Clinical Observation Of Nourishing The Kidney And The Liver Combined With Cycle Therapy In Treating Irregular Menstruation Of DOR With Kidney Deficiency And Liver Stagnation Type

Objective:This study used nourishing the kidney and the liver combined with cycle therapy and western medicine therapy to treat patients with DOR of kidney deficiency and liver stagnation,to observe the changes of clinical symptoms and serum sex hormones of the patients,to explore the clinical effect of kidney-nourishing and liver-nourishing on irregular menstruation.Methods:In this study,we selected the patients with DOR of kidney deficiency and liver stagnation who met the screening criteria in the gynecology clinic of the first affiliated hospital of tianjin university of TCM from January 2019 to February 2020.There were two groups in the sixty patients according to the principle of randomness,each with 30 patients.The treatment group according to the BBT of the patients,was treated with the empirical formula of the tutor professor zhu ying,by taking zishentianjing decoction at the follicular stage（the 4th to 12th day of the menstrual cycle）,taking cupai decoction at the ovulation stage（the 13th to 22nd day of the menstrual cycle）,and the taking shuganyangxue decoction at the premenstrual and menstrual period（the 23rd day of the menstrual cycle to the 3rd day of the next menstrual cycle）.The control group was given 1mg Qd orally on the 5th day of the menstrual cycle for 21 days,and progestin capsule 100mg Bid was added on the 16th day.There were three menstrual cycles.The menstrual status,TCM syndromes score,b FSH,b E₂and b FSH/LH levels of the two groups of patients before and after treatment were observed and recorded,and made statistics to evaluate the therapeutic effect of the two groups,and discussed the observation indexes before and after treatment were scored and statistical data were collected to evaluate the therapeutic effect of the two groups and to explore the therapeutic effect of traditional Chinese medicine on DOR.Results:1.Baseline data:the differences in age,TCM symptom scores,and basic sex hormone levels（b FSH,b E₂,b FSH/LH）were no statistically significant（P>0.05）,suggesting comparability.The incidence of DOR increased with age.2.Curative effect of TCM syndromes:in the treatment group,2 cases were cured,10 cases were effective,13 cases were effective,and 2 cases were ineffective,with a total effective rate of 92.59%.In the control group,0 cases were cured,4 cases were effective,20 cases were effective,and 4 cases were ineffective,with a total effective rate of 85.71%.The difference between groups was statistically significant（P<0.05）.3.Main symptom scores of TCM:as a result of the treatment in the two groups,each main symptom’scores were lower,and the difference between the two groups was not statistically significant（P>0.05）.The reduction degree of"menstrual cycle"score in the control group was superior to that in the treatment group,however,the treatment group had an advantage over the control group in reducing the score of"menstrual volume,color and quality",the difference was statistically significant（P<0.05）.4.Score of secondary symptoms in TCM:as a result of the treatment in the two groups,each symptom’scores were lower,and the difference between the two groups was statistically significant（P<0.05）.The treatment group had an advantage in reducing the scores of"soreness and weakness of waist and knees,neurolysis,distending pain of breasts during menstruation,chest distress and sigh,irritability,hot sweating,upset insomnia"over the control group,and the difference was statistically significant（P<0.05）.The two groups were compared in improving the score of"dizzy tinnitus",and the curative effect was similar（P>0.05）.5.Total score of TCM symptoms:as a result of the treatment in the two groups,TCM symptoms’total score was lower（P<0.05）.The reduction effect in the treatment group was more advantageous than that in the control group,and the difference between the groups was statistically significant（P<0.05）.6.Serum basic sex hormone levels:after treatment,serum levels of b FSH,b FSH/LH and b E₂in the two groups all decreased compared with the previous levels（P<0.05）.There was no statistically significant difference between the groups（P>0.05）.Research conclusions:1.The intervention of nourishing the kidney and the liver combined with cycle therapy can improve the clinical manifestations of menstrual disorders in DOR patients with kidney deficiency and liver stagnation,especially the improvement of menstrual volume,color and quality is better than the control group.2.The intervention of nourishing the kidney and the liver combined with cycle therapy can improve the symptoms of soreness and weakness of waist and knees,neurolysis,distending pain of breasts during menstruation,chest distress and sigh,irritability,hot sweating,upset insomnia in DOR patients with kidney deficiency and liver stagnation.3.The intervention of nourishing the kidney and the liver combined with cycle therapy can improve the patient’s serum levels of b FSH,b FSH/LH and b E₂,thus slowing the decline of ovarian function in patients with DOR.4.There was no obvious adverse reaction in the treatment of DOR patients with kidney deficiency and liver stagnation by nourishing the kidney and the liver combined with cycle therapy,indicating the safety of the treatment,so it will provide new ideas and treatment for the DOR patients and has clinical promotion value.