Clinical Study Of Yijing Decoction Combined With Hormone Replacement Therapy In The Treatment Of Premature Ovarian Failure (Kidney-yin Deficiency)

Objective: To observe the clinical effect of yijing decoction combined with hormone replacement therapy on patients with premature ovarian failure of kidney-yin deficiency type,analyze the effect of yijing decoction on improving clinical symptoms and laboratory indicators,and explore the effective method of combined traditional Chinese and western medicine to treat premature ovarian failure.Methods: 40 cases of premature ovarian failure diagnosed from March 2017 to March 2019 in the affiliated hospital of jiangxi university of traditional Chinese medicine were randomly divided into two groups,20 cases in each group.After the general examination before enrollment was basically normal,two different treatment methods were adopted for the patients in the two groups.The treatment group was treated with yijing decoction combined with hormone replacement therapy,and the control group was treated with hormone replacement therapy alone.Each group was treated for 12 weeks(3 menstrual cycles),and recorded before and after the treatment of traditional Chinese medicine symptom integral,ovarian volume,antral follicle count and serum Anti-mullerian hormone,follicle-stimulating hormone,Luteinizing hormone,Estradiol on the third day.These data were collated and input into SPSS19.0 for analysis.Finally,the clinical efficacy of yijing decoction combined with hormone replacement therapy in the treatment of premature ovarian failure was comprehensively analyzed.Results: A total of 58 patients were included in the final data analysis,including 1 patient in the control group who did not take the medicine as required and 1 patient in the treatment group who could not complete the treatment.After 3 menstrual cycles of treatment,the total effective rate of the treatment group and the control group was 90% and 80%,respectively,there was a statistical difference,so the therapeutic effect of the treatment group was better than the control group.In terms of TCM syndrome scores before and after treatment,both groups showed significant improvement in TCM syndrome scores after treatment compared with before treatment(P < 0.01),indicating that both groups had significant curative effect in the treatment of premature ovarian failure.Compared with the control group,the treatment group was superior to the control group(P < 0.05),During the follow-up visit,P>0.05 was compared between the treatment group and this group at the end of treatment,P < 0.05 was compared between the control group and this group at the end of treatment,and P < 0.05 was compared between the treatment group and the control group during the same period,indicating that yijing decoction combined with hormone replacement therapy can better reduce the TCM syndrome score than the application of hormone replacement therapy alone.In other words,it can better improve the clinical symptoms of patients with premature ovarian failure.Comparison of FSH in blood on the third day of menstruation: the FSH value of both groups was significantly lower after treatment than before treatment(P < 0.05),and the comparison between the two groups(P < 0.05)indicated that yijing decoction combined with hormone replacement therapy had more obvious advantages than the simple application of hormone replacement therapy.Comparison of LH on the third day of menstruation: LH in the treatment group was significantly decreased after treatment(P < 0.05),while LH in the control group showed no significant difference before and after treatment(P>0.05),indicating that yijing decoction had an obvious therapeutic effect in reducing LH value.Comparison of E2 in blood on the third day of menstruation: E2 values in both groups were significantly higher after treatment than before treatment(P < 0.05),and the comparison between the two groups(P < 0.05)indicated that yijing decoction combined with hormone replacement therapy had more obvious advantages in improving estrogen level than the application of hormone replacement therapy alone.Comparison of AMH in blood on the third day of menstruation: there was no statistically significant difference in AMH value between the two groups before and after treatment(P>0.05),indicating that the treatment with hormone replacement therapy alone or the combination of yijing decoction had no significant effect on the improvement of AMH value.Comparison of ovarian volume under b-mode ultrasound examination: no significant improvement in ovarian volume was observed in both groups after 12 weeks of treatment(P>0.05).Comparison of the number of follicles in the sinus under b-mode ultrasonography: after 12 weeks of treatment,the number of follicles in the treatment group was significantly improved compared with that before treatment(P < 0.05),while the number of follicles in the sinus of ovary before and after treatment in the control group showed no statistical significance.This indicates that yijing decoction combined with hormone replacement therapy can increase the AFC and neither of them can significantly improve the ovarian volume of patients with premature ovarian failure.Conclusion: Yijing decoction combined with hormone replacement therapy has no obvious adverse reactions and side effects in the treatment of premature ovarian failure with kidney-yin deficiency.Yijing decoction combined with hormone replacement therapy for the treatment of premature ovarian failure has obvious advantages in total clinical efficacy,TCM syndrome integral,blood FSH,LH,E2 and AFC,etc.,compared with the single application of hormone replacement therapy,especially in increasing the number of bilateral sinus follicles and reducing the blood LH value.The recovery of serum AMH is relatively delayed.Although there is no significant therapeutic effect,it is more prominent than the simple application of hormone replacement therapy to delay the decline of AMH.