{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T06:46:38Z","timestamp":1776840398853,"version":"3.51.2"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Zhejiang Provincial Medical Association Clinical Medical Research Special Funds Project","award":["2023ZYC-A148"],"award-info":[{"award-number":["2023ZYC-A148"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the efficacy of Honghua Ruyi Pills combined with estradiol valerate and dydrogesterone tablets in promoting endometrial repair and menstrual recovery after artificial abortion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a randomized, double-blind, double-dummy, controlled trial conducted at a single center. A total of 380 patients who underwent artificial abortion were randomly assigned to Honghua Ruyi Pills alone (Group 1,\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f129), estradiol valerate plus dydrogesterone tablets alone (Group 2,\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f118), or the combination of all three medications (Group 3,\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f133). The primary outcome was endometrial thickness at 1\u202fweek post-surgery. Secondary outcomes included time to postoperative abdominal pain resolution, postoperative vaginal bleeding duration, time to menstruation resumption, postoperative menstrual duration, menstrual volume, menstrual blood color, and the incidence of adverse reactions. All outcomes were assessed after a 21-day treatment period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary outcome analysis showed that Group 3 had significantly greater endometrial thickness at 1\u202fweek post-surgery compared with Groups 1 and 2 (\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.002). For secondary outcomes, Group 3 demonstrated shorter postoperative abdominal pain duration (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), bleeding duration (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), time to menstrual resumption (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), and menstrual duration (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001) compared with the other groups. Kaplan\u2013Meier analysis indicated that patients in Group 3 achieved favorable postoperative outcomes more rapidly (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). The incidence of adverse reactions did not differ significantly among the three groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single-center trial, the combination of Honghua Ruyi Pills with estradiol valerate and dydrogesterone tablets showed preliminary superiority in promoting short-term endometrial repair and menstrual recovery after artificial abortion compared with either treatment alone. These findings are hypothesis-generating and warrant confirmation in multicenter trials with longer follow-up and clinically relevant reproductive endpoints such as pregnancy rate and intrauterine adhesion formation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1778706","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:48:42Z","timestamp":1776836922000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The multiple positive effects of Honghua Ruyi Pills combined with estradiol valerate and dydrogesterone tablets on postoperative recovery in women after artificial abortion"],"prefix":"10.3389","volume":"13","author":[{"given":"Bing","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ningbo Beilun Third People\u2019s Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ningbo Beilun Third People\u2019s Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhua","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ningbo Beilun Third People\u2019s Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ningbo Beilun Third People\u2019s Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ningbo Beilun Third People\u2019s 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intra-uterine adhesions evaluated by hysteroscopy\u2014a prospective study","volume":"8","author":"Friedler","year":"1993","journal-title":"Hum Reprod"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1111\/jog.13254","article-title":"Role of dilatation and curettage performed for spontaneous or induced abortion in the etiology of endometrial thinning","volume":"43","author":"Azumaguchi","year":"2017","journal-title":"J Obstet Gynaecol Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"881","DOI":"10.3760\/cma.j.issn.0529-567x.2015.12.001","article-title":"Chinese expert consensus on clinical diagnosis and treatment of intrauterine adhesions","volume":"50","year":"2015","journal-title":"Chin J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3969\/j.issn.1674-1870.2019.03.020","article-title":"Analysis of pregnancy outcomes after suture of moderate to severe intrauterine adhesions","volume":"46","author":"Chen","year":"2019","journal-title":"Int J Obstet Gynaecol"},{"key":"ref8","volume-title":"Safe Abortion: Technical and Policy Guidance for Health Systems","year":"2012"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"322","DOI":"10.19538\/j.fk2021030114","article-title":"Expert consensus on promoting endometrial repair after induced abortion","volume":"37","author":"Liu","year":"2021","journal-title":"Chin J Pract Gynecol Obstet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.3390\/cells13151236","article-title":"Unraveling the dynamics of estrogen and progesterone signaling in the endometrium: an overview","volume":"13","author":"Dias Da Silva","year":"2024","journal-title":"Cells"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1093\/oxfordjournals.humrep.a138208","article-title":"Induced regeneration of endometrium following curettage for abortion: a comparative study","volume":"8","author":"Farhi","year":"1993","journal-title":"Hum Reprod"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1713144","DOI":"10.3389\/fmed.2025.1713144","article-title":"Effects of oral and transdermal estrogen on postoperative endometrial recovery after missed abortion: a retrospective longitudinal cohort study","volume":"12","author":"Zhang","year":"2025","journal-title":"Front Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.3969\/j.issn.1004-0412.2023.05.061","article-title":"A clinical study on the effect of estradiol valerate combined with dydrogesterone tablets on endometrial thickness in patients after induced abortion","volume":"44","author":"Liu","year":"2023","journal-title":"Jilin Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"409","DOI":"10.3109\/09513590.2014.906571","article-title":"Treating patients with \u201cthin\u201d endometrium\u2014an ongoing challenge","volume":"30","author":"Lebovitz","year":"2014","journal-title":"Gynecol Endocrinol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s40824-021-00242-6","article-title":"Recent trends in therapeutic strategies for repairing endometrial tissue in intrauterine adhesion","volume":"25","author":"Ma","year":"2021","journal-title":"Biomater Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"865","DOI":"10.3969\/j.issn.1673-7202.2015.06.016","article-title":"Observation on the effect of modified Juantong Yin formula on dysmenorrhea caused by endometriosis by inhibiting endometrial antibodies","volume":"6","author":"Xiao","year":"2015","journal-title":"World Tradit Chin Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3969\/j.issn.1672-1993.2014.10.019","article-title":"Clinical observation of Safflower Ruyi Pills in treating dysmenorrhea caused by 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women","volume":"28","author":"Zhang","year":"2017","journal-title":"Biomed Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jtcms.2023.12.010","article-title":"Can Tibetan medicine Honghua Ruyi Pills relieve endometriosis-associated dysmenorrhea? Protocol for a randomized placebo-controlled trial","volume":"11","author":"Han","year":"2024","journal-title":"J Tradit Chin Med Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1432815","DOI":"10.3389\/fmed.2024.1432815","article-title":"Registration and characteristics of clinical trials on traditional Chinese medicine and natural medicines for endometriosis: a comprehensive analysis","volume":"11","author":"Zhao","year":"2024","journal-title":"Front Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1093\/humupd\/dmu011","article-title":"Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis","volume":"20","author":"Kasius","year":"2014","journal-title":"Hum Reprod Update"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/s0015-0282(01)01847-7","article-title":"Determination of total menstrual blood 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abortion","volume":"4","author":"Yunxia","year":"2023","journal-title":"Reflexol Rehabilit Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3668\/j.issn.1008-7338.2023.03.009","article-title":"Comparison of the effects of transdermal estradiol gel and drospirenone ethinyl estradiol tablets after abortion","volume":"25","author":"Xiang","year":"2023","journal-title":"Jiangsu Health Care"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.3892\/ol.2018.8702","article-title":"Effects of endometrial stem cell transplantation combined with estrogen in the repair of endometrial injury","volume":"16","author":"Wang","year":"2018","journal-title":"Oncol Lett"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"688","DOI":"10.12048\/j.issn.1674-229X.2018.10.010","article-title":"Analysis of the efficacy of estradiol valerate tablets in preventing uterine cavity adhesion after induced abortion pharmacy today","volume":"28","author":"Liang","year":"2018","journal-title":"Pharm Today"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"46","DOI":"10.13638\/j.issn.1671-4040.2018.07.022","article-title":"Observation on the efficacy of medroxyprogesterone acetate tablets combined with estradiol valerate tablets in preventing intrauterine adhesions after recurrent induced abortions","volume":"18","author":"Qiong","year":"2018","journal-title":"Pract Clin Appl Integr Tradit Chin West Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"45","DOI":"10.3969\/j.issn.1671-945X.2018.04.026","article-title":"Clinical observation on the efficacy of estradiol valerate combined with dydrogesterone in preventing intrauterine adhesions after missed abortion","volume":"16","author":"Xie","year":"2018","journal-title":"China Prescr Drugs"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"24,7","DOI":"10.3969\/j.issn.2095-8803.2017.35.016","article-title":"Efficacy of estradiol valerate tablets combined with medroxyprogesterone acetate tablets for endometrial repair and prevention of uterine adhesion after multiple abortions","volume":"4","author":"Yanli","year":"2017","journal-title":"Electron J Pract Gynaecol Endocrinol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1093\/humupd\/4.6.856","article-title":"Preparation of endometrium for egg donation","volume":"4","author":"Devroey","year":"1998","journal-title":"Hum Reprod Update"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1093\/humupd\/dmg045","article-title":"The endometrium in stimulated cycles for IVF","volume":"9","author":"Bourgain","year":"2003","journal-title":"Hum Reprod Update"},{"key":"ref36","first-page":"329","article-title":"Clinical efficacy evaluation of Saffron Ruyi Pill in treating menstrual disorders","volume":"31","author":"Ding","year":"2015","journal-title":"Pharmacol Clin Tradit Chin Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3969\/j.issn.1006-6810.2005.04.001","article-title":"Clinical observation of Tibetan medicine Safflower Ruyi Pills in the treatment of menstrual disorders","volume":"11","author":"Zhang","year":"2005","journal-title":"Chin J Ethn Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1609299","DOI":"10.3389\/fphar.2025.1609299","article-title":"Carthamus tinctorius L.: a comprehensive review of its ethnomedicine, phytochemistry, pharmacology, and clinical applications","volume":"16","author":"Bai","year":"2025","journal-title":"Front Pharmacol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"6672","DOI":"10.19082\/6672","article-title":"Medical uses of Carthamus tinctorius L. (Safflower): a comprehensive review from traditional medicine to modern medicine","volume":"10","author":"Delshad","year":"2018","journal-title":"Electron Physician"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0962-4562(03)00092-4","article-title":"Effects of Zataria multiflora and Carum carvi essential oils and hydroalcoholic extracts of Passiflora incarnata, Berberis integerrima and Crocus sativus on rat isolated uterus contractions","volume":"13","author":"Sadraei","year":"2003","journal-title":"Int J Aromather"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.3969\/j.issn.1673-7202.2016.07.030","article-title":"A study on the efficacy and partial mechanism of Honghua Ruyi Pills in treating chronic pain caused by adnexitis","volume":"7","author":"Xiao","year":"2016","journal-title":"World Chin Med"},{"key":"ref42","first-page":"854","article-title":"Studies on estrogen receptor signal transduction","volume":"30","author":"Miao","year":"2010","journal-title":"Chem Life"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"104","DOI":"10.3969\/j.issn.1672-6375.2021.08.032","article-title":"Study on the effect of Safflower Ruyi Pill in the treatment of post-medical abortion uterine cavity residue","volume":"50","author":"Li","year":"2021","journal-title":"Gansu Sci Technol Rev"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1778706\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:48:55Z","timestamp":1776836935000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1778706\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":43,"alternative-id":["10.3389\/fmed.2026.1778706"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1778706","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1778706"}}