disorder To affect the thickness of the inner membrane.

2. Abortion uterine curettage Damage to intima.

The intima is divided into three layers. The top layer is peeled off every month. The middle layer and the bottom layer are not peeled off. If the middle layer is damaged, the impact is not significant. If the bottom layer is damaged, the consequences will be serious.

3. Endometrial lesions

as Endometrial polyps , endometrial cancer, etc

therapeutic method

1. Supplement estrogen

Endometrium grows under the stimulation of estrogen. Most of them use estrogen to improve the thickness of endometrium. However, western medicine estrogen has certain effects on endocrine Interference effect 。 If drug supplementation is needed, it can be improved through traditional Chinese medicine therapy. Traditional Chinese medicine adopts compound drugs, with relatively few side effects.

2. Relax

Relaxing is actually the most effective way to regulate endocrine, which is very important. Under the influence of good mood, women can not only have more health, but also exude charming charm. Don't ignore this.

In addition, the thickness of endometrium period of ovulation There are changes at different times from menstruation. It keeps getting thicker from very thin, then falls off during menstruation, and then gets thicker from very thin. If excluded as congenital Thin endometrium If so, it should be endocrine disorder. Doctors can increase estrogen to thicken it, or drink traditional Chinese medicine to recuperate it. If menstruation has been abnormal, abnormal ovulation will also lead to thin endometrium. Pregnancy is not easy, but the opportunity is still great.

matters needing attention

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1、 Endometrial hyperplasia The patient fasted longans, red dates, donkey hide gelatin Royal jelly Isothermic, coagulant and hormonal food

（ modern medicine Research shows that food can also be supplemented estrogen , mainly fresh royal jelly flaxseed 、 cereal crop 、 sunflower seed 、 sesame , onion Wine 、 Peanut butter It also contains a certain amount of estrogen. It is recommended that women who love beauty should eat more in life.)

1. It conflicts with the description in estrogen, and I don't understand

2. You should avoid spicy food liquor Frozen, frozen, and other foods. Do not overeat

3. Patients with endometrial hyperplasia should have light diet and not eat mutton , shrimp, crab Eel 、 Salted fish 、 snakehead Etc

4. Often eat nutritious Dry Fruits Food like, such as peanut, sesame melon seed Etc

5. The diet should be diversified, not unitary. You should eat more Grains Such as corn peas and beans Etc

6. Adherence of patients with endometrial hyperplasia Low fat diet , eat more lean meat , eggs Green vegetables , fruit, etc

7. Patients with endometrial hyperplasia Overeating Lean meat, chicken, eggs Quail egg 、 Crucian carp Fish Turtle 、 Whitefish , Chinese cabbage asparagus , celery Spinach , cucumber Winter melon , mushroom, tofu Kelp 、 Laver , fruit, etc

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