The multiple positive effects of Honghua Ruyi Pills combined with estradiol valerate and dydrogesterone tablets on postoperative recovery in women after artificial abortion

Objectives 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. Methods 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 = 129), estradiol valerate plus dydrogesterone tablets alone (Group 2, n = 118), or the combination of all three medications (Group 3, n = 133). The primary outcome was endometrial thickness at 1 week 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. Results The primary outcome analysis showed that Group 3 had significantly greater endometrial thickness at 1 week post-surgery compared with Groups 1 and 2 ( p = 0.002). For secondary outcomes, Group 3 demonstrated shorter postoperative abdominal pain duration ( p < 0.001), bleeding duration ( p < 0.001), time to menstrual resumption ( p < 0.001), and menstrual duration ( p < 0.001) compared with the other groups. Kaplan–Meier analysis indicated that patients in Group 3 achieved favorable postoperative outcomes more rapidly (all p < 0.001). The incidence of adverse reactions did not differ significantly among the three groups. Conclusion 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.