| Premature ovarian failure refers to the clinical syndrome that patients with normal secondary sexual characters as well as due or late menarche, present with persistent amenorrhea and even genital atrophy before the age of40. It is routinely accompanied by elevated follicle stimulating hormone (FSH) and luteinizing hormone but declined estrogen levels. So far, Despite modern medicine has not pinpointed the exact cause, it is widely accepted that it involves with several contributing factors. They include genetic and immune influences, metabolic abnormalities, iatrogenic injury, gonadotropin receptor injury, psychological problems, environmental impact and infections, which are considered highly relat ive with smoking, drinking, insomnia, hair dying, emotional fluctuation, abortion, weight loss, etc. A wide range of treatment approaches such as artificial cycle, ovulation and assisted reproductive therapy can be carefully selected and employed according to the needs of fertility.For premature ovarian failure, there are no explicit definitions or specific diagnosis criteria in the traditional Chinese medical books. Nevertheless, some relevant clinical manifestation records such as "bloodexhaust","amenorrhea","infertility","blood ompartment", and "woman hysteria" are sparsely spotted. We think its occurrence should be mainly ascribed to kidney deficiency and also related to disorder of viscera such as liver, spleen, heart and Chongren,etc. To be specific, it can be categorized into kidney yang deficiency,live-and-kidney yin deficiency, kidney deficiency with liver stagnation, spleen-kidney yang deficiency, heart-kidney disharmony, and kidney deficiency with blood stasis according to the clinical syndromes. Traditional Chinese treatments including periodic treatment by Chinese herbal medicine, integrated traditional Chinese and western medicine therapy, acupuncture and massage, dietary therapy, and psychological guidance, exhibit a notably curative performance with fewer adverse effects in comparison with western medicine methods.This paper is dedicated to sorting out etiology and pathology, clinical classification, differential diagnosis and treatment based on an extensive and comprehensive review of approximately600papers home and abroad. We elegantly picked out61articles, which present pure Chinese traditional therapy with detailed herb dose and a general curative efficiency above70%. In order to investigate the differential treatment rules of premature ovary failure, the etiology and pathology, clinical classification and prescription selections presented in aforementioned publications are analyzed in detail. The herbs in the prescriptions are also categorized through Siqi and Wuwei theory, dosage, and channel tropism to facilitate the analysis.According to prescription statistics, the most frequent used herb is angelica sinensis, and followed in turn by old land, dodder, epimedium and glycyrrhiza. The sequence of old land, angelica sinensis, dodder, epi medium and Chinese yam is arranged on the bas is of quant itative dosage. It is easy to identify that the most frequently used and the most quantitatively used herbs show a general agreement with each other. Among the most used herbs, angelica sinensis, old land, dodder, epimedium, Chinese yam, ligustrum lucidum and white peony root are also commonly used in Chinese medicine prescriptions for other diseases. Most of the mentioned herbs are employed to remedy viscera deficiency. Angelica sinensis, old land and white peony root are hematonics that have active functions of nourishing liver and kidney, adjusting menstruation and remedying blood stagnancy. Lanceolata, atractylodes, Chinese yam and glycyrrhiza are qi-invigorating drugs that contribute to strengthening spleen and benefiting vital qi. Dodder, epimedium and rhizome curculiginis are yang-invigorating herbs that are conducive to kidney-invigorating and strengthening yang. Further statistical analysis finds that tonic drugs accounts for57.14%of the number of total herbs in prescript ionsin terms of occurrence frequency and56.02%of the total effective dosage, which together makes it the most used category of herbs for curing premature ovarian failure. Through statistical analysis with regard to etiology and pathology, we find that the main pathology for the disease is liver-kidney deficiency accounting for22%, followed by kidney deficiency with liver stagnation accounting for17%, kidney-jing deficiency accounting for14%and spleen-kidney yang deficiency accounting for13%. Kidney deficiency is considered to be the main pathology in95.23%of the investigated literature while liver deficiency chosen by39.68%. It can be concluded that kidney-liver deficiency is one of the main pathologies for premature ovarian failure. It also justifies the prescription drugs featuring kidney-invigorating, strengthening yang and kidney-liver nourishing.From the view of channel tropism, the prescription drugs are mostly directed to liver account ing23.24%while kidney, heart and spleen claim21%,12%and12%, respectively. Due to homogeny of liver and kidney, liver and kidney are said to prosper or suffer as one. It is understandable that a considerable number of drugs are directed to liver based on the fact most patients usually begin with liver dysfunction, go through kidney-jing deficiency and finalize with amenorrhea. From the point of Siqi theory, the warm-natured drugs top the four qi with a proportion of26.88%, and the cold drugs come next accounting for22.58%. Finally, based on the Wuwei theory, the sweet drugs occupy the first spot among the five flavors, with the bitter, the hot and the acid seen queued in line, which are corresponding with the disease’s featured deficiency of multi-organ and preferred treatment efforts to invigorating and nourishing ying-yang. |
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