Controlling the Recurrence of Pelvic Endometriosis after A Conservative Operation: Comparison between Chinese Herbal Medicine and Western Medicine

Zhao RH et al, Chin J Integr Med 2013 Nov;19(11):820-825

Chinese Journal of Integrated Medicine

A randomised and controlled trial (involving 200 women) studied the prevention of recurrence of endometriosis after surgery and showed that Chinese medicine was as effective a therapy as western pharmaceuticals in preventing recurrence but had significantly fewer side effects. Chinese medicine achieved a higher conception rate in women who had previously been infertile.



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.

Full article