| ObjectiveOvarian premature aging (premature ovarian failure, POF) refers to before the age of 40 because ovarian follicles depletion or destroyed, or because of the surgical removal of the ovaries of ovarian function failure occurs, more than 80% of the patients have menopausal symptoms such as hot flashes. POF in secondary amenorrhea in women account for 10% to 20%. Incidence of POF in the general population is roughly 1% to 2%, is an important cause of infertility. POF is the pathological basis of ovarian follicle in depletion or be destroyed before the age of 40, ovarian similar change, menopause is shrinking. POF in addition to the cause of infertility and with low estrogen symptoms, can also cause such as nervous, metabolism, cardiovascular and bone mineral density and a series of serious imbalance, the body to the patients’physical and mental are huge pain. With the deepening of the study cause of POF, has realized the ovarian premature aging is a multifactor disease, genetic defects, immune abnormalities, iatrogenic injury are premature aging has certain correlation with the ovary, but about 80% of the POF patients with unknown etiology. Peripheral resting CD4+T cells in immune organs were induced to differentiate into iTreg, participate in local inflammation, restrain their reactive T cells, but its endogenous D3tx mice increased Treg may not be enough to curb their reactive T cell proliferation and move on to the normal female CD4+CD25+Treg D3tx body, its reactive T cells has been a huge increase in Treg inhibition, effectively restrain the occurrence of AOD, and ovarian source of regional lymph node of CD4+CD25 +Treg have stronger inhibitory effect. "Ovarian premature aging" is the modern medicine of disease, but not for similar diseases such as amenorrhea, years old and through water, infertility, etc., all previous dynasties Chinese medicine doctor to discuss, think that the main pathogenesis is:based on kidney, qi and blood stasis resistance as the standard, involving multiple viscera lesions, such as liver and spleen kidney factors. Premature ovarian function decline seriously affect women’s quality of life and family happiness, the disease of patients with mental and physical damage.1.1.5.4 gonadotropic hormone (HMG/HCG) or chlorine meters Finn to induce ovulationGonadotropin or chlorine meters can induce ovulation, but large doses of gonadotropins on ovarian premature aging effect is not big, because its regulating mechanism is reverse to the ovary, so ovarian premature aging induced ovulation does not adopt the traditional scheme. Exogenous GnRH can recover part of the normal development of ovarian follicle premature aging patients, but stimulate ovulation after estrogen therapy, have certain of success. A phase after treatment method is artificial cycle, low-dose estrogen alone again, have been subdued, FSH and LH, after can be daily used HMG, ultrasonic monitoring to mature follicle, inject to human chorionic gonadotropin (HCG) induced ovulation. But when FSH> 50 iu, supplement estrogen is not decreased FSH, unfavorable use HMG.1.1.5.5 GnRH-alpha therapyDue to high levels of GnRH can lead to decreased ovarian their receptors, so give the exogenous gonadotropin-releasing hormone agonist (GnRH-alpha) inhibition of endogenous gonadotropic hormone (FSH) to premenopausal level, can improve the sensitivity of the ovaries to gonadotropin, promote follicle growth synchronization. Generally advocates are keeping FSH 5-10 IU/L advisable, not suppress too low. When the withdrawal make inhibition of removal, rapid rise in FSH levels can stimulate follicular development and ovulation. Therefore, after amenorrhea induced ovulation mainly based on the basis of estrogen or GnRH-suppress FSH levels.1.1.5.6 immunotherapyFor autoimmune antibody positive, adrenal cortical hormone treatment, commonly used drugs for prednisone 5 mg/d or dexamethasone 0.75 mg/d. Anti cardiolipin antibody positive, can be used aspirin,100-400 mg/d. Therefore, how to effectively control ovarian premature aging, reduce the incidence of ovarian premature aging, is today’s reproductive medicine and reproductive health research of one of the hot and difficult. The disease treatment purpose has three aspects:first, to improve and eliminate ovarian premature menopause symptoms; Second, the elimination of vaginal dryness, improve your sex life, prevent vaginal atrophy, promote the development of uterus. Third, regulate the menstrual function, to expect fertility, strive to make it through the pregnancy and fetus after stimulate ovulation. At present modern medicine for the treatment of the disease, there is no satisfactory clinical effect of hormone replacement therapy due to the long course of treatment, side effects, and potentially dangerous for breast and estrogen on target organs. And with the combination of disease and syndrome differentiation of traditional Chinese medicine, in reducing or eliminating whole accompany symptoms, improving patients’ quality of life and fertility, shows the unique advantages of small side effects. This study basic pathological characteristics in ovarian premature aging to kidney and liver as a starting point, combining with the characteristics of geographical environment, climate in Taiwan, and most of the patients with liver depression and blood stasis symptoms, based on the kidney and liver qi and therapeutic principle, to the traditional two fairy soup to add and subtract kidney prescription, in the original party remove medicinal indianmulberry root, rhizoma anemarrhenae, cortex phellodendri, join the radix bupleuri liver, blood circulation by removing blood stasis, salvia miltiorrhiza, angelica dodder solid, kidney main licorice to reconcile the medicine. In order to achieve the effect of kidney and liver blood, to observe "plus or minus two fairy soup" in kidney liver depression clinical efficacy in patients with ovarian, explore "plus or minus two fairy soup" mechanism for the treatment of ovarian premature senility may exist.MethodsIn July 2013 to October 2014 to chongqing hall clinic of traditional Chinese medicine, diagnosis of ovarian premature aging, and kidney in patients with liver depression type of syndrome differentiation of TCM, random select 60 patients were divided into control group and treatment group comparison research.Add and subtract two fairy soup (according to Chinese medicine science daily dose:2 g a fairy curculigo spleen 2 g dodder 3 g angelica radix bupleuri salvia miltiorrhiza 1.5 g 1.5 g 1 g main licorice 1 g) oral treatment, control group:liuwei dihuang pill 6 g and xiaoyao powder 6 g oral therapy, taking three times a day. Source of traditional Chinese medicine drugs from traditional Chinese medicine science selected science pharmaceutical factory:, pharmaceutical co., LTD. TCM symptom scores before and after treatment after 3 months observation, serum FSH, LH, E2 level changes, to explore and subtract two fairy soup clinical curative effect of kidney liver depression type ovarian premature aging and its related mechanism.Results1. baseline balanceThis study adopts the method of randomized controlled trials for clinical trials, a total of 60 patients with closed qualified. Treatment group minimum age 24 years old, biggest 37; Shortest duration 5 months and 36 months. Syndromes before treatment to the total score of 30.43 ±3.44. Mean serum endocrine level before treatment was 56.62 and 11.9 IU/FSH, LH,44.68 and 8.74 L IU/55.15 and 9.01 L, E2 pmol/L. Control the youngest 25, the maximum 36 years old; The shortest duration of five months, the longest 35 months. Syndromes before treatment to the total score of 30.23 and 3.81. Average level of serum endocrine control group before treatment is 58.43 and 11.6 IU/FSH, LH,44.10 and 9.50 L IU/56.11 and 7.92 L, E2 pmol/L. Degree of two groups in age, course of the disease, patient, TCM syndrome integral, serum endocrine levels after the data statistics of comparable (P>0.05), two groups of good balance.2. compare before and after the treatment itselfAccording to their respective treatment for 3 months after treatment, the treatment group of TCM syndrome total score of 7.00 and 2.52. Syndromes was the control group total score of 11.57 and 2.46. Average level of serum endocrine treatment group after treatment is FSH dropped to 13.79 and 3.50 IU/L, LH dropped to 10.78 and 2.40 IU/L, E2 rose to 92.61 and 14.78 pmol/L; Average serum hormone level in the control group after treatment is FSH dropped to 26.23 and 5.33 IU/L, LH dropped to 19.67 and 4.03 IU/L, E2 rose to 75.69 and 10.17 pmol/LResults suggest after treatment, two groups of patients with TCM syndrome integral, FSH, LH was decreased significantly, the E2 is significantly increased before treatment, add and subtract two fairy soup and liuwei dihuang pill+xiaoyao powder can improve kidney liver depression in patients with ovarian premature aging of various syndromes, serum endocrine balance its level.3. comparing the two groups after treatmentTreatment group and control group in their three months after treatment, the treatment group after treatment of TCM syndrome total score of 7.00 and 2.52, the control group after treatment of TCM syndrome total score of 11.57 and 2.46, compared to the total integral difference ways of syndromes without statistical significance (P>0.05), but in the vaginal dryness, loss of libido, mouth GanYan dry cold, and cold limbs, poor sleep much dream, forgetfulness, irritability, chest pain, chest tightness is not comfortable, depressed sigh integral comparison, treatment group score was significantly lower than control group, the difference statistically significant (P<0.05). Average level of serum endocrine treatment group after treatment is FSH dropped to 13.79 and 3.50 IU/L, LH dropped to 10.78 and 2.40 IU/L, E2 rose to 92.61 and 14.78 pmol/L; Average serum hormone level in the control group after treatment is FSH dropped to 26.23 and 5.33 IU/L, LH dropped to 19.67 and 4.03 IU/L, E2 rose to 75.69 and 10.17 pmol/L. Instructions to add and subtract two fairy soup in improving kidney liver depression in patients with ovarian premature aging of vaginal dryness, loss of libido, mouth GanYan dry cold, and cold limbs, poor sleep much dream, forgetfulness, irritability, chest pain, chest tightness is not comfortable, depressed sigh is better than that in control group, in hot, damp sweat out, lumbar debility, dizziness tinnitus, five upset hot, night to urinate, works the same in the two groups; The treatment group was significantly lower than control group, FSH, LH, E2 is significantly higher than the control group, add and subtract two fairy soup and liuwei dihuang pill+xiaoyao powder can improve kidney liver depression in patients with ovarian premature aging serum level of endocrine, but add and subtract two fairy soup effect is better.4. clinical curative effectAdd and subtract two fairy soup with liuwei dihuang pill+free and unfettered scattered two scheme is effective to all patients, patients who received add and subtract two fairy soup in 25 patients with clinical symptoms improved degree range had marked effect,5 patients clinical symptoms improved degree within the effective range;Accept+xiaoyao powder has 4 cases of liuwei dihuang pill improved clinical symptoms within *,26 patients clinical symptoms improved degree within the effective range, the gap between rank and tested tips have obvious difference (p<0.05).5, menstrual agger rateAdd and subtract two fairy soup 13 cases of patients during treatment period after tide, agger rate 43.3%;Accept+xiaoyao powder has 4 cases of liuwei dihuang pill during menstruation after tide, agger rate was 13.3%. Gap after rank and inspection tips have obvious difference (p< 0.05).4, clinical curative effectAdd and subtract two fairy soup with liuwei dihuang pill+free and unfettered scattered two scheme is effective to all patients, patients who received add and subtract two fairy soup in 25 patients with clinical symptoms improved degree range had marked effect,5 patients clinical symptoms improved degree within the effective range;Accept+xiaoyao powder has 4 cases of liuwei dihuang pill improved clinical symptoms within*,26 patients clinical symptoms improved degree within the effective range, the gap between rank and tested tips have obvious difference (p<0.05).5, menstrual agger rateAdd and subtract two fairy soup 13 cases of patients during treatment period after tide, agger rate 43.3%;Accept+xiaoyao powder has 4 cases of liuwei dihuang pill during menstruation after tide, agger rate was 13.3%. Gap after rank and inspection tips have obvious difference (p<0.05).Conelusions1. plus or minus two fairy soup with liuwei dihuang pill+xiaoyao powder can improve kidney liver depression in patients with ovarian premature aging of various syndromes, balance its serum level of endocrine.2. add and subtract two fairy soup in improving kidney liver depression in patients with ovarian premature aging of vaginal dryness, loss of libido, mouth GanYan dry cold, and cold limbs, poor sleep much dream, forgetfulness, irritability, chest pain, chest tightness is not comfortable, depressed sigh is better than that in control group, in the hot, damp sweat out, lumbar debility, dizziness, tinnitus, five upset hot, night to urinate, works the same in the two groups.3. add and subtract two fairy soup with liuwei dihuang pill+xiaoyao powder can improve kidney liver depression in patients with ovarian premature aging serum hormone levels, but add and subtract two fairy soup effect is better. |
PDF Full Text Request