Clinical Study On The Treatment Of Premature Ovarian Insufficiency Of Kidney-yin Deficiency With Staged Acupuncture Therapy Based On The Theory Of "Chong Meridian Is The Sea Of Blood"

Objective To observe the synergistic effect of staged acupuncture therapy based on " Chong meridian is the sea of blood" combined with Climen on premature ovarian insufficiency of kidney-yin deficiency.Methods This study was designed as a randomized,parallel controlled,double-blind trial of evaluators and statisticians.72 patients who met the inclusion criteria were divided into the control group(n = 36)and the acupuncture group(n = 36)according to the random number table method.The main acu POInts were Gong sun,Nei guan,Xue hai,San yin jiao,Tai xi and the acu POInts were matched with corresponding acu POInts according to the stages of female physiological cycle.Three times a week,one menstrual cycle for a course of treatment,three courses of statistical efficacy,12 weeks of follow-up period.Serum basic sex hormones FSH,LH and E2;Number of basal sinus follicles detected by transvaginal or transrectal b-ultrasonography;Clinical symptom scale score were used as the observation index.The criteria for the diagnosis and treatment of diseases and syndromes in traditional Chinese medicine was used as the evaluation criteria for comprehensive efficacy.Adverse events and adverse drug reactions were carefully observed and recorded during the study.SPSS24.0 software was used for statistical analysis and processing of the data.Results(1)Baseline analysis(1)Age before treatment was compared between the two groups(P=0.59),the difference was not statistically significant(P>0.05),which was comparable.(2)Comparison of scores between the two groups before treatment(P=0.56),the difference was not statistically significant(P>0.05),which was comparable.(3)Comparison of hormone indexes between the two groups before treatment,FSH(P= 0.96),LH(P= 0.56)and E2(P=0.97)showed no statistical significance(P >0.05),which was comparable.(4)The number of basal sinus follicles between the two groups before treatment,AFC(P=0.37),the difference was not statistically significant(P>0.05),which was comparable.(2)Comparison of comprehensive efficacy between the two groups After treatment,19 cases were cured in the acupuncture group,6 cases showed significant effect,4 cases were effective,5 cases were ineffective,and the total effective rate was 85.29%;10 cases were cured in the control group,7 cases showed significant effect,6 cases were effective,11 cases were ineffective,and the total effective rate was 67.65%.Comparison of comprehensive efficacy between the two groups(P=0.02)showed statistically significant difference(P<0.05),indicating that the comprehensive effect of acupuncture group was better than that of the control group.(3)Comparison of clinical symptom scores between the two groups(1)Comparison between groups: POInts in the third month after treatment in the acupuncture group(5.17±5.29);POInts in the third month after treatment in the control group(8.74±7.07);POInts in clinical symptoms after treatment in the two groups were compared(P=0.02),which was statistically significant(P<0.05).The scores of acupuncture group at the 6th month after treatment(5.68±4.44)and the control group at the 6th month after treatment(9.56±5.68)were statistically significant(P=0.002).(2)Intra-group comparison: the scores of acupuncture group before and after treatment in the third month were compared,Z=-0.59,P < 0.001 by rank-sum test;The scores of the control group before and after treatment in the third month were compared,and Z=-0.58,P < 0.001 by rank-sum test.The data gap between treatment group and control group with statistical significance(P<0.05).The results showed that the improvement of clinical symptoms in the acupuncture group was significantly better than that in the control group,and the sustained effect of the acupuncture group on clinical symptoms was significantly better than that in the control group.(4)Comparison of serum sex hormone changes(1)Comparison between groups FSH(23.84±12.82)in the acupuncture group after treatment,and FSH(38.08±10.08)in the control group after treatment,and FSH(P< 0.001)in the two groups after treatment,the difference was statistically significant(P<0.05).LH(6.45±4.74)after acupuncture treatment in the treatment group,LH(12.21±3.69)after treatment in the control group,LH(P< 0.001)after treatment in the two groups,the difference was statistically significant(P<0.05).E2(224.78±84.61)after treatment,in the acupuncture group and E2(147.87±69.99)in the control group were significantly different(P< 0.001).(2)Intra-group comparison Comparison of FSH before and after treatment in the acupuncture group showed that T=15.77,P < 0.001 after paired t-test.Compared with control group before and after FSH treatment,paired T test showed that T=15.69,P <0.001;Compared of LH before and after LH treatment in the control group showed that T=12.41,P < 0.001 after paired t-test showed that T=9.03,P < 0.001;Comparison of E2 before and after treatment in the acupuncture group showed that T=-12.22,P < 0.001 after paired t-test.Control group before and after E2 treatment,paired T test,T=-8.08,P < 0.001;The data gap between treatment group and control group with statistical significance.The results showed that acupuncture group reduced the serum concentrations of FSH and LH.Elevated serum E2 concentration was superior to the control group.(5)Comparison of the number of follicles in the basic sinus of the ovary(1)Comparison between groups:AFC of acupuncture group after treatment(6.47±2.02),control group after treatment(4.41±1.33),two groups of patients after treatment AFC(P< 0.001),the difference was statistically significant(P<0.05).(2)Intra-group comparison:Comparison of AFC in acupuncture group before and after treatment by rank-sum test,Z=-4.97,P < 0.001;The control group was compared before and after AFC treatment,and Z=-4.44,P < 0.001 by rank-sum test.The data gap between treatment group and control group with statistical significance.The results showed that acupuncture group was superior to the control group in increasing the number of sinus follicles.Conclusion Based on "Chong meridian is the sea of blood" staging with hormone replacement therapy,acupuncture and moxibustion therapy can significantly improve premature ovarian insufficiency of kidney-yin deficiencyclinical symptoms in patients with ovarian dysfunction based sinus,regulate hormone levels,increase ovarian follicle number and three months after the end of treatment in patients with clinical symptoms were improved obviously.Show that based on the "go to blood" staging acupuncture with g age cover of early-onset ovarian dysfunction has a synergistic effect.Its mechanism may be related to acupuncture can lower the serum concentration of FSH,LH,E2 in serum concentration increased.